2013 Hen Wrap up 2014 Quality Preview

All Hospital Engagement Network’s goal: To Reduce Hospital Acquired Conditions by 40% and reduce preventable readmissions by 20% by January 1, 2014.

ASHNHA Quality Review AHA HEN began in earnest May 2012 Combination of HEN and State Flex Funding supported all Quality-related activities Over 40 people traveled to the Improvement Leadership Fellowship and Improvement Collaboratives Mentors for Quality Program began Hosted Weekly calls on a variety of Quality-related topics Three Statewide meetings: Oct 3, 2012 HEN Kick-Off March 5,6 Quality Summit Dec 5, Quality Collaborative

Mentors for Quality

Review of past 22 months Partnered with state to support NHSN Training and travel to the APIC Conference for 14 participants Falls Prevention Expert, Dr. Pat Quigley, visited 13 hospitals/LTC Lean Training, funded by FLEX, provided to 5 member hospitals Three full days of training for 3 participants from each hospital One full day training on site for 15-20 participants at each hospital

Working Together to Prevent Falls

Data Reporting Success Eleven hospitals reporting on 6 or more quality topics Falls CLABSI CAUTI Pressure Ulcers Surgical Site Infections Early Elective Deliveries One hospital reporting on ALL 11 topics

Data Challenges Different hospitals used different measure definitions Not everyone began at the same time HRET defines the first data point as “baseline” when there is not more than 12 data points(months) Data is not validated Small numbers

Let’s run the numbers

Reducing Early Elective Deliveries Success to last a lifetime Combined Alaska Percentage 6+ Months Since the Last EED! Participating Hospitals: ANMC, Bartlett, Fairbanks Memorial, Mt. Edgecumbe, PeaceHealth, South Peninsula, Sitka Community Hospital and Yukon-Kuskokwim Health Center

Preventing Pressure Ulcers Stage 1 or Higher 1968 Discharges from 4 hospitals = 1 patient discharge = 1 patient with an ulcer Participating Hospitals: Cordova, Maniilaq, Sitka, Yukon-Kuskokwim

Preventing CLABSI All Tracked Units, by Device Days 3 Hospitals had no CLABSIs! Alaska Rate Rate/1000 Device Days HEN Rate Alaskan Hospitals 4 AK Hospitals’ Average Performance Outpaced the HEN’s Average Rate of CLABSI HEN Participating Hospitals: ANMC, Bartlett, Central Peninsula, Fairbanks, Memorial, Mt. Edgecumbe, PeaceHealth, South Peninsula

Preventing CLABSI Rate / 1000 Discharges = 1 patient discharge 1161 Discharges from 5 hospitals – No CLABSI Participating Hospitals: Cordova, Maniilaq, Sitka, Petersburg, Yukon-Kuskokwim

Preventing CAUTI All Tracked Units, by Catheter Days 2 Hospitals had no CAUTI! Rate per 1000 Urinary Catheter Days Alaska Rate HEN Rate 2 AK Hospitals’ Average Performance Outpaced the HEN’s Alaskan Hospitals Average Rate of CAUTI HEN Participating Hospitals: ANMC, Bartlett, Central Peninsula, Fairbanks Memorial, Mt. Edgecumbe, PeaceHealth, South Peninsula

Falls and Injury Prevention Falls By Discharges Individual Hospital Rates Cumulative Rate of Falls Alaska Rate Absolute Values of Falls for All Hospitals Participating Hospitals: Cordova, Maniilaq, Petersburg, Sitka, Yukon-Kuskokwim

Falls and Injury Prevention Rate of Falls, With or Without Injury Alaska Rate and trend line Rate/ 1000 Patient Days HEN Rate Participating Hospitals: ANMC, Central Peninsula, Fairbanks Memorial, PeaceHealth, South Peninsula

Falls and Injury Prevention Rate of Falls, With or Without Injury Rate/ 1000 Patient Days Participating Hospitals: ANMC, Central Peninsula, Fairbanks Memorial, PeaceHealth, South Peninsula

The results are a call to action!

Looking Ahead: Increased quality reporting demands Increased consumer pressure for quality transparency Increased government “involvement” in quality /transparency/payment/clinical practice Increased Payor push for payment reform

ASHNHA Quality Strategy

Offensive or Defensive?

Who’s got the ball?

ASHNHAQuality Strategy

Data ASHNHA members walk the talk of Quality Transparency ASHNHA members have control over data ASHNHA members have collective ability to respond to public, state ASHNHA members have ability to benchmark against state and national benchmarks Relatively non-competitive market allows a “raise all boats” mentality

2014 ASHNHA Quality ASHNHA Partnership for Patients(PfP) an invitation to all members ASHNHA Partnership for Patients(PfP) Statewide QI Effort Guided by Nat’l PfP effort Statewide direction by PfP Advisory Group Reporting Data to ASHNHA on 10 Topics To focus on streamlining data collection

Future ASHNHA Response Hospitals--working together to improve care in Alaska!