1. Nursing Home INTERACT Pilot Project Thomas P. Meehan, MD, MPH Chief Medical Officer Qualidigm

2. Progress in Decreasing Hospital Readmissions in Connecticut Medicare Public Reporting of Hospital Readmissions July 2009 Communities of Care Heart Failure Project February 2010 Last Month of 6-Month Rolling Average Greater New Haven Community-Based Care Transitions Project March 2012 All-Cause Readmissions Project February 2012 Connecticut Hospital Association – Hospital Engagement Network May 2012 Greater Hartford Community-Based Care Transitions Project August 2012 Medicare Readmissions Financial Penalties October 2012

3. Reasons to Develop Quality Improvement Programs in Nursing Homes Clinical integration – bundled payments Preferred provider networks Financial penalties Public reporting of outcomes Improve quality, safety, cost, and patient satisfaction Marketing opportunity

4. Qualidigm’s Nursing Home QI Pilot in the Middletown Community Recruit 14 NHs with ≥ 10% 30-day readmission rates Obtain leadership support in on-site visits Collect and analyze Needs Assessment data Train/assist staff on use of INTERACT data tracking tools Train/assist staff on QI process and use of other INTERACT tools Follow-up quarterly after six-month training period (January – June, 2014)

5. Progress as of May, 2014 Leadership meeting/commitment to QI pilot – completed at six NHs Needs Assessment data collection and analysis– completed at six NHs Training and assistance on use of INTERACT data tracking tools – completed at seven NHs Training and assistance on QI and INTERACT tools, e.g. SBAR, Stop and Watch – ongoing at six NHs

6. 30-Day All Cause Nursing Home Readmission Rates

7. Lessons Learned Barriers to Success – Lack of previous QI experience and infrastructure – Inadequate resources – Staff turnover Facilitators of Success – Leadership commitment to quality improvement – Sequential implementation of INTERACT tools