Reducing the Days Children Spend in the Hospital Tableau Data Tool May 2018 Learning Session

Background… The Inpatient Bed Day Disparity Reduction Team is working to understand the root causes of disparities across conditions so as to reduce the number of days children spend in the hospital. Our Mission… In-community work/SDH Chronic disease work Balanced focus between chronic conditions managed at least in part by the health system & in-community/social determinants Our Approach… Our Tools… How we are using Tableau Data Analytics to help us reach our goals

Inpatient Bed Day Disparity Reduction Key Driver Diagram   Project Leader(s):  Andy Beck, MD and Kristy Anderson, LISW-S Revision Date:  04/10/2018 Global Aim Key Drivers Interventions Measures Cincinnati’s children the healthiest in the nation through strong community partnerships Chronic diseases are well controlled (i.e. preventable morbidity is prevented) CHW-driven outreach Community-based “touches” Child HeLP referrals ACT scores 3 month med supplies Readmissions Condition-based disparities Divisions activated Clinics activated Transition bundle adherence Preventive care adherence Asthma standardization FY18 SMART Aim Easy for families to receive the right care in the right place To reduce the inpatient bed day rate by 7% from 99.9 to 93 per 1000 children by 06/30/2018 Transitions of care Proactive supports assist families remove barriers to health (i.e. action on the social determinants of health) Work across divisions\conditions (e.g. diabetes, sickle cell, epilepsy, dental, outpatient pharmacy) Democratized, transparent data FY20 SMART Aim Standardized approach to clinical decision making that can be adjusted to patient and family needs To reduce the inpatient bed day rate by 10%, from 99.9 to 90 per 1,000 children by 6/30/2020 In-community care provision Daycare infection prevention Entire health system and community is activated to achieve equity Population Standardization of admission decision making (ED, elective surgery) Children aged 0 -17 years living in Avondale, Lower Price Hill, and East Price Hill Potential intervention Active intervention Adopted/Abandoned intervention Legend

Ability to connect patient’s address changes with admissions Using Tableau to Inform our Thinking This chart helps us understand the medical and social journey for a specific patient Ability to connect patient’s address changes with admissions

Comparisons This chart breaks down number of bed days for specific admitting diagnosis for a neighborhood with comparison to Hamilton County.

One possible are of focus How Data Drives Strategy For children admitted to the hospital per neighborhood, this map lets us see where they are living down to the street level. This shows us how many days the children in this neighborhood are spending in the hospital and for what reason One possible are of focus

Measures and Results

Kristy Anderson, LISW-S Contacts Thank you! We welcome any questions or further discussion… Andy Beck, MD Kristy Anderson, LISW-S Stuart Taylor Andrew.Beck1@cchmc.org Kristy.Anderson@cchmc.org Stuart.Taylor@cchmc.org General Pediatrics Clinical Manager Data Analyst