Partnership for PatientsPartnership for Patients

Georgia Hospital Association Research & Education Foundation (GHAREF) Hospital Engagement Network Cohort Kick-Off Conference February 7, 2013

Dennis Wagner & Paul McGann, M.D.Co-Directors, Partnership for Patients

Jack Jordan, Deputy Director

U.S. Department of Health & Human Services CMS Center for Medicare & Medicaid Innovation

1. What are some initial accomplishments of the Partnership for Patients?

2. How can you and your organization benefit from and contribute to the Partnership?

3. What are some accomplishments you are most proud of in delivering care to patients and families in your healthcare setting?

Questions to Run On Questions to Run On

Breakthrough Aims of the Partnership for Patients

Breakthrough Aims of the Partnership for Patients

• 40% Reduction in Preventable Hospital Acquired Conditions– 1.8 Million Fewer Injuries– 60,000 Lives Saved

• 20% Reduction in 30-Day Readmissions– 1.6 Million Patients Recover Without Readmission

If we always do what we’ve always done, we’ll always get what we’ve always got.If we always do what we’ve always done, we’ll always get what we’ve always got.• Partnership for Patients is About All of Us Doing Things

Differently.

• We have unprecedented Federal action and coordination.

• We have an unprecedented CMMI Investment in taking proven practices to scale.

• We have unprecedented action and alignment by community-based organizations, hospitals, clinicians, private partners and others.

• Evolve the Plan: Join with GHA and HHS in making the most of this extraordinary opportunity for change and improvement.

Partnership for Patients Achieves Results Through “3 Engines”

Partnership for Patients Achieves Results Through “3 Engines”

Powerful Partners Are Aligning Their Work With the

PartnershipA number of major partners from across the spectrum of health care stakeholders have made significant commitments aligned to our aims.

Powerful Partners Have Aligned Their Work With the Partnership

Powerful Partners Have Aligned Their Work With the Partnership

• Authentically engage patients in our work; model this

• Identify organizations that reflect best practices

• Replicate and spread effective practices• Track progress on PFE across hospitals and

increase transparency• Team with and support others involved in

leading this work

Partnership for Patients Work on Patient & Family Engagement (PFE)

Partnership for Patients Work on Patient & Family Engagement (PFE)

• Infusing the patient’s voice in PfP activities and collaborating with a cadre of patient advocates to share their stories, serve on workgroups, and spread best practices

• Partnering with organizations such as Planetree, National Priorities Partners/National Quality Forum, and more to affect point of care, policy and design, governance, and community

• Teaming with patient advocates to develop and refine a new set of PFE measures to track and measure HEN performance

• Encouraging hospitals and HENs to include patients in meetings/presentations and actively participate on boards, workgroups, and advisory councils

Patient and Family Engagement at Work in the Partnership

Patient and Family Engagement at Work in the Partnership

• Reduce harm across the board. It is a call for hospitals to produce reductions in every type of harm.

• Take a systemic approach. It is a call to transform the organization and its practices to eliminate all the causes of harm. “Using every means at our disposal.”

• Make your safety transparent to all. It is a call for hospitals to define themselves by their safety performance; define themselves to their employees, doctors, patients and the community.

• Make safety personal & compelling. Make every incident of harm a personal patient story that propels the institution to higher levels of performance.

Partnership for PatientsFour Requests to Georgia Hospitals

Partnership for PatientsFour Requests to Georgia Hospitals

Questions to Run OnQuestions to Run On

1. What is the State of the PfP Network?2. How does GHAREF HEN compare to the other

HEN Networks? 3. What/who are some of the practices, people

and results of High Performing Hospitals and how can we mobilize them as a force to improve the state of healthcare?

Partnership for Patients Results:We Are Moving in the Right Direction!

Partnership for Patients Results:We Are Moving in the Right Direction!

• Progress on Patient and Family Engagement is Accelerating

• National Support and Management System for Reducing HACs and Readmissions is in Place for 3700+ Hospitals

• Dramatic Progress on EEDs in Multiple Networks and Hundreds of Hospitals; Further Rapid Improvement Expected

• Initial Estimates Show Decreases in Average Medicare 30-Day Readmissions in 2012

• 2011 National Scorecard Results Show Almost All Trends Are Positive and Moving in the Right Direction

• High performing hospitals…• Entire systems of hospitals…• And hospitals across entire states…

…have figured out how to achieve the results we seek. The challenge is spread.

We Know How to Achieve the Results We Seek

We Know How to Achieve the Results We Seek

Partnership for Patients 2010 Readmissions Baseline and 2013 Target

Partnership for Patients 2010 Readmissions Baseline and 2013 Target

PAYERPAYER-

SPECIFIC RATE

TOTAL INDEX ADMISSIONS (2009

FOR MEDICAID; 2010 FOR ALL OTHERS)

TOTAL READMISSIONS

NUMBER OF READMISSIONS TO PREVENT TO

REACH 20% REDUCTION,

BASED ON 32.85 MILLION

ADMISSIONSMEDICARE 18.7% 14,672,303 2,742,187 548,437MEDICAID 14.0% 6,004,407 838,412 167,682PRIVATE INSURERS

8.6% 8,527,941 731,101 146,220

UNINSURED POPULATION

10.3% 1,650,410 170,518 34,104

ALL OTHER 12.7% 1,996,018 253,315 50,663TOTAL 14.4% 32,851,079 4,735,532 947,106

Progress in Reducing 30 Day Readmissions

Progress in Reducing 30 Day Readmissions

• More than 100,000 Fewer Readmissions Over the Last 12 Months

• Hospitals Across the Nation Have Figured Out How to Reduce Readmissions– Better Discharge– Care Transitions– Medication Reconciliation– Get outside the walls of the

hospital• Patients Would Rather Be at

Home

5,196

3,699

3,524

3,479

3,155

1,953

278

National Support SystemHospitals Engaged, Reporting, Improving, & Generating

Benchmark Results on PfP in January 2013

National Support SystemHospitals Engaged, Reporting, Improving, & Generating

Benchmark Results on PfP in January 2013

Total Number of Short Stay, Acute Care Hospitals

in the Nation

Total Number of PfP Hospitals Engaged on 6 or More of the 10 Priorities

Total Number of PfP Hospitals Engaged on 3 or More of the 10 Priorities

Total Number of PfP Hospitals Showing

Improvement on 1 or More of 10 Priorities

Total Number of PfP Hospitals Showing at

Benchmark Status on 1 or More of the 10 Priorities

Total Number of Short Stay, Acute Care Hospitals

in the PfP

Total Number of PfP Hospitals Reporting Data

to their HEN

15

Partnership for Patients Hospitals Engaged, Reporting, Improving & Generating Benchmark Results

-- Rapid Improvements in 4 Months --

Partnership for Patients Hospitals Engaged, Reporting, Improving & Generating Benchmark Results

-- Rapid Improvements in 4 Months --

Sep-12Jan-13

0

500

1000

1500

2000

2500

3000

3500

4000

Number of PfP Hospitals Reporting DataEngaged in 3+ PrioritiesEngaged in 6+ PrioritiesImprovement in 1+ Priori-tiesBenchmark Status on 1+ Priorities

5196 Short Stay Acute Care Hospitals in the U.S.

National vs. Georgia Benchmark Results

National vs. Georgia Benchmark Results

Septe

mber

October

November

December

January0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

59%

85%

16%

53%

2%

8%

National

September

October

November

December

January0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

23%

94%

28%

46%

4% 3%

GHAREF

Hospitals Engaged in 6+ Priorities

Hospitals Improving in 1+ Priorities

Hospitals Showing Benchmark in 1+ Priorities

GHAREF ReadmissionsGHAREF Readmissions

16.5%

17.0%

17.5%

18.0%

18.5%

19.0%

19.5%

20.0%

18.3%

17.6%

Readmissions

Read

mis

sion

s r

ate

Hospital Status by HEN and HACEngaged and Reporting Data

(at 2 or higher on the Z-scale)

Hospital Status by HEN and HACEngaged and Reporting Data

(at 2 or higher on the Z-scale)

HEN ADE VTE PrU EED OB AE Falls VAP CAUTI CLABSI SSI ReadmissionsAscension 99% 99% 99% 98% 98% 99% 100% 99% 100% 100% 99%Carolinas 100% 100% 96% 95% 95% 100% 100% 100% 100% 100% 100%DFW 68% 91% 91% 61% 83% 91% 90% 91% 95% 91% 91%Dignity 97% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%Georgia 40% 84% 95% 74% 100% 95% 62% 98% 94% 99% 100%AHA/HRET 16% 24% 29% 32% 29% 49% 44% 57% 59% 52% 60%Intermountain 75% 74% 83% 87% 1% 86% 23% 18% 35% 18% 87%Iowa 91% 85% 87% 88% 89% 91% 86% 88% 90% 90% 94%JCR 51% 57% 68% 93% 56% 84% 79% 97% 92% 76% 73%LifePoint 96% 96% 96% 100% 100% 96% 96% 96% 96% 96% 96%Michigan 13% 46% 36% 84% 84% 53% 80% 83% 83% 56% 40%Minnesota 20% 100% 79% 32% 35% 85% 97% 32% 83% 36% 100%NJ 33% 18% 36% 95% 36% 41% 59% 87% 92% 93% 52%NoCVA 23% 80% 84% 63% 73% 93% 49% 60% 79% 51% 91%NPHHI 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%Nevada 29% 96% 58% 64% 100% 71% 80% 71% 81% 78% 96%New York 80% 88% 85% 72% 0% 91% 82% 85% 89% 86% 93%Ohio Children's 100% 84% 94% 60% 60% 97% 100% 90% 100% 97% 87%Ohio 99% 94% 97% 41% 13% 31% 100% 99% 100% 99% 97%Pennsylvania 100% 100% 100% 39% 39% 61% 96% 100% 97% 97% 97%Premier 39% 56% 73% 32% 34% 85% 50% 92% 68% 81% 99%TCQPS 80% 72% 78% 42% 39% 80% 72% 81% 95% 80% 83%Tennessee 5% 100% 100% 100% 100% 42% 83% 70% 96% 91% 100%UHC 92% 100% 100% 28% 98% 100% 100% 100% 100% 100% 100%VHA 22% 18% 36% 8% 23% 54% 43% 52% 53% 31% 46%WA 0% 75% 91% 83% 83% 48% 84% 58% 84% 97% 91%

HEN ADE VTE PrU EED OB AE Falls VAP CAUTI CLABSI SSI ReadmissionsAscension 16% 16% 16% 80% 51% 33% 41% 1% 29% 3% 6%Carolinas 0% 21% 57% 43% 0% 4% 46% 14% 43% 14% 11%DFW 0% 64% 91% 6% 0% 55% 30% 77% 55% 0% 27%Dignity 25% 33% 58% 81% 52% 56% 78% 58% 53% 56% 22%Georgia 3% 4% 4% 25% 0% 5% 25% 23% 26% 6% 9%AHA/HRET 2% 2% 2% 9% 2% 4% 10% 13% 12% 7% 6%Intermountain 33% 24% 33% 57% 1% 22% 6% 2% 32% 4% 36%Iowa 0% 0% 2% 11% 7% 7% 0% 2% 3% 0% 2%JCR 11% 16% 30% 74% 15% 22% 55% 38% 50% 16% 8%LifePoint 0% 0% 0% 100% 0% 0% 0% 0% 0% 0% 0%Michigan 0% 0% 3% 35% 0% 1% 45% 21% 51% 19% 1%Minnesota 0% 0% 6% 0% 0% 9% 3% 0% 0% 2% 43%NJ 8% 2% 3% 86% 9% 3% 30% 39% 38% 54% 7%NoCVA 1% 31% 61% 33% 34% 40% 37% 43% 53% 35% 29%NPHHI 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%Nevada 4% 29% 33% 27% 36% 29% 50% 38% 43% 28% 0%New York 13% 18% 14% 7% 0% 27% 33% 17% 32% 19% 7%Ohio Children's 13% 3% 6% 0% 0% 29% 13% 0% 0% 6% 0%Ohio 33% 42% 49% 11% 4% 26% 68% 56% 88% 65% 21%Pennsylvania 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%Premier 14% 6% 46% 0% 16% 32% 20% 34% 31% 22% 29%TCQPS 7% 10% 22% 24% 26% 17% 59% 46% 60% 35% 9%Tennessee 0% 0% 0% 56% 0% 0% 35% 0% 56% 15% 11%UHC 0% 5% 40% 5% 11% 19% 28% 13% 39% 15% 4%VHA 5% 9% 15% 5% 12% 16% 27% 23% 31% 12% 18%WA 0% 67% 91% 74% 74% 19% 71% 37% 63% 69% 44%

Hospital Status by HEN and HAC Showing Improvement

(at 3 or higher on the z scale)

Hospital Status by HEN and HAC Showing Improvement

(at 3 or higher on the z scale)

Great ≥ 10%

GHAREF ProgressGHAREF Progress

• As of January 2013, Georgia Hospital Association Research and Education Foundation’s SIR, CAUTI, Fall, Pressure Ulcer, and Readmission rates have declined since the 2010 baseline rate.

Georgia Shines in Multiple HACs for the 3rd Quarter of 2012:

Georgia Shines in Multiple HACs for the 3rd Quarter of 2012:

• 34 hospitals showed an EED rate of ≤ 5%• 23 hospitals reported zero CAUTI• 28 hospitals reported zero CLABSI• 25 hospitals reported zero VAP ICU

*GA HEN is currently working with 116 hospitals

• 2012 Quarter 3: Progress!– Zero EED Rate– Zero CLABSI – Zero CAUTI: ICU – Zero VAP: ICU

Upson Regional Medical CenterUpson Regional Medical Center

• 2012 Quarter 3: Progress!– Zero CLABSI – Zero CAUTI: ICU – Zero VAP: ICU

Habersham Medical CenterHabersham Medical Center

• Each HEN was given the flexibility to measure harm in a manner to accommodate local needs.

• Where possible we leverage common national measures but where local needs require something different we encourage that usage.

MeasurementsMeasurements

• Utilize Performance and Improvement Strategies – Engaging Patient and Families– HAC Learning Collaboratives (LCs) – Become an early adopter of best practices

• Transparency as a vehicle for culture change– Increased transparency among Partners, Patients

and Employees – Sharing information with front line staff

Culture Change and Engagement Culture Change and Engagement

• Encourage Hospital Participation in Eliminating All Cause Harm.

• Utilizing Ideal Hospitals to Serve as Mentors in Safety Transparency and Develop Levels of Safety Performance.

Harm Across the Board Harm Across the Board

Readmission Outcomes!Readmission Outcomes!

Hospitals Reporting Reduction in Readmission Outcomes • Effingham Health System • Georgia Health Sciences Medical Center • Hamilton Medical Center • Hughston Hospital • Northridge Medical Center • Redmond Regional Medical Center • Southeast Georgia Health System Camden Campus • Stephens County Hospital • Tift Regional Medical Center • Ty Cobb Regional Medical Center

• What progress and results would you like to celebrate from your own organization?

• What actions might you take as a result of what you are hearing this morning?

• What are your insights, ideas and suggestions for CMS and the Department?

Questions for Discussion, Potential Action and Follow-up

Questions for Discussion, Potential Action and Follow-up

Prescription for ResultsPrescription for Results

Achieving a 20% Reduction in 30-Day Readmissions Name: Georgia Hospital Leaders Commit to Achieving These

Results Commit to Reducing all10

HACs simultaneously Make Patients and Families

an integral part of your safety program

Engage top leaders in your hospital to make your hospital safe

And a 40% Reduction in Hospital Acquired ConditionsDate: February 7, 2013 Be Transparent with your

Data Maximize the help offered by

GHA Don’t Wait, Start Now

Questions to Run OnWe Want Your Answers; Now and Later

Questions to Run OnWe Want Your Answers; Now and Later

1. What can I do to help my hospital dramatically improve progress toward the Aims to help the patients in Georgia?

2. What action(s) will I take based on these presentations to strengthen my game plan and accelerate progress towards making care safer for the residents of Georgia?

3. What are your insights and advice about how the PfP & GHAREF Leadership can be most helpful in dramatically making care safer?

Monday, February 11, 20133:00 – 4:30 PM (ET)

The Partnership for Patients is hosting a webinar focused on Patient and Family Engagement.

This will be a dynamic and exciting event, and we encourage all participating hospitals to attend!

Pre-registration is NOT required. Just email the NCD at:

NationalContentDeveloper@EconometricaInc.com

You’re Invited!You’re Invited!