Partnership for Patients Betsy Lee, RN, MSPH March 2, 2012

National Partnership for Patients National program launched on April 12, 2011 Focus on two aims by 2013:  Reduce hospital readmissions by 20%, and  Reduce hospital-acquired harm by 40% Up to $1 billion in funding for the program  Up to $500 million - Community-based Care Transitions Program (CCTP)  $218 million – all Hospital Engagement Networks  IHA funding through HRET subcontract –  Target dollars toward efforts that build sustainable capacity in Indiana

Preventing Harm – Categories Reducing Readmissions Adverse Drug Events Catheter Associated Urinary Tract Infections (CAUTI) Central Line Associated Blood Stream Infections (CLABSI) Surgical Site Infections (SSI) Ventilator-Associated Pneumonia (VAP) Harm from Falls and Immobility Pressure Ulcers Venous Thromboembolism (VTE) Obstetrical Adverse Events 3

Preliminary Needs Assessment Data – July 2011

Hospital Engagement Networks (HENs) HENs will coordinate training, assist with measurement, and provide technical assistance to hospitals 26 HECs awarded IHA included in the AHA/HRET proposal  33 state associations and nearly 2,000 hospitals will share strategies  Recognized by CMS for leadership in readmissions strategy  National experts for all content areas IHA will work with Purdue Healthcare TAP and Center for Medication Safety Advancement 5

Indiana/HRET HEN Summary 120 Indiana hospitals aligned with IHA/HRET Includes: –26 critical access hospitals –8 psychiatric hospitals –5 rehabilitation hospitals –4 long term acute hospitals Other HENs in Indiana include: Ascension, VHA, NAPH, UHC, Ohio Children’s Hospital collaborative, Joint Commission Resources 6

I HA’s Plan Design 7 HRET (Prime Contractor) IHA (Subcontractor) Direct and Shared Services Support: Coalitions and affinity groups Administrative/organizational support Local support and facilitation Technical Assistance: Purdue Healthcare TAP and CMSA Individual hospital plans/assessments Statewide coaching network Communities of Practice (Lean, etc) HRET National Education: Access to National Programs 4 groupings of 10 topics Plus HCAHPS,TeamSTEPPS (AHRQ funded activities) Fellowship Programs Stand-alone programs (Webinars educational sessions, etc) Learning networks Indiana Education: State and regional education: Needs assessment Tools training (Lean certification, medication safety, etc) Leadership for cultural improvement HRET Support: Measurement warehouse Best practice clearing house Access to national experts Partially defray data collection costs

Hospital Expectations Submit monthly data for one process and one outcome measure for each topic selected Encourage intensive engagement on 2-3 topics, and moderate topics on 3-4 over the 2-year period Participate in regional coalition, affinity group and statewide education and technical assistance For IHA/HRET: Send 1-2 staff to HRET Improvement Leader Fellowship program 8

Support for Hospitals HRET needs assessment Individual hospital plans Support for regional coalitions and affinity groups (e.g. critical access hospitals) National Improvement Leader Fellowship program Free access to national, state, and regional educational programs (face-to-face and virtual) Tools and training to build capacity – Lean, team training, culture of safety and leadership strategies Alignment with key stakeholders, including affiliated societies (APIC, InAHQ, IONE, ISHP, ISHRM), ISDH, Health Care Excel, IRHA, other provider associations, and other HENs for guidance on leveraging statewide resources and reducing duplication 9

HRET HEN Support Support for data collection. HRET recognizes that data collection is a burden and has allocated resources to help hospitals with particular needs to partially defray data collection costs. HRET will also leverage existing data collection processes, such as NHSN, where applicable 10

Proposed Affinity Groups Anticipated National Peer Categories –critical access hospitals –long term care hospitals –psychiatric hospitals Depending on the interest and numbers, IHA will create similar groupings 11

Indiana HEN Activities Statewide improvement activities around the highest level of need as defined by the needs assessment Development of a statewide “vanguard” network to support mentoring and coaching and share best practices as well as support innovation and implementation, and to link high performers to other hospitals in the state Regional and statewide support of culture, teamwork, and communications improvement as well as leadership for safety 12

Purdue University Resources Purdue University HealthcareTAP:  Regional Lean certification and training  Dissemination of knowledge at a local level  Lean Community of Practice Purdue Center for Medication Safety Advancement  Web-based medication safety continuing education  Best practice dissemination 13

14 Ten regional coalitions cover Indiana: only state in the country with this model Members agree not to compete on patient safety Envision layered model of regional coalitions and affinity groups – Indiana’s “transformation grid” to support dissemination Benefits: Innovate at the front lines Align with state and national efforts, and standardize when beneficial Model builds local and hospital- specific capacity for improvement and innovation Indiana Regional Patient Safety Coalitions

Next Steps – IHA HEN Finalize subcontract, action plan, and budget Design blend of technical assistance and educational programs based upon needs assessment for 10 topic areas - plus leadership, culture, teamwork, and global harm Synchronize Indiana plan with HRET offerings Complete subcontract with Purdue Healthcare TAP Create plan to optimize support for the regional patient safety coalitions and other affinity groups Hire staff Work with hospitals to design individual plans 15

Contacts Betsy Lee, RN, MSPH Director, Indiana Patient Safety Coalition Indiana Hospital Association Kathy Wallace Director of Performance Improvement Indiana Hospital Association

Questions?