Advancing Quality & Improving Care: Getting to the Results that Matter. Shantanu Agrawal, MD, MPhil October 9, 2018
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1 Advancing Quality & Improving Care: Getting to the Results that Matter Shantanu Agrawal, MD, MPhil October 9, 2018
2 Results with National Impact Lives saved Drop in early elective delivery rates Reduction in central line infections million fewer harms Decrease in surgical site infections Reduction in rate of 30-day readmissions of Medicare patients 2
3 Evolving Measurement Improving Care on the Frontlines Achieving Health Equity
4 NQF Evolving Measurement Emerging Quality Areas Quality Gaps Measure Development Best Scientific Measures Strategic Blueprints Measure Incubator Endorsement Prioritization Feedback
5 Emerging Quality Areas Diagnostic quality and safety Telehealth NQF provides strategic blueprints national guidance on key health Interoperability issues to map a path forward to improve care in areas with major measurement gaps or lack of clarity. Trauma Outcomes Chief-Complaint Ambulatory care Healthcare System Readiness 5
6 Trauma Outcomes Fourth leading cause of death and $56.7 billion in costs (2012) Unique challenges to measurement Strategic Blueprint Reviews existing quality measures Identify gaps and address challenges Accountability, risk adjustment, attribution Completion Spring
7 Chief Complaint One-quarter of acute care visits in ED Measurement focused on discharge diagnosis Strategic Blueprint Reviews existing quality measures Identify gaps and address challenges Data sources and standard language Completion
8 Healthcare System Readiness Wide variation in preparedness capabilities Few measures to assess healthcare system readiness Strategic Blueprint Reviews existing quality measures Identify gaps and areas for measure development Completion Summer
9 Measure Innovation: NQF Measure Incubator TM All NQF Measure Incubator TM projects include patients - key contributors to understanding gaps and priorities. 9
10 NQF Measure Prioritization Criteria Prioritization Phase 1 Prioritization Phase 2 Outcome-focused (25%) Outcome measures and measures with strong link to improved outcomes and costs Improvable (25%) Measures with demonstrated need for improvement and evidence-based strategies for doing so Equity Focused Measures that are disparities sensitive Meaningful to patients and caregivers (25%) Person-centered measures with meaningful and understandable results for patients and caregivers Support systemic and integrated view of care (25%) Measures that reflect care that spans settings, providers, and time to ensure that care is improving within and across systems of care 10
11 Evolving Measurement NQF + IHA developing a benchmarking framework for California ACOs, which could serve as a national model 11
12 Translating Quality Measurement knowledge to the Bedside 12
13 Measurement Feedback Engage with advisory group and partners Synthesize and share feedback Develop methods to optimize and scale measurement feedback efforts Identify incentives to get frontline feedback Integrate measurement feedback into NQF processes 13
14 National Quality Partners Playbook : Antibiotic Stewardship in Post-Acute & Long-Term Care An essential tool for post-acute and long-term care facilities seeking to implement, improve, and sustain antibiotic stewardship programs Can assist facilities in complying with the new CMS CoPs related to infection prevention and control Includes concrete implementation strategies, solutions, and practical tools and resources
15 National Quality Partners Playbook : Shared Decision Making (SDM) in Healthcare Patient/consumers part of Action Team Aims to make shared decision making the standard of care for all patients Provides essential guidance to implement and strengthen SDM Highlights practical solutions to common barriers to SDM in clinical practice Includes snapshots that highlight success stories and key resources 15
16 National Quality Partners Playbook : Opioid Stewardship Patient/consumers part of Action Team Provides essential guidance for healthcare organizations and clinicians across care settings committed to opioid stewardship Includes concrete examples and tactics for implementation, barriers and corresponding solutions, and practical tools and resources Identifies important drivers of change that can impact and advance opioid stewardship 16
17 New National Quality Partners Initiatives SERIOUS MENTAL ILLNESS DATA INTEGRATION OF SOCIAL DETERMINANTS OF HEALTH The SMI Action Team, which includes 35 NQFmember organizations from all healthcare sectors, Statements of Interest to participate on the Data Integration Action Team Open Now through November 2 17
18 Achieving Health Equity Identify Disparities and At-Risk Populations Influence Performance Measurement Inspire Implementation Best Practices Inform Payment 18
19 Food Insecurity and Housing Stability 19
20 Connect With #SupportNQF
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