2011 Indian Health Services National Combined Councils

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1 2011 Indian Health Services National Combined Councils Joe McCannon Senior Advisor to Administrator Dennis Wagner Co-Director, Partnership for Patients Centers for Medicare & Medicaid Services July, 2011

2 CMS is Changing 2

3 CMS Vision CMS is a major force and a trustworthy partner for the continual improvement of health and health care for all Americans. 3

4 Operating Values How we shall work together and with others? Boundarilessness Speed and Agility Unconditional Teamwork Valuing Innovation Customer Focus

5 The Three-Part Aim Better Health for the Population Better Care for Individuals Lower Cost Through Improvement 5

6 5 New Centers and Functions Added in 1 Year 1. Center for Strategic Planning, Tony Rodgers 2. Center for Program Integrity, Peter Budetti 3. Center for Medicare and Medicaid Innovation, Rick Gilfillan 4. Center for Consumer Information and Insurance Oversight, Steve Larsen 5. Federal Coordinated Health Care Office, Melanie Bella Center for Medicare, Jon Blum Center for Medicaid, CHIP, and S&C, Cindy Mann Office of Clinical Standards and Quality, Patrick Conway, MD 6

7 June 2011

8 40% 1.8 million 60,000 20% 1.6 million 35 billion 8

9 1. Keep patients from getting injured or sicker. By the end of 2013, preventable hospital-acquired conditions would decrease by 40% compared to Achieving this goal would mean approximately 1.8 million fewer injuries to patients with more than 60,000 lives saved over the next three years. 2. Help patients heal without complication. By the end of 2013, preventable complications during a transition from one care setting to another would be decreased so that all hospital readmissions would be reduced by 20% compared to Achieving this goal would mean more than 1.6 million patients would recover from illness without suffering a preventable complication requiring rehospitalization within 30 days of discharge. Potential to save up to $35 billion dollars over three years. 9

10 Partnership 4,500+ partners have signed the Partnership pledge, including over 2000 hospitals, 883 Clinicians, 549 consumers, community organizations and patient groups, and 159 employers, unions, health plans, governments. Media Coverage Earned Media: Nearly 150 articles have been written in national print and online publications about the Partnership and initial outreach events. Trade Press and Scientific Publications: include JAMA, American Medical News, WSJ blog, The Remington Report Social Media: 300+ blog posts, Facebook links, and Twitter #HHSPFP hits posted post-launch Field Events The Partnership has been central to 51 field events, including 12 organized by HHS and 39 organized by partners. Alignment A number of Affordable Care Act provisions including the Medicaid Provider-Preventable Conditions Rule, Medicare IPPS Rule, Medicare Value Based Purchasing Rule, and Community-Based Care Transitions Program - have been aligned with Partnership activity. Early Engagement Applications are beginning to come in for the Community Care Transitions Program. 10

11 Hospitals: Ascension Health and its 65 hospitals Catholic Healthcare West and its 40 hospitals Hospital Corporation of America and its 163 hospitals Kaiser Foundation Hospitals and its 35 hospitals Tenet Healthcare Corporations and its 49 hospitals Department of Veterans Affairs and its 171 hospitals Virginia Mason Hospital & Medical Center American Hospital Association Federation of American Hospitals National Association of Public Hospitals and Health Systems Clinicians: American Academy of Pediatrics Association for Professionals in Infection Control and Epidemiology American Academy of Family Physicians American Board of Medical Specialties American College of Physicians American College of Surgeons American Medical Association American Nurses Association American Society of Health-System Pharmacists National Hispanic Medical Association Consumer Organizations: Campaign for Better Care National Partnership for Women and Families National Patient Safety Foundation Unions: AFL-CIO UAW Retiree Medical Benefits Trust Employers Business Roundtable CalPERS Catalyst for Payment Reform The Dow Chemical Company General Electric Healthcare Leadership Council Honeywell IBM Intel Corporation Johnson & Johnson Motorola Solutions, Inc. National Business Coalition on Health National Business Group on Health Pacific Business Group on Health Safeway Starbucks Walmart Xerox Health Plans: Aetna America s Health Insurance Plans BlueCross BlueShield Association Cigna Group Insurance Commission, Commonwealth of Massachusetts United Health Group Wellpoint Other Partners Cerner Corporation The Joint Commission The Leapfrog Group Working Draft - Last Modified 7/22/2011 4:14:37 PM 11

12 There is no silver bullet. We must apply many incentives. We must show successful alternatives. We must offer intensive supports. Help providers with the painstaking work of improvement. 12

13 We Know Major Improvement Is Possible 150 New Jersey health care facilities reduced pressure ulcers by 70% Rhode Island reported a 42% decrease in Central Line-Associated Bloodstream Infections (CLABSI) ( ) More than 65 Institute for Healthcare Improvement Campaign hospitals reported going more than a year without a ventilatorassociated pneumonia in at least one unit. Ascension Health sites participating in a 2007 peri-natal safety initiative achieved birth trauma rates that were at or near zero. And much more

14 Ascension Health Our Journey to Zero FY10 Results National Average 65% Birth Trauma 89% Neonatal Mortality 94% Pressure Ulcers 74% VAP 43% Blood Stream Infections 57% Falls with Serious injuries 25% Mortality Measurement of Ascension Health Performance 07/01/09-6/30/10. National estimates are the latest available in the literature and other sources of data (data collection methodologies may not be identical). Birth Trauma & Neonatal Mortality -2005, Facility-Acquired Pressure Ulcers 2004 data; Falls with Serious Injury data; Central Line Blood Stream Infection & Ventilator- Associated Pneumonia data, Mortality 2009 data. 14

15 All hospitals will be able to tap into a national learning platform offering vast set of best-in-class learning supports Virtual Grand Rounds led by expert faculty Case studies and live-case visits conducted at participating institutions Audience Response Systems to provide instant feedback and education Hospitals will be also be able to get local state, system and association-based forms of support to address common forms of harm (e.g., state consortiums, large private systems, associations) Ambitious hospitals with a history of improvement invited to: Achieve Partnership goals in a more accelerated timeframe Tackle the challenge of reducing all-cause harm Learn from their peers and mentor participating hospitals 15

16 Existing Department Resources OASH Partnering to Heal AoA Care Transition Toolkit & Webinars CDC HAI Prevention Activities AHRQ Patient Safety materials QIO 10 th Statement of Work. Building upon IHS experience and skill in improvement (Sign-up? Outreach?). Other Department resources included on Partnership for Patients website. Additional Resources Available (Summer 2011) Community Care Transitions Program NQF/NPP webinars focused on each intervention Each stakeholder to pursue First Five (five key actions to begin to advance this work) 16

17 The effort will seek to support a grassroots movement for change. It will include a national education campaign to inform patients, families, caregivers, and the public of Partnership goals and activities. It will involve patients and families in effective redesign of care. It will provide accessible patient safety and care transitions resources (e.g., discharge planning tools). 17

18 1. They have shared, crisp, public aims, owned by leadership. 2. They welcome everyone. (Unleash, don t control.) 3. They get to the field. 4. Their work is rooted in actions and transactions. (Value) 5. They are brutally opportunistic. (Jazz) 6. They play well with levers. 7. They operate a Recognition Economy. 8. They have a shared story and they use the language of creation (not avoidance). 9. They examine and revise their rules base. 10. The patient is in the room always. 18

19 I ve never seen public-private cooperation like this it s kind of shocking. I can t believe we had this much potential look at what we unleashed! This initiative was just so helpful to me every day. I love this network! It produces results faster than anything I ve seen before. I am so grateful for this initiative it helped us feel less overwhelmed and made us feel so much safer. 19

20 1. They have shared, crisp, public aims, owned by leadership. 2. They welcome everyone. (Unleash, don t control.) 3. They get to the field. 4. Their work is rooted in actions and transactions. (Value) 5. They are brutally opportunistic. (Jazz) 6. They play well with levers. 7. They operate a Recognition Economy. 8. They have a shared story and they use the language of creation (not avoidance). 9. They examine and revise their rules base. 10. The patient is in the room always. 20

21 2009 Total Joe, age 65 Joe, age 62 Winchester Hospital Frank, age 88 Judy, age 86Preventable Harm Events Ed, age 82 Chris, age 87 Linda, age 84 Kelly, age 1 Joan, age 76 Jane, age 56 Susan, age 28 Karen, 45 Jim, age48 October 2008 through September Sal, age Falls with Injury Rob, age Lisa, age 60 total 76 Ventilator Tim, age 76 Associated 28 Mary, age 81 Pneumonia 2009 Goal 2 Doug, age Kevin, age 50 Sam, age 90 Patient Safety Karl, age 33 3 Central Line Bob, age 76 Associated Felicia, age 8 Blood Stream Serious Infection Med Errors Goal 0 6 Michael, age Rose, age 90 Surgical Site Ted, age Timothy, age 84 Susan, age 8962 Infections Marie, 77 age 0 Rick, age 80 2 Matthew, age 2011 Dan, age Bill, age Goal 89 Leo, age Raymond, age 54 Paul, age 67 Peter, age 78 Fiscal Year 2009 Goal: Reduce preventable harm by 50%

22 Requests for IHS Clinicians and Healthcare Organizations Join the Partnership for Patients Gain Leadership Buy-in and Support Your Organization The People You Serve Establish Organizational Aims Aligned with the Partnership for Patients Aims Stay in Concerted Action to Achieve Your Aims Actively Share: Challenges, Learnings, Best Practices, more Team with the National Community of Practice 22

23 Offers Let Us Know When You Have Successes and Results That We Can Broadcast Call on Us Try Us Join with CMS-Supported Hospital Engagement Contractors Engage in Spirit of Counter-Offers and Counter- Requests with CMS, Other Partners, Your Tribal Leaders 23

24 Sharing Insight, Possibility and Action IHS Combined Councils My biggest insight from this session is:. The possibilities I see for potential action and results on the Partnership for Patients by my organization or others present are: My main advice to CMS & HHS about what to keep the same or improve is: Name, Organization, 24

25 Contact Information Joe McCannon Dennis Wagner Centers for Medicare and Medicaid Services 7500 Security Blvd. Baltimore, MD

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