Strategy for Quality Improvement in Health Care
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1 Strategy for Quality Improvement in Health Care Neal D. Kohatsu, MD, MPH, DHCS Medical Director Desiree Backman, DrPH, RD, UC Davis Institute for Population Heath Improvement & DHCS Chief Prevention Officer August 2012
2 What s Driving the DHCS Quality Strategy? 2
3 National Quality Strategy The National Quality Strategy s goal is to build a consensus so that stakeholders can align their quality efforts for maximum results. The strategy serves as a national framework for quality measurement, measure development, and analysis. 3
4 Three Aims Better Care Healthy People/Healthy Communities Affordable Care Six Priorities National Quality Strategy 1. Making care safer by reducing harm caused in the delivery of care. 2. Ensuring that each person and family are engaged as partners in their care. 3. Promoting effective communication and coordination of care. 4. Promoting the most effective prevention and treatment practices for the leading causes of mortality, starting with cardiovascular disease. 5. Working with communities to promote wide use of best practices to enable healthy living. 6. Making quality care more affordable for individuals, families, employers, and governments by developing and spreading new health care delivery models. 4
5 National Quality Strategy 2012 National Initiatives Identified in the National Quality Strategy Partnership for Patients Million Hearts Initiative Community Transformation Grants CMS Innovation Center Other 5
6 Health Care Culture Change OLD Process Measures Cost Fee-For-Service Unit Approach Silos Reactive Individual Budget Provider-Focused NEW Outcomes Value Capitated Systems Approach Matrix Innovative Team Quality Member-Focused 6
7 Other Drivers Commitment to eliminating overuse, ineffective services, and avoidable complications, and providing safe, effective care Medicaid 1115 Waiver, the Bridge to Reform Patient Protection and Affordable Care Act 7
8 Components of the DHCS Quality Strategy 8
9 Three Linked Goals Improve the health of all Californians Enhance quality, including the patient care experience, in all DHCS programs Reduce the Department s per capita health care program costs 9
10 Polling Question To what extent do you support the three linked goals? Strongly Support Somewhat Support No Opinion Somewhat Disagree Strongly Disagree 10
11 Seven Priorities 11
12 Improve Patient Safety 12
13 Improve Patient Safety California Children s Services Neonatal Quality Improvement Initiative Aim: To reduce the Collaborative s central lineassociated blood stream infection rate by another 25% among participating neonatal intensive care units 13
14 Deliver Effective, Efficient, Affordable Care 14
15 Deliver Effective, Efficient, Affordable Care Integrate care for dual eligible (Medicare and Medi-Cal) individuals Test person-centered delivery models that integrate the full range of acute, behavioral health, and long-term services Maximize the ability of dually eligible individuals to remain in their homes and communities with appropriate services in lieu of institutional care 15
16 Engage Persons and Families in Their Health 16
17 Engage Persons and Families in Their Health In collaboration with partners, leverage social media and other community outreach tools to: Enhance transparency Engage members Connect members to health promotion resources in their communities Foster health-promoting social networks 17
18 Enhance Communication & Coordination of Care 18
19 Enhance Communication & Coordination of Care Increase adoption of Electronic Health Records (EHR) Goal by 2015: 90% of Medi-Cal providers eligible for incentive payments will have adopted EHRs for meaningful use in their practices Expected outcomes Improved care coordination Greater member engagement Population health improvement 19
20 Advance Prevention 20
21 Advance Prevention Medi-Cal Incentive to Quit Smoking Project $10 million/5-year project Testing the use of incentives to encourage Medi-Cal members to quit smoking Partnering with the California Smokers Helpline to provide counseling services and incentive delivery 21
22 Advance Prevention Policy Change + Systems Change + Quality Improvement = Lower Smoking Prevalence Reduced Health Care Costs Improved Population Health *Policy and systems change recommendations are based on the US Public Health Service, Clinical Practice Guidelines: Treating Tobacco Use and Dependence, 2008 Update. 22
23 Foster Healthy Communities 23
24 Foster Healthy Communities Improve population health by enhancing the link between health care and population health promotion Continue to strengthen collaborative efforts with the California Department of Public Health Established an Interagency Agreement with the Institute for Population Health Improvement at the UC Davis Health System 24
25 Eliminate Health Disparities 25
26 Eliminate Health Disparities Partner with the newly created Office of Health Equity at the California Department of Public Health and others to reduce and ultimately eliminate health disparities 26
27 Polling Question To what extent do you support the seven priorities? Strongly Support Somewhat Support No Opinion Somewhat Disagree Strongly Disagree 27
28 Guiding Principles 28
29 Guiding Principles Person-centeredness and family engagement are central to high-quality care Science provides the foundation for policy 29
30 Guiding Principles Integration and coordination of services and systems within the Department and among its partners will accelerate Policy, interventions, and new innovations are designed and implemented with substantive stakeholder engagement and collaboration 30
31 Guiding Principles Ongoing evaluation and updates of the Quality Strategy represent a commitment to strive for the highest quality and best possible outcomes 31
32 Polling Question To what extent do you support the guiding principles? Strongly Support Somewhat Support No Opinion Somewhat Disagree Strongly Disagree 32
33 Vision 33
34 34
35 35
36 UC Davis Health System Institute for Population Health Improvement 36
37 Next Steps for the Quality Strategy Receive stakeholder input Webinar Stakeholder survey Analyze input and revise the Quality Strategy Complete the DHCS quality improvement inventory Develop an implementation plan 37
38 Member-Focused, High-Quality Care 38
39 Questions & Answers 39
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