2017 E3 Grant Program Webinar Dianne Radigan Vice President, Community Relations October 26, 2016

Webinar Logistics Please put your phone on mute until you are ready to talk. Please do not put your phone on hold. The presentation will be posted on our website after the October 26th call.

Agenda Logistics for the call Overview/goals for the webinar Very brief history of the E3 grants and Cardinal Health Foundation’s commitment to fostering excellence in healthcare and accelerating the rate of change Focus on outcomes and sharing Resources available Grant criteria Eligibility Content Scoring Tips Questions

Goals for the Webinar Help potential applicants send the very best proposal that is responsive and compelling Answer any and all questions Open the door for additional communication

Saving days, dollars and lives History of E3 Grants Goal: Provide resources to help hospitals, systems, clinics and collaboratives provide the very best care for patients – improve healthcare efficiency, effectiveness and excellence and save days, dollars and lives. To help accelerate the rate of change. Cardinal Health Foundation has invested $8.6m since 2008 for improvement projects Level of support: $7.5k-35K Areas of focus have narrowed each year. In 2017 the focus is: Patients with diabetes and multiple chronic diseases Best use of medications - especially in transitions to ‘home’ The spread of successful efforts To engage patients and their families Saving days, dollars and lives

E3 Outcomes 2013-2014 grantees Improving transitions to home for post-acute seniors Senior Independence, Toledo, Ohio At Senior Independence, registered nurses serve as transition coaches, and provide immediate and close follow-up to Medicare patients, post hospital discharge. Results: Reduced 30-day readmission rates to 4.3% (compared to regional average of 14%); 42 readmissions and 202 hospital days saved Senior Services of Southeastern Virginia, Norfolk, Virginia This Area Agency on Aging surrounds high-risk seniors with a care team that includes a certified transition coach, the hospital care coordination team and a pharmacist, ensuring coordinated transition of care and medication reconciliation. Results: Reduced 30-day readmissions from baseline of 19.6% to 6% 15 readmissions and 94 hospital days saved   Southwestern Indiana Regional Council on Aging, Inc, Evansville, Indiana Certified social workers serve as transition coaches for high-risk seniors who have chronic diseases, making in-home visits and follow-up phone calls to patients post discharge. Results: Reduced 30-day readmission rates from 20% to 14%; reduced 60-day readmissions from nearly 29% to 18%; 21 readmissions saved 32 hospital days saved;

E3 Outcomes 2013-2014 grantees Increasing medication safety for patients admitted from the ER Trinity Medical Center, Rock Island, Illinois Medication reconciliation nurses collect complete medication histories as soon as patients are admitted to the hospital from the emergency room. Results: Increased medication accuracy from 40% to 76%; prevented adverse drug events due to inaccurate medications for 209 patients.    Using the WHO Surgical Checklist NorthShore University Health System, Evanston, Illinois NorthShore integrated the WHO Surgical Safety Checklist into its existing electronic health record software, increasing overall compliance from 48% to 92%. Results: 32% decrease in perioperative risk events; 8 hospital days saved Virginia Mason Medical Center, Seattle, Washington A multi-disciplinary surgical team developed the rolling wrap-up, a post-surgical process to debrief before the patient leaves the operating room. Results: 24 hospital days saved.

E3 Outcomes 2013-2014 grantees Increasing medication safety for older adults Knute Nelson Foundation, Alexandria, Minnesota A medication safety program combines transition education, medication reconciliation and continuous, real-time monitoring of health conditions. Results: Decreased per-person medication count from 15 to 11; reduced 30-day readmissions from 25% to 19%; 49 hospital readmissions saved 655 hospital days saved   Increasing access for the under and uninsured West Virginia Health Right, Charleston, West Virginia This free clinic partnered with three area hospitals to provide a medical home for nearly 500 uninsured and underinsured patients. Results (for two years of grant funding): 38% reduction in hospitalizations; 67% decrease in ER use 32 readmissions and 213 hospital days saved

E3 outcomes 2013-2014 grantees Adding pharmacy services to a multi-disciplinary discharge team Franciscan St. Margaret Health-Hammond, Mishawaka, Indiana As part of a multi-disciplinary discharge team, the pharmacist provides medication counseling plus follow up within 72 hours of discharge. Results: Follow-up phone calls reduced readmission rates from 22% to 16% 1,813 hospital days saved Improving outcomes for high-risk chronically ill patients Trinity Medical Center, Rock Island, Illinois A continuity-of-care pharmacist service provides medication therapy management and customized interventions for chronically ill home care patients taking nine or more medications per month. Results: Improved patients’ ability to manage their medications from 47% to 58% reduced acute care hospitalizations from 19% to 15% 155 hospital days saved Trinitas Regional Medical Center, Elizabeth, New Jersey Pharmacists provide medication reconciliation and counseling, and address barriers to medication access for chronically ill elderly patients as they transition to home. Results: Reduced 30-day readmission from 18% to 14% 74 hospital days saved

Resources Available in 2017 Cardinal Health Foundation funding We anticipate 15-20 grants up to $35k Requests / budgets should not exceed $35k Please describe other sources of funding for additional project expenses Invitation to participate in a Leadership Development program Invitation to join a learning network and / or a convening of grantees over the course of the year Applications due December 9th

Grant Criteria - Eligibility Tax exempt 501(c)(3) organizations Typically, hospitals, systems, clinics, collaboratives, ambulatory settings Include letters of commitment for partner organizations Applicants can be in the acute or ambulatory setting If previously funded, a final report or update on work- in-process should be submitted

Grant Criteria - Content Very focused on three areas: Patients with diabetes or multiple chronic diseases Medication safety across transitions of care from the acute setting to the community/home. Engaging patients and their families in their care.

What to measure Baseline and post intervention for Process measures Lengths-of-stay Readmissions Patient clinical outcomes Also describe how learnings from this work will be shared

Grant Criteria - Scoring 0-5 points 0-80 points 0-15 points Cover letter Description of the program Previous experience Specific objectives Driver diagram Timeline Outcomes anticipated Letters of commitment for partner organizations Budget (no Cardinal Health products should be a part of the request)

Grant Criteria - Tips Limit the proposal to five pages not including the cover letter, budget, driver diagram and other graphics Focus on implementing best practices or spread of previously successful efforts Be very specific about Previous experience Baseline data Protocols Outcomes anticipated Include a driver diagram Include a timeline that addresses all aspects of the work including IRB approval, if needed Quantify anticipated outcomes in terms of days, dollars and lives potentially saved

Patient engagement resources Centers for Medicare and Medicaid Services (CMS) Partnership for Patients: https://partnershipforpatients.cms.gov CMS Transforming Clinical Practice Initiative: https://innovation.cms.gov/initiatives/Transforming-Clinical-Practices/ CMS Quality Improvement Organization-Quality Improvement Network Campaign for Meds Management: http://www.qioprogram.org/campaign-meds-management American Institute for Research: http://www.air.org/project/roadmap-guides-patient-and-family-engagement-healthcare Patient and Family Engagement in Healthcare: http://patientfamilyengagement.org/ Healthcare Information and Management Systems; Center for Patient and Family-Centered Care: http://www.himss.org/library/NEHC; http://www.himss.org/library/patient-engagement-toolkit Minnesota RARE (Reducing Avoidable Readmissions Effectively) Campaign: http://www.rarereadmissions.org

Additional Opportunity in 2017 American Society of Health-System Pharmacist and Cardinal Health Award for Excellence in Medication-Use Safety This award honors a pharmacist-led multidisciplinary team for its significant institution-wide system improvements related to medication-use. Three hospitals are recognized with the ‘winner’ receiving a $50,000 award and the two finalists a $10,000 award. Letter of intent due January 4, 2017 For award information and application materials, visit www.ashpfoundation.org/excellenceaward

Q&A

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