© Copyright 2012, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. October 15, E 3 Grant Program Webinar Dianne Radigan Vice President, Community Relations

© Copyright 2012, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. 2 Webinar Logistics Please put your phone on mute until you are ready to talk. Please do not put your phone on hold. If you need assistance during the conference, press # for a list of menu options.

© Copyright 2012, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. 3 Agenda Logistics for the call Overview/goals for the webinar Very brief history of the E 3 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

© Copyright 2012, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. 4 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

© Copyright 2012, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. 5 History of E 3 Patient Safety 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. $8m since 2008 for improvement projects Level of support: $7.5k-50K Areas of focus have narrowed each year Medication use in transitions to ‘home’ Spread of successful efforts Engaging patients and their families Saving days, dollars and lives

© Copyright 2012, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. 6 E 3 Outcomes Antelope Memorial Hospital decreased medication error rates by 50%, and near miss rate by 52% implementing electronic medical records, Pyxis dispensing systems, medication reconciliation, and computerized physician order entry. Centrastate Medical Center demonstrated a 60% reduction in nursing interruptions by wearing white vests reading "Please do not interrupt while passing medications", leading to potential avoidance of medication administration errors. Christian Hospital Northeast addressed antibiotic therapy and resulted in a savings of $148k. Cleveland Clinic Foundation implemented video technology education in their anticoagulation clinic and saved $44,400/year / 100 new patients / month. Clovis Community Medical Center utilized a pharmacy technician for medication reconciliation and demonstrated dramatic increases in the number of complete home medication regimens documented and also improved physician and pharmacist confidence in the accuracy of home medication lists. El Rio Community Health Center pharmacists were provided patient diagnosis information during review of electronic prescription orders, leading to identification of 52 prescribing problems in 9 days with 7 significant interventions made. FirstHealth Moor Regional Hospital Scripted hourly rounding, decreased the use of nursing call bell usage, decreased the number of patient falls, and increased patient satisfaction scores. Forsyth Medical Center Foundation implemented a medication reconciliation project and reduced 30 and 60-day readmission by 9.7 and 15.8% saving $363k. HealthAlliance of the Hudson Valley used risk reduction strategies that lead to zero wrong-site surgeries or incorrect invasive procedures performed in the last two years through the performance of Failure Modes and Effects Analysis and the use of Six Sigma – Lean. Health Care Improvement Foundation hospitals and the Institute for Safe Medication Practices initiated interventions to reduce medication errors involving hydromorphone resulting in an estimated cost savings ranging from $82,708 for significant ADEs to $235,364 for life-threatening ADEs. Holy Spirit Health System decreased operating room turnover time between surgeries by 53% (from 32 to 17 minutes) resulting in a cost savings of $1,394,280. Inova Health Care Services implemented MRSA presurgery screening and reports saving between $ k Kansas University implemented pharmacist discharge planning and reduced readmission from 26% to 16.2%. Lahey Clinic reduced related CHF readmissions by 25% in one year, due in part to improving communications with patients and families, and focusing on medications at discharge. Lee Memorial implemented an asthma mgt. program and reports reducing ED visits 86% and loss of days of school or work by 64%.

© Copyright 2012, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. 7 E 3 Outcomes Maine Memorial reports a savings of $100k after implementing a standardized discharge planning and med. rec. process. Memorial Sloan-Kettering Cancer Center participants who received a communication-based intervention reported increased self-efficacy related to communicating patient safety concerns, and improved their scores in the communication domain of the AHRQ Patient Safety Culture Survey. Nationwide Children’s Hospital prevented 427 harmful adverse drug events and avoided $2,000,053 in unnecessary hospital costs in its critical care units since February 2010 via implementation of medication reconciliation, infusion pump programming, and independent double checks. National Coalition for Cancer Survivorship trained over 150 health care professionals about oral adherence, barriers, motivational interviewing and other best practices leading to improved oral chemotherapy monitoring. Niagara Falls Memorial Medical Center’s Bedside Medication Administration system reduced medication errors by 57% in 2011 and has continued to decrease by 27% in 2012 with an estimated savings of $102.5k. Rhode Island Hospital studied error rates of surgical site- marking in the operating room and found there would be less opportunity for error when compared to pre-op site-marking. Rush University Medical Center identified hospital patients at high risk for readmission and intervened with medication management and psychosocial counseling, leading to decreased readmission rates and savings of $50,000. Saint Alphonsus Family Maternity Center paired TeamSTEPPS® with scripted simulation exercises to train C- section surgical team members in a universal communications platform, increasing understanding of Universal Protocol by 35%, and advancing patient safety in the OB OR by supporting previously unacquainted clinicians to serve as “interchangeable” members of a Universal Surgical Team. Scripps Health implemented system-wide glycemic controls and reports saving $2m from reduced lengths of stay. Suburban Hospital addressed and tracked the effectiveness of medication processes throughout the inpatient stay as well as medication reconciliation at discharge, before the transition to a long term care facility The Wellmont Foundation implemented a pharmacy technician-based medication reconciliation program at Bristol Regional Medical Center that demonstrated a direct cost savings due to labor cost and efficiency ($59,900 per year). Pharmacy technicians performed more accurate medication reconciliation than nurses and more accurately reconciled home medications (finding more than 4,200 medication variances). Wayne State University introduced Electronic Medication Alert Systems for computerized physician order entries in a pediatric emergency department, leading to an overall reduction rate per 100 prescriptions and made changes to 19.5% of the prescriptions that generated a drug range checking alert, preventing harm from reaching the patient. 9.7 and 15.8% saving $363k.

© Copyright 2012, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. 8 Focus on Sharing Examples of publications / presentations Nationwide Children’s presented on formula prep for children with severe medical needs at the Pediatric Nutrition Managers Conference. Healthcare Improvement Foundation published “The costs of adverse drug events in community hospitals.” Joint Commission journal on quality and patient safety Inova Health presented at numerous venues including Seventh Annual Sigma Theta Tau meeting, Washington Regional Nursing Research Consortium and IHI’s Annual Forum Pasadena Hospital Assoc. presented at the Nat’l Assoc. of Neonatal Nurses St. John Hospital presented at APIC and ICAAC (Interscience Conf. for Antimicrobial Agents and Chemotherapy CDC website – Barnes Christian NE for antimicrobial stewardship Joint Comm. Journal on Quality and Safety – Univ. of New Mexico Piedmont Hospital presented and published at the Society of Hospitalist Medicine and Visiting Nurse Health Systems Wayne State University presented as a poster at the Pediatric Academic Societies Meeting in Boston, May 2012

© Copyright 2012, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. 9 Resources Available in 2016 $1M from the Cardinal Health Foundation A major change in 2016 is to invite multi-year grants We anticipate grants up to $50k per year for up to three years –Requests / budgets should not exceed $50k –Please describe source of funding for additional project expenses Invitation to join a learning network and / or a convening of grantees over the course of the one to three years of the effort

© Copyright 2012, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. 10 Grant Criteria - Eligibility Tax exempt 501(c)(3) organizations Typically, hospitals, systems, clinics, collaboratives, ambulatory settings –Include letters of commitment for any 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

© Copyright 2012, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. 11 Grant Criteria - Content Very focused on three areas: Medication safety across transitions of care from the acute setting to the community/home. Spreading previously successful work within an institution to other settings – to an entire system, community or state. Engaging patients and their families in their care.

© Copyright 2012, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. 12 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 (not included in 5 page limit) Budget (no Cardinal Health products should be a part of the request)

© Copyright 2012, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. 13 Grant Criteria - Tips Focus on implementing best practices or spread of previously successful efforts Be very specific about –Previous experience –Baseline data –Protocols –Outcomes anticipated 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

© Copyright 2012, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. 14 Additional Opportunity in 2015 American Society of Health-System Pharmacist and Cardinal Health Medication-Use Safety Award –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 December 11, 2015 For more information

© Copyright 2012, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. 15 Q&AQ&A

© Copyright 2012, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. 16 Thank you!