National Priorities Partnership Meeting

Transcription

1 National Priorities Partnership Meeting Strategic Guidance for Monday, April 16, :00 am 2:00 pm ET Audience Registration:

2 Table of Contents Agenda Meeting Presentation Tab 1... Overview of NPP s Scope of Work Tab 2... NPP s Action Pathways for Improving Maternity Care and Reducing Avoidable (Re)admissions Tab 3... NPP and the Partnership for Patients Tab 4... NPP s Communications Needs Appendix A... NPP Roster

3 MEETING OF THE NATIONAL PRIORITIES PARTNERSHIP MONDAY, APRIL 16, 2012 NATIONAL QUALITY FORUM TH STREET NW, 9 TH FLOOR CONFERENCE CENTER WASHINGTON, DC AGENDA MEETING OBJECTIVES: 1. Obtain strategic guidance on NQF s scope of work and deliverables related to NPP project areas; and 2. Obtain strategic guidance on NPP s communications needs in :00 am Welcome and Introductions, Overview of Meeting Objectives 9:10 am Overview of NPP s Scope of Work 9:30 am NPP s 2012 Input into the National Quality Strategy 10:30 am Break 10:45 am NPP s Action Pathways for Improving Maternity Care and Reducing Avoidable (Re)admissions 11:45 am Opportunity for Public Comment 12:00 pm Lunch 12:30 pm NPP and the Partnership for Patients 1:15 pm NPP s Communications Needs 1:45 pm Next Steps 2:00 pm Adjourn Page 1

4 4/11/2012 National Priorities Partnership Meeting convened by the Strategic Guidance for April 16, 2012 Meeting Objectives Obtain strategic guidance on NQF s scope of work and deliverables related to NPP project areas (Tabs 1 3) Obtain strategic guidance on NPP s communications needs (Tab 4) 2 1

5 4/11/2012 Context for NPP s Role in Consultative Role on National Priorities and Goals Providing input to HHS on the National Quality Strategy Action Catalyst Role Catalyzing and supporting action on National Quality Strategy priorities and goals Providing ongoing support for the Partnership for Patients initiative to improve safety, care coordination, and affordability 3 NPP s Guiding Principles The Three C s Collaborating Demonstrating a commitment to collaborate with other NPP Partners and with broader stakeholder groups to advance the NQS priorities and goals. Catalyzing Demonstrating collective commitment to catalyze efforts around national priorities and goals Communicating Seeking opportunities to communicate with one another and with stakeholders beyond NPP about aligning efforts with the NQS to improve health and healthcare. 4 2

6 4/11/2012 NQF s Proposed Scope of Work in 2012: National Priorities Partnership NPP s Consultative Role NPP Action Pathways Partnership for Patients Quarterly Summits Partnership for Patients Affinity Groups and Action Registry Reports Currently in discussion with HHS regarding NPP s ongoing role in providing input to the Secretary of HHS on the National Quality Strategy Action pathway development and Implementation Maternity action pathway emphasizing elective deliveries and cesarean section (Re)admissions action pathway emphasizing care across the continuum that addresses the needs of vulnerable populations Template for NPP approach to action pathway development Quarterly PfP safety summits for up to 200 participants, including NPP Partners, PfP stakeholders, partners, contractors Accelerate progress towards achievement of the PfP goals through collaborative public private sector efforts and actions Provide a forum for affinity groups to identify obstacles, barriers, and solutions to reducing readmissions and healthcare acquired conditions. Convene 4 cross cutting affinity groups (e.g., rural health, patient and family engagement, clinician engagement) Webinars to address affinity group challenges and opportunities Content input into HHS web portal Action registry for tracking and monitoring action commitments, including NPP action teams and affinity groups inputs 5 Are there any overarching questions before we dive deeper into each content area? 6 3

7 4/11/2012 NPP s 2012 Input into the National Quality Strategy 7 The Affordable Care Act: A Framework & Resources for Measurement Based Improvement HHS must establish a national strategy to improve the delivery of healthcare services, patient health outcomes, and population health The national strategy is to be shaped and specified with input from diverse healthcare leaders in the field of health and healthcare Coordination and alignment within the Federal government and across the public and private sectors is key to the ultimate success of the national strategy in transforming the U.S. healthcare system 8 4

8 4/11/2012 HHS National Quality Strategy Aims and Priorities 9 Moving Forward: Capitalizing on Identified Strategic Opportunities One: A national strategy for data collection, measurement and reporting that supports measurement based improvement Two: Community infrastructure (public private) responsible for improvement efforts, benchmarking resources, comparing progress and performance, & mechanisms to identify, share and evaluate progress Three: Payment and delivery system reform emphasizing primary care that rewards value over volume; promotes patient centered outcomes, efficiency, and appropriate care while reducing waste 10 5

9 4/11/2012 How can NPP best catalyze private and public sector alignment around the strategic opportunities to advance the National Quality Strategy? 11 Break (15 minutes) 12 6

10 4/11/2012 NPP Action Pathways Improving Maternity Care and Reducing Avoidable (Re)admissions 13 National Priorities Partnership (NPP) Action Team Draft Template Formulation Identify appropriate action areas Aligned with the National Quality Strategy priorities and goals, as well as other major initiatives (e.g., Partnership for Patients, Million Hearts, Strong Start) With potential to achieve quick and meaningful wins based on NPP input, existing evidence base, and efforts underway Seek NPP Partner consensus and refinement Secure Partner support for areas of action team focus Seek Partner recommendations on action team leads Convene Action Team Identify action team members with input from NPP Co chairs and action team leads Ensure action team includes key NPP Partners, multistakeholder representation, technical experts, and Federal partners Action Pathway Development Execution Evaluation Develop initial scope Elicit Action Team input on strawman/draft problem statement, goals, barriers to change, and action drivers Review and refine Action Pathway Incorporate feedback from action team members into draft action pathway Prioritize drivers and complementary actions to address key barriers Identify three or four highleverage drivers around which to develop action steps Identify specific and tangible action steps and champions to drive them, considering: who will be accountable who else is needed what needs to be done by when and how Communicate and disseminate draft action pathway broadly among NPP Partners, NQF councils and external audiences Promote alignment with existing programs and key stakeholders Facilitate necessary connections and supports Refine action steps as needed Sustain momentum and continue to support progress Elicit ongoing report backs from champions regarding progress Identify indicators and proxy measures of success Monitor action step execution and barriers to progress Record completed action steps and consider subsequent impact Identify lessons learned and best practices Establish feedback loops with NPP Partners, NQF councils, and external audiences Develop written summary report of action pathway development, execution, and results Communicate and disseminate resulting successes and promote continued efforts for sustainability Expected timeline (total 18 months) Month 1 4 Project Launch Month 5 8 Month 9 15 Month

11 4/11/2012 NPP 2012 Maternity and (Re)admissions Action Pathways Maternity Care Goals Reduce the percentage of babies electively delivered prior to 39 weeks gestation to 5 percent or less Reduce cesarean births among low risk women to 15 percent or less Strategies Increase use and reporting of perinatal measure sets Promote tools, systems, and strategies that drive appropriate care delivery (e.g., hard stop policies, ACOG checklists) Align provider and consumer messaging Avoidable (Re)admissions Goal Reduce avoidable (re)admissions across all care settings by 20 percent Strategies Promote patient, family, and caregiver engagement to identify and provide care concordant with preferences for care Build workforce capacity by promoting the development of skills necessary to provide care for high risk populations 15 NPP Maternity Action Team 2012 Action Pathway Maternity Care Goals Reduce the percentage of babies electively delivered prior to 39 weeks gestation to 5 percent or less Reduce cesarean births among low risk women to 15 percent or less Strategies 1. Increase use and reporting of perinatal measure sets 2. Promote tools, systems, and strategies that drive appropriate care delivery (e.g., hard stop policies, ACOG checklists) 3. Align provider and consumer messaging 16 8

12 4/11/2012 NPP Feedback on Maternity Draft Action Steps (Tab 2) Guidance on prioritization of the action steps? Suggestions for collectively accelerating the actions? NPP Partner support for augmenting the actions? 17 NPP (Re)admissions Action Team 2012 Action Pathway Action Team Goal Reduce avoidable admissions and readmissions across the continuum of care by 20 percent. Strategies 1. Promote patient, family, and caregiver engagement to identify and provide care concordant with preferences for care 2. Build workforce capacity by promoting the development of skills necessary to provide care for high risk populations 18 9

13 4/11/2012 NPP (Re)admissions Action Team Strategies Factors and Incentives that Influence Hospitalization of LTC Patients Patient and Family Engagement Strategies Maslow and Ouslander; LTQA White Paper: Measurement of Potentially Preventable Readmissions Workforce Strategies 19 NPP (Re)admissions Action Team Strategies Promote alignment and dissemination of effective patient centered tools, strategies, and models that support high quality care through existing initiatives and campaigns. Patient and family engagement 1. Promote consistent identification of at risk patients; patient, family, and caregiver preferences for care; and care that is concordant with these preferences 2. Promote the engagement of patients, families, and caregivers in care planning and enable selfmanagement 3. Promote information for patients, families, and caregivers about nursing home/home care readmission rates and their implications to aide informed decisionmaking Workforce capacity 1. Promote team based, patient centered care across the continuum 2. Promote a workforce with necessary skills e.g., in geriatric or palliative care to adequately and appropriately care for vulnerable populations 3. Promote the ability of clinicians to practice to the fullest extent of their licensure 20 10

14 4/11/2012 NPP Feedback on (Re)admissions Draft Action Steps (Tab 2) Guidance on prioritization of the action steps? Suggestions for collectively accelerating the actions? NPP Partner support for augmenting the actions? 21 Opportunity for Public Comment 22 11

15 4/11/2012 Lunch Break (30 minutes) 23 NPP and the Partnership for Patients 24 12

16 4/11/2012 Partnership for Patients NPP Quarterly Meetings One Year Later June 16, 2011 Launching the PfP NPP Partnership at the 1 st quarterly meeting & individual organizations commit to action Sept. 16, 2011 Building momentum at the 2 nd quarterly meeting & interdependence of our commitments to accelerate change January 19, 2012 April 30, 2012 Catalyzing action at the 3 rd quarterly meeting & formation of affinity groups Focusing on action at the 4 th quarterly meeting through affinity groups 25 Partnership for Patients NPP Patient Safety Webinar Series 10,000 connections 20 hours of archived programming 13 webinars featuring 65 speakers Webinar Series Part One June October PfP Goal Areas Listening to the Audience Key themes Webinar Series Part Two November February Tactical Approaches One goal: Improve patient safety 26 13

17 4/11/2012 NPP PfP Action Registry To date, nearly 180 commitments and actions to advance the aims of the PfP were reported by 60 organizations Will become an electronic, user friendly tool that allows stakeholders to connect in real time Opportunities for alignment include: Collaborating around value based practices Spreading innovative and evidence based practices Collaboratives to reduce HACs 27 Moving Forward: Affinity Groups and Action Registry Reporting Convene four cross cutting affinity groups Groups in motion: rural health, medication safety, and patient and family engagement Include leadership and participation from Hospital Engagement Networks and others Reach a broader audience through webinars addressing challenges to implementation Provide content input into HHS s web portal: Further develop the action registry for tracking and monitoring NPP and PfP partner commitments 28 14

18 4/11/2012 National Quality Strategy Partnership for Patients Affinity Groups NPP Action Teams Maternity Readmissions CMS Support HEN, QIO, CCTP, NCD, PFE Contractor, Strong Start 29 NPP s Action Catalyst Role How do we best leverage NPP s role as an action catalyst through the affinity group efforts? 30 15

19 4/11/2012 Guidance on a NPP Communications Strategy 31 NPP s Guiding Principle on Communication and Dissemination NPP Partners should seek opportunities to communicate with one another and with stakeholders beyond NPP about aligning efforts with the NQS to improve health and healthcare. To fulfill NPP s aims, Partners are expected to: Contribute to ongoing efforts to establish a clear communication strategy for sharing information and knowledge with important audiences within and beyond NPP Partners; Disseminate information about promising practices; Share concrete examples to inspire and catalyze action; Demonstrate the value of focusing on shared priorities and goals; and Report on indicators of progress, such as NPP Partner collaborations that are catalyzing change

20 4/11/2012 Prioritizing Communication Needs Decide on a purpose for each communication effort (i.e., broad based education, persuasion, behavior change, etc.) Formulate key messages for NPP members to carry forward across key dimensions of NPP work Map out and execute on a plan to communicate effectively using the vehicles we already have in place NPP Communications Framework NPP s Role Advancing the NQS and Strategic Opportunities Action Catalyst Maternity Care Action Catalyst (Re)admissions What should we communicate? What are the key messages? What will communications help to achieve? Support for the NQS priorities Successes on the goals Successes on the strategic opportunities Effect of aligning efforts around common and shared priorities Collaborative actions taken and successes achieved Prioritized action steps and results Collaborative actions taken and successes achieved Prioritized action steps and results Education Activation Activation Who are we most focused on reaching? Federal partners Health plans Consumers Providers State hospital associations What does success look like? X core talks developed and incorporated into X annual conference agendas X articles written on core action and disseminated through X websites X articles written on core actions and disseminated through X websites 34 17

21 4/11/2012 Wrap up and Next Steps Next NPP Partnership for Patients Quarterly Summit: April 30, 2012 Additional Quarterly Summits to be tentatively scheduled for July and November 2012 Ongoing Maternity and (Re)admissions Action Team work and outreach Communications efforts to further disseminate 2012 strategies and catalyze action beyond NPP 35 18

22 Tab 1 Overview of NPP s Scope of Work

23 NQF s Proposed Scope of work in 2012: National Priorities Partnership NPP s Consultative Role NPP Action Pathways Partnership for Patients Quarterly Summits Partnership for Patients Affinity Groups and Action Registry Reports Currently in discussion with HHS regarding NPP s ongoing role in providing input to the Secretary of HHS on the National Quality Strategy Action pathway development and Implementation Maternity action pathway emphasizing elective deliveries and cesarean section (Re)admissions action pathway emphasizing care across the continuum that addresses the needs of vulnerable populations Template for NPP approach to action pathway development Quarterly PfP safety summits for up to 200 participants, including NPP Partners, PfP stakeholders, partners, contractors Accelerate progress towards achievement of the PfP goals through collaborative public-private sector efforts and actions Provide a forum for affinity groups to identify obstacles, barriers, and solutions to reducing readmissions and healthcare-acquired conditions. Convene 4 cross-cutting affinity groups (e.g., rural health, patient and family engagement, clinician engagement) Webinars to address affinity group challenges and opportunities Content input into HHS web portal Action registry for tracking and monitoring action commitments, including NPP action teams and affinity groups inputs 1

24 NPP s Guiding Principles NPP Partners serve as leaders in shaping the aims, priorities and goals of HHS s National Quality Strategy (NQS), and as role models in implementing them. To that end, the principles and necessary actions that guide the successful achievement of healthy people/communities, better care and more affordable care are described below within the context of three important C s: Collaborate, Catalyze, and Communicate. Collaborating Demonstrate a commitment to collaborate with other NPP Partners and with broader stakeholder groups to advance the NQS priorities and goals. To fulfill NPP s aims, Partners are expected to: Bring together diverse stakeholder groups around the NQS priorities and goals; Identify areas on which to focus collaborative efforts to achieve the three aims of better care, affordable care, and healthy people and communities. Help form and maintain strategic collaborations and leverage one another s assets; Contribute to the development of tools and resources that support collaborative activities; Make individual and collective commitments to support national priorities; and Follow through on individual commitments and hold one another accountable. Catalyzing and Supporting Action Demonstrate collective commitment to catalyze efforts around national priorities and goals. To fulfill NPP s aims, Partners are expected to: Form and support affinity groups to develop pathways to implementation, considering the NPP-identified strategic opportunities; Support communities in identifying collaborative strategies to adopt and improve upon the national priorities and goals; Identify specific joint actions by Partners to address key gap areas and barriers to change, including timelines and key indicators of success; and Monitor advancement in the priorities and goals. Communicating and Disseminating Seek opportunities to communicate with one another and with stakeholders beyond NPP about aligning efforts with the NQS to improve health and healthcare. To fulfill NPP s aims, Partners are expected to: Contribute to ongoing efforts to establish a clear communication strategy for sharing information and knowledge with important audiences within and beyond NPP Partners; Disseminate information about promising practices; Share concrete examples to inspire and catalyze action; Demonstrate the value of focusing on shared priorities and goals; and Report on indicators of progress, such as NPP Partner collaborations that are catalyzing change.

25 NPP Partner Responsibilities Strong commitment to building consensus on national priorities and goals for improving health and healthcare across the nation and acting to achieve them. Willingness to work collaboratively with other Partnership members, respect differing views, and reach agreement on recommendations. Input should not be limited to specific interests, though sharing of interests is expected. Impact of decisions on all healthcare populations should be considered. Input should be analysis and solution-oriented, not reactionary. Ability to volunteer time and expertise as necessary to accomplish the work of the Partnership, including meeting preparation, attendance and active participation at meetings, completion of assignments, and service on ad hoc groups. Commitment to attending meetings. Organizational representatives may request to send a substitute in exceptional circumstances and with advance notice. If an organizational representative is repeatedly absent, the chair may ask the organization to designate a different representative. Demonstration of respect for the Partnership s decision making process by not making public statements about issues under consideration until the Partnership has completed its deliberations. Acceptance of the Partnership s conflict of interest policy. Partners will be required to publicly disclose their interests and any changes in their interests over time.

26 Tab 2 NPP s Action Pathways for Improving Maternity Care and Reducing Avoidable (Re)admissions

27 NATIONAL PRIORITIES PARTNERSHIP ACTION TEAMS AND DEVELOPMENT OF ACTION PATHWAYS Background In addition to providing consultative input to the Department of Health and Human Services (HHS) and the broader health and healthcare field on priorities and goals for improving quality, the National Priorities Partnership (NPP) is strongly committed to focusing efforts on driving improvement. The results of a formal evaluation conducted over the summer of 2011 reinforced NPP s desire to focus more intentionally and intensively on catalyzing and supporting action at the national, state, and community level to achieve the priorities and goals of the National Quality Strategy (NQS). To this end and building on the earlier work of NPP workgroups in developing action plans more broadly around the six NPP priority areas NPP is embarking on two projects to convene Partners and critical stakeholder groups to develop action pathways for specific topic areas related to the NQS. These pathways will include high-leverage action points, i.e., tactics that NPP Partners and others will target to drive improvement at all levels of the system along with anticipated timeframes and milestones for completion Action Pathways NPP has selected two prototype action pathways for its work in 2012, which include: 1. Reducing avoidable admissions and readmissions across the continuum of care; and 2. Improving quality and safety for mothers and babies by reducing elective deliveries. In identifying these specific action areas, NPP considered: National Quality Strategy priority and goal areas for which the potential for improvement is great and which could yield significant returns in terms of health, quality, safety, and affordability; and Areas in which NPP Partners working individually or collaboratively with each other and with other critical partners can collectively have a significant impact Developing Action Pathways For each project, Action Team members will lead the development of an action pathway, which each team will present to the full Partnership for feedback and refinement. These pathways will serve as the foundation for NPP s action agenda over the next 6-9 months, and as prototypes for similar future projects. Action points will be identified around a menu of drivers i.e., payment, public reporting, accreditation, certification, and informed consumer decision making that have the potential to catalyze system-level change while achieving shorter-term outcomes and improvements. Once the action pathway is developed, the Partners and Action Teams will work with identified stakeholder groups to play out their respective contributions in more detail. At future NPP meetings, the Action Teams will provide progress updates and solicit feedback and/or additional assistance as needed.

28 National Priorities Partnership (NPP) Action Team Draft Template Formulation Identify appropriate action areas Aligned with the National Quality Strategy priorities and goals, as well as other major initiatives (e.g., Partnership for Patients, Million Hearts, Strong Start) With potential to achieve quick and meaningful wins based on NPP input, existing evidence base, and efforts underway Seek NPP Partner consensus and refinement Secure Partner support for areas of action team focus Seek Partner recommendations on action team leads Convene Action Team Identify action team members with input from NPP Co chairs and action team leads Ensure action team includes key NPP Partners, multistakeholder representation, technical experts, and Federal partners Action Pathway Development Execution Evaluation Develop initial scope Elicit Action Team input on strawman/draft problem statement, goals, barriers to change, and action drivers Review and refine Action Pathway Incorporate feedback from action team members into draft action pathway Prioritize drivers and complementary actions to address key barriers Identify three or four highleverage drivers around which to develop action steps Identify specific and tangible action steps and champions to drive them, considering: who will be accountable who else is needed what needs to be done by when and how Communicate and disseminate draft action pathway broadly among NPP Partners, NQF councils and external audiences Promote alignment with existing programs and key stakeholders Facilitate necessary connections and supports Refine action steps as needed Sustain momentum and continue to support progress Elicit ongoing report backs from champions regarding progress Identify indicators and proxy measures of success Monitor action step execution and barriers to progress Record completed action steps and consider subsequent impact Identify lessons learned and best practices Establish feedback loops with NPP Partners, NQF councils, and external audiences Develop written summary report of action pathway development, execution, and results Communicate and disseminate resulting successes and promote continued efforts for sustainability Expected timeline (total 18 months) Month 1 4 Project Launch Month 5 8 Month 9 15 Month 16 18

29 NPP Maternity Action Team Roster Maureen Corry, Action Team co-chair Bernie Rosof, Action-Team co-chair Bruce Bagley Larry Gilstrap Lorrie Kaplan Gerald Joseph Michael Shabot George Isham Paul Jarris Kathleen R. Simpson Eric Fennel Stanley Davis Nancy Foster Leah Binder Cindy Pellegrini Neal Kohatsu Jane Hooker Penney Berryman Mary Barton Charlie Homer Lee Partridge Bonnie Paris David Hopkins Jochen Profit Margaret van Amringe Christine Hunter Childbirth Connection Physician Consortium for Performance Improvement* American Academy of Family Physicians American Board of Obstetrics and Gynecology American College of Nurse-Midwives American Congress of Obstetricians and Gynecologists American Medical Informatics Association* America s Health Insurance Plans* Association of State and Territorial Health Officials* Association of Women s Health, Obstetric and Neonatal Nurses Centers for Medicare & Medicaid Services* Fairview Health Services Hospital Quality Alliance* Leapfrog* March of Dimes National Association of Medicaid Directors* National Association of Public Hospitals and Health Systems* National Business Group on Health* National Committee for Quality Assurance* National Initiative for Children s Healthcare Quality* National Partnership for Women and Families* Network for Regional Healthcare Improvement* Pacific Business Group on Health* Texas Children s Hospital The Joint Commission* U.S. Office of Personnel Management *Denotes NPP Partner

30 NPP (Re)admissions Action Team Roster Helen Darling, Action Team co-chair Susan Frampton, Action-Team co-chair Joyce Dubow Julie Lewis Lois Cross Ruta Kadonoff Maureen Dailey Shekhar Mehta Ann Hendrich Diane Meier Alisa Ray Ashley Ridlon Joe Ouslander Nancy Foster Richard Snyder Carol Raphael Jill Steinbruegge Harold Miller Kristofer Smith Marcia Nielsen Julie Kuhle Patricia Kurtz Christine Hunter National Business Group on Health* Planetree* AARP* Alliance for Home Health Quality and Innovation* American Case Management Association American Health Care Association* American Nurses Association* American Society of Health-System Pharmacists Ascension Health Center to Advance Palliative Care Certification Commission for Health Information Technology* Center for Medicare & Medicaid Innovation Florida Atlantic University Hospital Quality Alliance* Independence Blue Cross* Long-Term Quality Alliance National Association of Public Hospitals and Health Systems* Network for Regional Healthcare Improvement* North Shore Long Island Jewish Health System Patient-Centered Primary Care Collaborative* Pharmacy Quality Alliance* The Joint Commission* US Office of Personnel Management *Denotes NPP Partner

31 Tab 3 NPP and the Partnership for Patients

32 Partnership for Patients National Priorities Partnership Issue Brief I. Supporting Patient Safety through the National Quality Strategy In April 2011, the Department of Health and Human Services (HHS) launched the Partnership for Patients initiative (PfP) to support the National Quality Strategy (NQS) priority and goals around patient safety, emphasizing that success was dependent on collective action from both public and private sectors of healthcare. This initiative laid out two primary goals reducing hospital-acquired conditions (HAC) by 40 percent and preventable hospital readmissions by 20 percent by the end of 2013 that require strategic, ongoing collaboration as well as a series of actions throughout the industry. To help reach these ambitious goals, HHS requested the National Quality Forum (NQF) to convene the National Priorities Partnership (NPP) a multi-stakeholder group of 51 organizations representing organizations from across the healthcare industry to facilitate a shared discussion with stakeholders of the PfP and to build upon NPP s broad network of collective efforts in advancing patient safety. Given its history of building consensus and mobilizing action around national priorities, the NPP was uniquely qualified to assume this role with a long history of leadership and commitment to patient safety. Building on the NPP s input into the NQS and support of the patient safety priority area, the PfP-NPP partnership created a forum for leaders in the public and private sectors to discuss strategies for achieving the PfP goals. Perhaps more importantly, however, these forums allowed for ongoing identification of opportunities for further public-private sector collaboration and for engaging with and supporting front-line providers in their efforts to improve patient care. II. Taking Collaborative Action through Public-Private Partnerships One of the key actions undertaken by NPP in support of the PfP goals was quarterly summits of approximately 100 leaders in the public and private sectors, who came together to share updates on progress of the PfP; gather input on relevant public- and private-sector initiatives; and identify key contributions each stakeholder can make to advance this important work. These meetings provided a unique opportunity for dialogue in an open forum, which enhanced and supported collaboration among and between government agencies and the private sector. During each of these meetings, participants looked to the future and strongly voiced a readiness for action to advance the goals of the patient safety initiative and other efforts under the overarching NQS. Participants indicated their commitment to align their organizations efforts through deliberate publicprivate collaboration, and to leverage strategic opportunities to achieve the aims of better care, affordable care, and healthy people and communities. Input received from participants during the quarterly NPP meetings and post-meeting evaluations indicated a widespread commitment to accelerating progress, and the need for opportunities that connect organizations and frontline providers with each other. For example, in the January 2012 meeting evaluation, 100% of participants said the meeting enhanced their ability to contribute to public-private sector collaboration, and 91% said they would be able to better support and accelerate patient safety efforts in their organization or local community. March 30,

33 At each meeting, and during the time between sessions, participants were encouraged to share opportunities for collaboration and collective action with each other. In this space, participants highlighted and reaffirmed their commitment to actions that aligned with the PfP goals. Some examples of action identified by summit participants included: Employers in Action to Engage Patients & Families in Safe Care Dedicated to patient safety for years, Johnson & Johnson is launching a patient safety incentive program through its custom care management program called CareConnect for its U.S. employees and retirees to meet the goals of the Partnership for Patients (PfP). In collaboration with Johnson & Johnson s national insurance carriers, the CareConnect program encourages employees to speak with a registered nurse prior to being admitted to the hospital to receive information about the steps they should take to keep themselves safe before, during and after hospitalization. Employees and their covered spouses or partners enrolled in the Johnson & Johnson HealthyPeople Health Reimbursement Arrangement (HRA) Plan are eligible to receive a $100 deposit into their health reimbursement arrangement (HRA). The National Business Group on Health, a membership organization for large employers who purchase health insurance, is helping its membership identify key patient safety issues that are most important to ensuring patients receive safe care. Armed with a precise list of key issues, employers can take practical steps to help keep their employees safe. For example, to help reduce elective deliveries, employers can educate women through social media tools and work with hospitals to implement policies that discourage elective deliveries prior to 39 weeks gestation. Creating Tools to Improve Quality Georgia Health Policy Center and Communities Joined in Action (CJA) held a Partnership for Patients track in October, 2011 at the CJA Annual Conference in Washington, DC, with scholarships provided for Georgia community representatives to attend. Systems engineers worked with participants to map highleverage interventions for improving quality and decreasing cost for people eligible for both Medicaid and Medicare. A follow-up webinar was held in January, and a follow-up meeting was held in February The AFL-CIO is partnering with the National Business Coalition on Health, Robert Wood Johnson Foundation, other employers, business groups, and union trusts to build and use a database of patient safety payment incentives used by (or planned for use by) private insurance plans for reports. The database will be free for public use and is intended to promote private and public sector alignment across incentive-based programs. Unifying Hospitals under the National Quality Strategy The North Carolina Hospital Association (NCHA), a Hospital Engagement Network (HEN) with 111 network hospitals in North Carolina and Virginia, uses NQS priorities as a framework for transforming care in all its efforts. A foundation of the organization s strategic plan for years, the federal focus on key priority areas and more specifically the PfP emphasis on readmissions and healthcare acquired conditions (HACs) has taken NCHA s efforts to the next level. For example, the Central Line-Associated Bloodstream Infection (CLABSI) Collaborative, involving 40 ICUs across the region, recently achieved a 46 percent reduction in central-line infections over an 18-month time period. 2

34 Engaging Patients and Providers in Shared Decision-Making American Board of Internal Medicine Foundation, in partnership with nine specialty societies and Consumer Reports, launched the Choosing Wisely campaign, designed to help patients and physicians engage in conversations about the overuse and misuse of particular tests and procedures, and support physician efforts to help patients make smart and effective care choices. In February 2012, The Safe Care Campaign, a patient advocacy organization, launched two new tools designed to help hospitals and medical care providers get patients and their families involved in safe care. These tools use innovative mobile technology to provide educational information to patients and their families while they are receiving care. III. NPP Action Teams: Forging Ahead to Achieve the PfP Goals With the goal of accelerating deliberate public-private sector alignment, collaboration, and engagement of key multi-stakeholder groups around the NQS, NPP formed two Action Teams with the specific goals of: 1. Improving maternity care for mothers and babies by focusing on reducing cesarean section in low-risk women and reducing elective deliveries, particularly prior to 39 completed weeks; and 2. Reducing avoidable admissions and readmissions across the continuum of care by emphasizing long-term care, home care, and community-based settings. In support of the PfP initiative, these two teams are working to develop action pathways with specific tactics to achieve the goals. Each team meets regularly to identify goals, barriers, and high-leverage drivers to achieve success. It is envisioned that the action pathways created by these teams will serve as a prototype for future implementation efforts. NPP Maternity Action Team The NPP Maternity Action Team is comprised of nearly two-dozen stakeholders representing providers, purchasers, consumers, health plans, accreditation and certification bodies, and state, regional and local entities. The sheer number and variety of stakeholders from the business community and health plans to specialty societies and Medicaid rallying behind this single effort is unprecedented; the Action Team provides a venue for stakeholder groups that may not normally collaborate to come together for a common cause. The Maternity Action Team is in the process of developing an action pathway to address inappropriate maternity care, focusing specifically on reducing elective deliveries by general induction and reducing cesarean section in low-risk women. The pathway includes major barriers identified by the Action Team to achieving high-quality, high-value maternity care, as well as highest-leverage drivers and action points to address the identified barriers. The Maternity Action Team has identified two goals to help accelerate the PfP goal of reducing adverse obstetrical events by 50% in 2013: Reduce the percentage of babies electively delivered prior to 39 weeks gestation to 5 percent or less; and Reduce cesarean births among low-risk women to 15 percent or less. 3

35 Through the identification of high-leverage drivers and collaborative action, this Action Team is making progress towards these goals. For example, this group is working to increase the uptake of The Joint Commission Perinatal Core Measure Set, as well as promote systems that drive appropriate care delivery, including widespread implementation of hard-stop policies and patient safety checklists developed by the American Congress of Obstetricians and Gynecologists (ACOG). Building on this work, there has already been an early success the alignment of the Maternity Action Team goals and strategies with the Strong Start initiative, an effort launched by HHS in January 2012 to support high quality care for mother and babies by reducing early elective deliveries and providing evidence-based prenatal care to improve newborns outcomes. Through the Strong Start initiative, the Centers for Medicare & Medicaid Services (CMS) seeks to reduce early elective deliveries through public awareness, public reporting, and funding for providers and states to test new approaches in prenatal care that reduce birth complications. NPP (Re)admissions Action Team In alignment with the PfP goal around reducing readmissions by 20% in 2013, the NPP (Re)admissions Team goal is to reduce avoidable hospital admissions and readmissions by promoting strategies to improve high-quality care that addresses the needs of high-risk populations (e.g., patients eligible for both Medicare and Medicaid, patients with multiple chronic conditions) and builds system and workforce capacity across all care settings. This team has three key areas of focus: Supporting high-quality care by promoting alignment and dissemination of effective patientcentered tools, resources, strategies, and models; Identifying and addressing the needs of vulnerable populations based on individual risk for avoidable hospital admission and readmission and patient, family, and caregiver preferences; and Building a workforce with the necessary skills to offer team-based, patient-centered care across the continuum. To maintain momentum of the NPP Action Teams, several actions steps can be taken, such as identifying key stakeholders to work in collaboration to achieve the PfP goals, and providing ongoing opportunities for public and private sector groups to come together on a regular basis to celebrate and share successes. Moving into 2012 and 2013, the NPP Action Teams will continue to look for opportunities for alignment, identify goals, and capitalize on opportunities for success. IV. Engaging and Supporting Patients and Frontline Providers To accelerate spread of early success and to engage multiple stakeholders in patient safety, NQF hosted the PfP-NPP Patient Safety Webinar Series to offer an ongoing dialogue between national experts in the field, communities and frontline providers across the country. This 13-part program profiled best practices in patient safety for achieving effective and sustainable results, and provided tools, resources, and success stories for frontline providers and healthcare professionals who aimed to achieve the PfP goals in local communities nationwide. Each webinar offered the PfP-NPP partnership as an example of executing the patient safety priority of the NQS through a public-private multi-stakeholder collaboration. From June 2011 to February 2012, this series reached over 10,000 people across the country who deliver and receive healthcare services daily. 4

36 PfP-NPP Patient Safety Webinar Series: Topics and Participants DATE TOPIC PARTICIPANTS June 20, 2011 Introduction to Partnership for Patients 920 July 6, 2011 Care Transitions 2439 July 19, 2011 Adverse Drug Events 685 Aug. 3, 2011 Infections in the Intensive Care Unit 740 Aug. 16, 2011 Surgical Site Infections 696 Sept. 9, 2011 Pressure Ulcers and Falls 868 Sept. 28, 2011 Obstetrical Events 790 Oct. 5, 2011 Venous Thromboembolism 888 Nov. 17, 2011 Patient & Family Engagement 860 Dec. 9, 2011 Board Engagement 209 Jan. 11, 2012 Multidisciplinary Teams 690 Feb. 15, 2012 Hospital and Community Engagement 584 Feb. 23, 2012 Rapid Cycle Improvement 298 Total 10,667 The first part of the webinar series was focused on the ten areas targeted by the PfP, each one tied back to the primary goals of reducing readmissions and hospital-acquired conditions. While the audience benefitted from hearing about techniques to reduce medical error and improve care, comments and questions consistently arose around tactical approaches to achieve the PfP goals. To meet this need, the second part of the series addressed the recurring themes raised by participants, specifically: Creating culture change through organizational leadership and empowered frontline providers; Coordinating the efforts of multidisciplinary teams and organizations; Engaging patients and families in a meaningful way; Designing payment models that promote and incentivize quality and safe practices; and Measuring quality consistently and reliably within and between organizations. During the second half of the webinar series, these themes were discussed by frontline providers who shared their success stories and lessons learned around these areas. The audience actively participated in the discussion via live web polling, web chatting, and webinar evaluations. In a nine month timeframe, participants listened to and conversed with over 65 expert speakers, who along with the audience represented diverse perspectives and organizations. These included consumer advocates, doctors, nurses, pharmacists, social workers, quality improvement officers, healthcare administrators, purchasers, providers, employers, and patients themselves. Following are some key statistics about this series: The audience represented regional diversity with 33 percent of registrants coming from the South, 21 percent from the Midwest, 17 percent from the West, and 20 percent from the Northeast; Responses from over 3,000 webinar evaluations indicated 95 percent of participants learned something new from the webinar and 89 percent Webinar Participants by Location 5

37 indicated they would be able to implement something new in their organization based on what they learned; and Over 1,100 comments and questions were submitted via live web chat. Results from the webinar evaluation and comments from the audience both indicated a very engaged field eager to interact with each other, particularly to learn and put into practice innovative strategies for improvement. V. The Look Forward Since the launch of the PfP in April 2011, public-private sector collaboration through the PfP-NPP platform has enabled multiple stakeholders to contribute toward the attainment of the PfP goals as a vehicle for implementing the NQS. Some key accomplishments to date: Establishment of national priorities and goals recognized in the NQS, specifically around patient safety; Creation of multiple federal funding streams to implement the NQS, including the Strong Start, PfP, and Million Hearts initiatives; Building of momentum, commitments and focused action targeting the PfP goals throughout the healthcare industry; Identification of best practices and communities in action, as well as dissemination of implementation strategies, and Movement towards alignment of payment incentives with patient safety goals across private and public sector with patient safety goals. To reach the PfP goals of reducing readmissions and HAC by the end of 2013, there is an ongoing need for public and private sector stakeholders to collaborate, share success, and target barriers together. The NPP is committed to catalyzing action in support of the priorities and goals of the National Quality Strategy and the Partnership for Patients initiative, and will continue to take leadership in patient safety in Specifically, the NPP will continue to support affinity groups and quarterly convenings of multiple stakeholders to take collaborative action around the PfP goal areas. In addition, the NPP will work with the Measure Applications Partnership, convened by NQF, to ensure that patient safety measurement strategies align with the priorities, goals and activities of the public and private sectors. To support this work, NQF will fill critical measurement gaps through its census development process. All of these efforts will enable stakeholders from across the health care industry to work collaboratively to implement the patient safety priority area of the NQS. 6

38 NPP Maternity Action Team Roster Maureen Corry, Action Team co-chair Bernie Rosof, Action-Team co-chair Bruce Bagley Larry Gilstrap Lorrie Kaplan Gerald Joseph Michael Shabot George Isham Paul Jarris Kathleen R. Simpson Eric Fennel Nancy Foster Leah Binder Cindy Pellegrini Neal Kohatsu Jane Hooker Penney Berryman Mary Barton Charlie Homer Lee Partridge Bonnie Paris David Hopkins Jochen Profit Margaret van Amringe Christine Hunter Childbirth Connection Physician Consortium for Performance Improvement* American Academy of Family Physicians American Board of Obstetrics and Gynecology American College of Nurse-Midwives American Congress of Obstetricians and Gynecologists American Medical Informatics Association* America s Health Insurance Plans* Association of State and Territorial Health Officials* Association of Women s Health, Obstetric and Neonatal Nurses Centers for Medicare & Medicaid Services* Hospital Quality Alliance* Leapfrog* March of Dimes National Association of Medicaid Directors* National Association of Public Hospitals and Health Systems* National Business Group on Health* National Committee for Quality Assurance* National Initiative for Children s Healthcare Quality* National Partnership for Women and Families* Network for Regional Healthcare Improvement* Pacific Business Group on Health* Texas Children s Hospital The Joint Commission* U.S. Office of Personnel Management *Denotes NPP Partner 7

39 NPP (Re)admissions Action Team Roster Helen Darling, Action Team co-chair Susan Frampton, Action-Team co-chair Joyce Dubow Julie Lewis Lois Cross Ruta Kadonoff Maureen Dailey Shekhar Mehta Ann Hendrich Diane Meier Alisa Ray Joe Ouslander Nancy Foster Richard Snyder Carol Raphael Jill Steinbruegge Harold Miller Kristofer Smith Marcia Nielsen Julie Kuhle Patricia Kurtz National Business Group on Health* Planetree* AARP* Alliance for Home Health Quality and Innovation* American Case Management Association American Health Care Association* American Nurses Association* American Society of Health-System Pharmacists Ascension Health Center to Advance Palliative Care Certification Commission for Health Information Technology* Florida Atlantic University Hospital Quality Alliance* Independence Blue Cross* Long-Term Quality Alliance National Association of Public Hospitals and Health Systems* Network for Regional Healthcare Improvement* North Shore Long Island Jewish Health System Patient-Centered Primary Care Collaborative* Pharmacy Quality Alliance* The Joint Commission* *Denotes NPP Partner 8

40 Patient Safety Webinar Series Topics and Featured Guests Webinar #1: An Overview of the Partnership for Patients and Getting Started in Your Organization Webinar Date June 20, 2011 Moderators Bernie Rosof, MD, NPP Co-Chair Helen Darling, MA, NPP Co-Chair Featured Guests Don Berwick, MD, MPP, Administrator, Centers for Medicare & Medicaid Services (CMS) Joe McCannon, Senior Advisor, Office of the Administrator, CMS John Toussaint, MD, Chief Executive Officer, ThedaCare Center for Healthcare Value and CEO Emeritus, ThedaCare, Inc. Gary Kaplan, MD, Chief Executive Officer, Virginia Mason Medical Center Webinar #2: Improving Hospital Readmissions through Care Transitions Webinar Date July 6, 2011 Moderator Helen Darling, MA, NPP Co-Chair Featured Guests Eric Coleman, MD, MPH, Director, Care Transitions Mary Naylor, PhD, RN, Professor, University of Pennsylvania School of Nursing Robyn Golden, LCSW, Director of Older Adult Programs, Rush University Medical Center Traci Cornelius, MSW, Care Transitions Coach, Riverside County Regional Medical Center Webinar #3: Preventing Adverse Drug Events in Your Organization Webinar Date July 19, 2011 Moderator Bernie Rosof, MD, NPP Co-Chair Featured Guests Michael Cohen, MS, ScD, RPh, President, Institute for Safe Medication Practices Steven Meisel, PharmD, Director of Patient Safety, Fairview Health Services David Bates, MD, MSc, Chief, Division of General Medicine, Brigham and Women s Hospital Bob Galvin, MD, MBA, Chief Executive Officer, Equity Healthcare, The Blackstone Group 9

41 Webinar #4: Reducing Infections in the Intensive Care Unit Webinar Date August 3, 2011 Moderator Steven Findlay, MPH, NPP Partner and former Co-Chair, NPP Safety Workgroup Featured Guests Peter Pronovost, MD, PhD, Medical Director, Johns Hopkins University School of Medicine Helen Macfie, PharmD, Senior Vice President, Performance Improvement, Memorial Medical Care Centers Michael Klompas, MD, MPH, Associate Hospital Epidemiologist, Brigham and Women s Hospital Victoria Nahum, Executive Director, Safe Care Campaign Webinar #5: Decreasing Surgical Site Infections Webinar Date August 16, 2011 Moderator Bernie Rosof, MD, NPP Co-Chair Featured Guests Frank Opelka, MD, Chair of Surgical Quality Alliance, Louisiana State University, NPP Partner Dale Bratzler, DO, MPH, Professor and Associate Dean, University of Oklahoma, College of Public Health Jean Rexford, Executive Director, Connecticut Center for Patient Safety Vincent Kerr, MD, President, Care Solutions, UnitedHealthcare Webinar #6: Preventing Pressure Ulcers and Falls in Healthcare Settings Webinar Date September 9, 2011 Moderator Joyce Dubow, MUP, Senior Director, Health Care Reform, AARP, NPP Partner Featured Guests Mary Tinetti, MD Director, Program on Aging, Yale University School of Medicine Dan Berlowitz, MD, MPH, Director, Center for Health Quality Outcomes and Economic Research, Veterans Affairs Ross Ehrmantraut, RN, CCRN, Patient Safety Officer, Harborview Medical Center Ann Hendrich, RN, PhD, Vice President of Clinical Excellence Operations, Ascension Health Webinar #7: Addressing Obstetrical Adverse Events Webinar Date September 28, 2011 Moderator Bernie Rosof, MD, NPP Co-Chair Featured Guests Maureen Corry, MPH, Executive Director, Childbirth Connection Kathleen Simpson, PhD, RN Perinatal Clinical Nurse Specialist, St. John s Mercy Medical Center Peter Cherouny, MD, Emeritus Professor of Obstetrics, Gynecology, and Reproductive Sciences, University of Vermont Alan Fleischman, MD, Senior Vice President and Medical Director, March of Dimes 10

42 Webinar #8: Averting Venous Thromboembolism (VTE) and Catheter Associated Urinary Tract Infections (CAUTI) Webinar Date October 5, 2011 Moderator Helen Darling, MA, National Priorities Partnership Co-Chair Featured Guests Bill Geerts, MD, Director, Thromboembolism Program, Sunnybrook Health Sciences Centre Sanjay Saint, MD, MPH, Director, VA/University of Michigan Patient Safety Enhancement Program Greg Maynard, MD, Society for Hospital Medicine, Center for Hospital Innovation and Improvement Mary Jo Skiba, RN, BSN, Project Manager, Quality Improvement and Research, Alpena Regional Medical Center Webinar #9: Engaging Patients and Their Families Webinar Date November 17, 2011 Moderator Camille Smith, MSPH, MSW, Project Manager, National Quality Forum Featured Guests Robert and Barbara Malizzo, Patient Advocates and Members of the Medical Staff Review Board, University of Illinois Medical Center at Chicago Tim McDonald, MD, JD, Chief Safety Officer and Risk Officer for Health Affairs, University of Illinois Medical Center at Chicago Don Berwick, MD, Administrator, Centers for Medicare & Medicaid Services Carolyn Clancy, MD, Director, Agency for Healthcare Research and Quality Webinar #10: Getting Your Board on Board Webinar Date December 9, 2011 Moderator Bernie Rosof, MD, Chairman, Board of Directors, Huntington Hospital, NPP Co-Chair Featured Guests Carol Wagner, RN, MBA, Senior Vice President Patient Safety, Washington State Hospital Association Rosemary Gibson, MSc, Patient Advocate and Author of The Treatment Trap and Wall of Silence Webinar #11: Creating and Sustaining Successful Multidisciplinary Teams within Your Organization Webinar Date January 11, 2012 Moderator Camille Smith, MSPH, MSW, Project Manager, National Quality Forum Featured Guests Wendy Vernon, MPH, MPT, Senior Director, National Priorities, National Quality Forum Debra Sims, RN, Clinical Supervisor, Children s Hospital at Providence (2010 Eisenberg Award Recipient) Jack Jacob, MD, Staff Neonatologist, Pediatrix Medical Group Terry Rogers, MD, CEO, Foundation for Health Care Quality Hae Mi Choe, PharmD, Director, Innovative Ambulatory Care Pharmacy Practices, University of Michigan Hospital and Health Systems Lindsey Kelley, PharmD, MS, Coordinator, Ambulatory Pharmacy Initiatives and Transitions of Care 11

43 Webinar #12: Creating and Sustaining Successful Partnerships between Hospitals and Community Organizations Webinar Date February 15, 2012 Moderator Camille Smith, MSPH, MSW, Project Manager, National Quality Forum Featured Guests David Nau, PhD, RPh, Senior Director, Quality Strategies, Pharmacy Quality Alliance Richard Antonelli, MD, MS, Primary Care Pediatrician, Medical Director for Integrated Care, Children s Hospital Boston Heather O Donnell, JD, Director of Planning for Health Care Reform, CJE Senior Life Melinda West, RN, BEd, Intermediate Care Unit Manager, Bay Area Hospital Webinar #13: Attaining Patient Safety through Rapid Cycle Improvement Webinar Date February 23, 2012 Moderator Camille Smith, MSPH, MSW, Project Manager, National Quality Forum Featured Guests Lillee Smith Gelinas, MSN, RN, FAAN, Vice President and Chief Nursing Officer, VHA Inc. Cristin Sullivan, RN, BSN, Director of Quality, Eastern Wisconsin Division of Hospital Sisters Health System Sherry Rogers, RN, MSN, NEA-BC, Chief Nursing Officer, Redington-Fairview General Hospital Norma Munn, RN-BC, BSN, Medical Surgical Nurse Manager, Redington-Fairview General Hospital Susannah Warner, RN-BC, Medical Surgical Charge and Staff Nurse, Redington-Fairview General Hospital 12

44 Tab 4 NPP s Communications Needs

45 2012 NPP Communications Framework NPP s Role Advancing the NQS and Strategic Opportunities Action Catalyst Maternity Care Action Catalyst (Re)admissions What should we communicate? What are the key messages? What will communications help to achieve? Who are we most focused on reaching? What does success look like? 1