Improving Patient Safety Across Illinois Hospital Improvement Innovation Network (HIIN)

Transcription

1 Improving Patient Safety Across Illinois Hospital Improvement Innovation Network (HIIN) August 3, 2016

2 Agenda HEN 2.0 and Progress Introduction to HIIN Proposal IHA HIIN Approach Open Forum

3 MHA-IHA HEN 2.0 Initiative Sep 2015 Sep 2016

4 MHA-IHA HEN 2.0 Harms Prevented and Costs Saved to date HEN 2.0 Harms Prevented and Costs Baseline Performance Performance Performance Performance % Expected # Events Cost per Positive Cost Measure Baseline Period N N Saved Rate Period Numerator Denominator as of 7/9/16 Change of Events Prevented Event ($) Savings Measure Adverse Drug Events ADE-3 (gly) 2015 (Q3) (Q1) % 4, $ 1,518,498 ADE-3 (gly) ADE-4 (opioids) 9/ / (Q1) % 4, $ 3,094,927 ADE-4 (opioids) CAUTI CAUTI-2a 2012 (Q1) /2016-3/ % $ 196,178 CAUTI-2a CLABSI CLABSI-2a 2012 (Q1) /2016-3/ % $ 572, CLABSI-2a Falls Falls (Q3) /2016-3/ % $ 333, Falls-1 OB-2 (PSI-18) (Q3) % $ 4, OB-2 (PSI-18) OB Adverse Events OB-3 (PSI-19) (Q3) % $ 24, OB-3 (PSI-19) OB-6 (hemorrhage) 2015 (Q3) /2016-3/ % $ 32, OB-6 (hemorrhage) Pressure Ulcers PrU-1 (PSI-03) (Q3) % $ 238, PrU-1 (PSI-03) Surgical Site Infections SSI-2 (rate) 2012 (Q1) /2016-3/ % $ 523, SSI-2 (rate) VTE VTE-1 (PSI-12) (Q3) % $ 121, VTE-1 (PSI-12) VAE VAE (Q1) /2016-3/ % $ 1,284, VAE-1 Readmissions READ-1 (same) 4/2011-6/ /2015-8/ % 35, , $ 33,419, READ-1 (same) Total Number of Estimated Events/Harms Prevented: 5,319 Total Estimated Cost Savings: $41,364,247.49

5 Hospital Improvement Innovation Network (HIIN) On April 22 notification of the Hospital Improvement Innovation Networks (HIIN) grant proposal, an extension of HEN, was announced. The priority of HIIN will be to focus on the 11 core areas of harm identified in HEN, without OB, and support the work of the QIN-QIO 11th Scope of Work. HIIN will also engage hospitals, providers and broader care-giver communities to implement and spread well-tested, evidence-based, and measured best practices. Hospitals to report 4 clinical outcome measures: 3 Adverse Drug Event Metrics and 1 Falls metric. 5

6 HIINs 11 Areas of Harm 1. Adverse drug events (ADE)- opioid safety, anticoagulation safety, and glycemic management 2. Central line-associated blood stream infections (CLABSI)-in all hospital settings, not just Intensive Care Units (ICUs) 3. Catheter-associated urinary tract infections (CAUTI)-in all hospital settings, including avoiding placement of catheters, both in the ER, and in the hospital 4. Clostridium difficile (C. diff)- including Antibiotic Stewardship 5. Injury from falls and immobility 6. Pressure Ulcers 7. Sepsis and Septic Shock 8. Surgical Site Infections (SSI)-to include measurement and improvement of SSI for multiple classes of surgeries 9. Venous thromboembolism (VTE)-including all surgical settings 10. Ventilator-Associated Events (VAE)-to include Infection-related Ventilator- Associated Complication (IVAC) and Ventilator-Associated Condition (VAC) 11. Readmissions 6

7 Hospital Improvement Innovation Network (HIIN) Goals: 1. 20% reduction in all-cause patient harm (to 97 Hospital- Acquired Conditions [HACs]/1,000 discharges) from 2014 interim baseline (of 121 HACs/1,000 patient discharges); and 2. 12% reduction in 30-day readmissions as a population-based measure (readmissions per 1,000 people). Interventions may include: 1. Learning collaboratives 2. Data sharing networks 3. Peer-to-peer training among hospitals 4. Conference calls, webinars, and site visits 7

8 Differences Between HEN 2.0 and HIIN RFPs QIN-QIO More teamwork and collaboration Increased efficiencies Baseline New baseline of 121 harms/1000 discharges Expectation of significant improvement (97 harms/1000 discharges) New goals 20% reduction in HACs 12% in 30-day readmissions 8

9 Differences Between HEN 2.0 and HIIN RFPs Recruitment Must happen within 90 days of contract award Language Preventable harm changed to all harms Performance Period September 2016 September 2018 One year option period 9

10 IHA HIIN Approach High reliability Person and family engagement Data and results driven Participant value and patient safety Peer engagement

11 Data and Results Driven 11

12 High Reliability Engagement of HIIN hospitals in a journey towards High Reliability in partnership with the Center for Transforming Healthcare More than 20 hospitals have embarked upon the journey towards high reliability with IHA in HEN 2.0 to date The HIIN will use the ORO 2.0 assessment tool to identify hospitals level of advancement toward HRO Hospitals will receive support to address identified opportunities for improvement and develop an action plan to take specific steps that can leverage organizational strengths to achieve high reliability. Chassin MR, Loeb JM. High-Reliability Health Care: Getting There from Here. Milb Q 2013;91(3):

13 Person and Family Engagement The IHA HIIN will incorporate the best practices for improving PFE identified by the PfP and the QIN-QIOs Peer learning to understand successful strategies Learn to implement checklist for patients with planned admissions Including families in rounds, huddles, and bedside reporting Encouraging families to ask questions Providing families with a diary, and encouraging personal belongings in room Using whiteboards that hold more information 13

14 Peer to Peer Engagement For HEN 2.0, a Peer to Peer Learning Network was established as a resource forum This network will be continued and used as a platform for the sharing of best practices and to spread improvement across the HIIN 14

15 Innovative HIIN Offerings Quality Improvement Innovation Challenge-Hospitals and community partners will be awarded funding each year to pilot an approach or ramp up an existing program that aims at reducing avoidable harm or readmissions. Each hospital that is awarded funding must come to the table with a committed community partner in order to be awarded funding. Simulation Trainings-IHA is exploring offering simulation trainings open to all members of the HIIN. These simulation trainings would be regionally spread throughout the state so HIIN hospitals would have the opportunity to attend at the simulation training in their region or travel to another if they choose. Midwest Alliance for Patient Safety (MAPS) Safe Tables-IHA will be offering quarterly in-person Safe Table events focused on a different HAC each quarter. 15

16 Next Steps 1. As soon as we hear from CMS regarding HIIN awards, we will be letting you know and sending out Commitment Letters! 2. In the meantime, as applicable, pass along the HIIN and HRO one-pagers to your Senior Leadership and brief them on the HIIN 3. Any questions? Please contact Adam Kohlrus or Brigette Bucholz Thank You! We look forward to beginning/continuing our Quality/Safety partnership with you! 16

17 Please help us evaluate HEN 2.0! If you are a HEN 2.0 hospital, we need your feedback - please complete our HEN 2.0 Evaluation: 17

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