Telligen Making BIG Changes Attainable with Affinity Group Outreach June 3, 2016 1
Telligen QIN-QIO 2
For today Assess the landscape Evaluate how your projects align with affinity group interests Tell the story Learn how to present data to compel action Make it happen Identify, enlist and motivate your partners 3
SBAR Situation What s happening right now? What needs attention first? Back ground What s the context? What else happened to bring us to this point? Assessment From your perspective, what s the problem? What do you see happening? Recommendation What should happen next? 4
Situation - C Task Team Recruit 25 hospitals Follow for CAUTI, CLABSI, CDI Recruit 75% of Iowa nursing homes 330 nursing homes Overall improvement - Composite score, Antipsychotics Recruit 60% of Medicare population 276,636 Medicare beneficiaries Improve admission, readmission and community tenure rates AND New!! CDI in LTC Recruit 66 nursing homes to report into NHSN 5
Situation Recruit AND Maintain engagement AND Create sustainability AND Show improvement AND Staffing for C team Sheryl and Kate October 2015 added Kari 6
Background FTEs are limited Skill set Who is really good at what? Who is the best person to do the task? What kind of backgrounds does your team have? Scrum for daily work** Huddle at least 3x a week, more prn Schedules, what has been done, what needs to be done, what is holding up the work, PDSA review 7
Work space 8
Background Quality Improvement for everything QIO AND Use data to drive decisions Write PDSA, follow up, track RCA why didn t that work? Quality improvement for everything Different needs in different settings Don t need to be a subject matter expert in infection, readmission, nursing home just in QI 9
Assessment Efficient and Effective QI 101 for all How to collect data Using and understanding what you have Make it super easy PDSA and RCA Follow up and accountability Leadership and Organizing in Action principles 10
Recommendation how we did it for LTC Created affinity group for decreasing antipsychotics in LTC Used data to ID at risk performers QI 101 PDSA and RCA to dig into the problem Easy wins Follow up and follow through Success Stories and Barriers Many other affinity groups developing as a result UTI, unplanned transfers, pain, alarm reduction, corporations 11
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NNHQCC Evaluation Measures RIR antipsychotic long stay measure to current: Iowa Statewide = 15% Contract goal for July 2016 = 3% RIR composite score measure to current: Iowa Collaborative 8.01% Iowa Non-Collaborative = 3.01% National Collaborative = 2.90% 13
Recommendation how we did it - Communities Bridging the gap between ACO and LTC Used data to ID at risk performers QI 101 PDSA and RCA to dig into the problem Easy wins Follow up and follow through Success Stories and Barriers 14
Community Intervention 40.0% Percent of Reports without Orders (trend line added due to missing Sept data point) 35.0% 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% -5.0% Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16-10.0% 15
Recommendation how we did it - Hospitals Connecting Infection Prevention and Quality Improvment Used data to ID at risk performers QI 101 PDSA and RCA to dig into the problem Easy wins Follow up and follow through Success Stories and Barriers 16
Hospital Intervention 17
Recommendation how we did it - Stakeholders Nursing home trade associations Understanding what their goals are Hospital Engagement Network (HEN) Collaboration to avoid duplication Iowa Department of Public Health State Innovation Model (SIM) grants for communities 18
Recommendation how we did it Motivation Leave in action Everyone needs an action item or to-do every time Collect data There is always data to be collected Remember to share the data back with the group Meet regularly Quarterly meetings = 10 year improvement plan Monthly meetings = 1-2 year improvement plan Monthly meetings AND calls between = 90 or 100 day improvement plan 19
Recommendation how we did it Sustainment Creating a strong mission and vision statement Celebrate wins Share the story Shared leadership 20
What we learned - QIO Write your own PDSA and document on it regularly What went well, what didn t go well, any changes Relationships Team No one left behind Continuous communication Win together, lose together 21
What we learned Success stories are powerful! 22
What we learned Affinity Groups Need more family and resident/patient involvement Share the joy Use your super star staff to share the work Most problems can be solved through QI 23
** Scrum: The Art of Doing Twice the Work in Half the Time By Jeff Sutherland and JJ Sutherland 24
Contact Information Sheryl Marshall, RN, CDC QI Manager at Telligen Sheryl.marshall@area-d.hcqis.org 515-273-8844 25 This material was prepared by Telligen, the Medicare Quality Improvement Organization for Colorado, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 11SOW- IA-Cteam-05/2016-11647