ECU Teacher s in Quality Academy Vidant Health Quality Program Learning Session 1 March 24, 2014
Objectives 1. Describe organizational approach to patient safety/quality improvement at Vidant Health and Vidant Medical Center 2. Understand how approach is aligned with the national quality strategy 3. Describe critical success factors and outcomes in the VH and VMC quality journey 4. List current and planned quality initiatives at VH and VMC 1
A little history 2
A system perfectly designed to achieve 3
Our playbook 4
Quality definition Safe Timely Efficient Effective Equitable Patient Centered IOM 2000 5
Quality Vision Zero events of preventable harm and exceptional experiences for every patient, every time across Vidant Health 6
What it takes to Improve Will to change the current system Strong positive leadership and a realistic appraisal of the resources and barriers Ideas about changes that will improve the system And a theory that links changes to outcomes Execution of the ideas And a way to distinguish successful from unsuccessful changes 7
Performance Improvement Methods 8
Go Transparent 9
Storytelling 10
Channel Leadership Attention 11
Oversee Execution 12
Engage the Front Line 13
Involve Patients and Families
OUTCOMES 62% REDUCTION IN HAI SINCE 2008 99% OPTIMAL CARE ON CORE MEASURES FOR ALL 9HOSPITALS COMBINED (UP 20 PERCENTAGE POINTS SINCE 2007) FINANCIAL IMPACT IN FY 12 = $1,811,650 SYSTEM-WIDE HCAHPS PATIENT EXPERIENCE AT TOP TWENTY PERCENT 15
Critical success factors Transparency Engaging front line Putting a face on the numbers Engaging patients-families Leadership accountability Board oversight 16
Current quality priorities Harmful event reduction Optimal care Patient experience Readmission reduction Mortality reduction 17
Specific Projects Discussion of projects at VMC 18
Physician Engagement How do you get involved? 19
Vidant Health Quality Model Excellence Patient/Family Experience Patient Employee Physician Partnerships with patients, families, physicians, and staff Care transitions Performance Improvement Leading practices Publicly reported measures Peer review Mortality Reliability Safety Regulatory compliance Harmful Events Safety culture Infections National patient safety goals 20 FY 2013
Evolving quality agenda
The Financial Imperative Medicare Payment Reform Program Annual Payment Update Value Based Purchasing Readmission Reduction Revenue Impact to Vidant Health (millions) 2014 2015 2016 2017 2018 11.3 14.9 18.7 24.3 30.8 2.5 3.0 3.5 4.1 4.1 1.4 4.8 5.6 5.6 6.3 Meaningful Use 10.3 5.9 4.8 5.6 2.8 TOTAL 25.5 28.6 32.6 39.6 44 22
Impact of System Growth Vidant Health 2006 Vidant Roanoke Chowan Vidant Edgecombe Vidant Bertie Vidant Chowan Outer Banks Vidant Medical Center Vidant Health Hospital
Impact of System Growth Vidant Health 2014 24
Impact of Health Reform Legislation 25
National Quality Strategy Better Care Healthy People and Communities Affordable Care 26
Better Care National Quality Strategy Vidant Health Quality Strategy Healthy People and Communities Affordable Care Establish safety as a core value Manage transitions Apply leadership methods Engage physicians Engage in meaningful partnerships across boundaries Enhance education & build health literacy Transform primary care Reduce variation in care Eliminate waste Develop care coordination methods 27
Vidant Health Quality Model National Quality Strategy Vidant Health Quality Strategy Better Care Healthy People and Communities Affordable Care Establish safety as a core value Manage transitions Apply leadership methods Engage physicians Engage in meaningful partnerships across boundaries Enhance education and build health literacy Transform primary care Reduce variation in care Eliminate waste Develop care coordination methods Core Strategies: Reliable Design/Continuous Readiness, Just Culture, Transparency, Patient Engagement, Disciplined use of PI Methods 28
A Day in the Life of Vidant Health 196 acute care admissions 7 medical air transports 136 surgeries 21 babies born 118 critical care patient 822 ED visits 1,377 outpatient visits 2,000 VMG practice visits 184 patients with central lines 78 patients on ventilators 144 patients with urinary catheters 29
Future Directions Highly reliable care Perfecting handover of patients from one setting to another Improving quality in the ambulatory setting Leveraging what we have learned in the hospital setting 30
ECU Teacher s in Quality Academy Vidant Health Quality Program Learning Session 1 March 24, 2014