1. MHA: Strategic Quality What’s Up Wednesday | Lunch and Learn Your clinical quality, process improvement resource

2. What is this about?  MHA’s Strategic Quality Initiatives  Review 2012-2014 Hospital Engagement Network performance  Preview 2015 Missouri preferred measures  Foundation for future work  HIDI  Quality Collections  Analytic Advantage+  Upcoming Events

3. MHA:SQI - Who are we? Leslie Porth, PhD-C, MPH, R.N. Division Vice President for Strategic Quality Improvement Triple Aim Population Health Oversight of division (Quality Improvement, Quality Works, Emergency Preparedness) MONL Alison Williams, R.N., BSN, MBA-HCM Vice President of Clinical Quality Improvement Clinical quality SME Oversight of Quality Improvement Grant management Collaboratives management MONL MOAHQ Dana Downing, B.S., MBA-H, CPHQ Director of Quality Program Development Patient and family engagement National quality measures Quality outcome transparency Electronic clinical quality measures MBQIP grant lead MOAHQ Jessica Rowden, R.N., BSN, MHA Clinical Quality Improvement Manager Clinical quality SME Data management and analytics HEN/AHRQ grant projects TeamSTEPPS Host of WUW|LNL MOAHQ MONL Cheryl Eads Executive Assistant of Quality Improvement Provides support to the SQI team Coordinates webinars, conference calls and meetings Distributes correspondence and communication Assists in maintaining reports Lporth@mhanet.com 573/893-3700x1305 Awilliams@mhanet.com 573/893-3700x1326 Ddowning@mhanet.com 573/893-3700x1314 Jrowden@mhanet.com 573/893-3700x1391 Ceads@mhanet.com 573/893-3700x1382

4. MHA:SQI - What do we do?  Research, develop, and promote a focused strategy to reduce variation and improve care.  Together we lead the efforts in every Missouri community for better health, better care, and lower costs. Value Added Member Benefits Include: 1:1 quality and process consultation Networking platform Data management and analytics Best practice portal

5. MHA:SQI - Where are we?  Physically: offices based in Jefferson City  Virtually: http://web.mhanet.com/strategic-quality/http://web.mhanet.com/strategic-quality/  New Webspace where you can learn about – MHA SQI – News worthy items – Upcoming events and registration links – List of partners – Pool of resources  Trajectories – Triple Aim publication available first Wednesday of the month

6. 2012-2014 Hospital Engagement Network Performance  CMS Partnership for Patients Grant  3,700 hospitals participating  26 National HENs: AHA/HRET, Premier, Ascension, eHEN, UHC, Childrens, etc.  AHA/HRET HEN – MHA was one of 31 State Hospital Association HENs – Ninety-three hospitals in Missouri were part of our cohort  P4P Grant sunset on December 8, 2014  Quality improvement work continues

7. 2012-2014 Hospital Engagement Network Performance  MO-40/20 Achievement in 6 Topics

8. 2012-2014 Hospital Engagement Network Performance Missouri HEN 1.0 Estimated Cost Savings Source: Methodology and average costs provided through HRET; n=93 Adverse event Percent Improvement (Goal 40 percent) # harms preventedAverage cost/harmCost savings ADE (adverse drug events) 15%-489$3,000($1,467,000) Birth Trauma61%-24$920($22,080) CAUTI (urinary tract infection) 2%-202$1,000($202,000) CLABSI (central line infection) 100%2$17,000$34,000 EED (early elective deliveries) 64%291$7,875 for 9.96% cases$228,246 Falls with Injury28%434$663$287,742 Readmissions7% (goal 20%)8,923$10,100$90,122,300 SSI (surgical site infection) 50%160$21,000$3,360,000 Stage III/IV Pressure Ulcer 62%11$40,500$445,500 VAP (ventilator pneumonia) 0%-8$21,000($168,000) VTE (blood clot)45%-38$22,240($845,120) Total9,060 $ 91,773,588

9. MHA:SQI Guiding force  Strategic Quality Advisory Committee  Comprised of 22 Missouri CEOs, CMOs, CNOs, QD  Provides feedback and direction for quality improvement strategies  Meet quarterly  Quality Taskforce Workgroups  Recruitment is in process  Readmission/Care Coordination & Clinical Excellence  Quality director and front line engagement focused

10. 2015 Missouri Preferred Measures

11. Topic Analysis: Measure Selection Quality of measure Validity – NQF endorsed Reliability – defined numerator and denominator HEN, eCQM, ACO Claims data to reduce hospital burden Financial implications Regulatory impact Value-based purchasing Readmission reduction Harm – HAC Ability to improve Variation across state Variation from goal Population health Align with CHNA Impact through continuum Care transitions Broader importance Upstream – advocacy Downstream – consumers Hospital Compare

12. Foundation for future quality work  High reliability organization principles  Triple Aim framework  Safety across the board  Transparency  Patient and Family Engagement  Immersion/Pilot Projects  HEN 2.0

13. 2015 and beyond: HRO  High Reliability Organizations  Principles of an HRO  Healthy preoccupation with failure  Reluctance to simplify  Sensitivity to operations  Commitment to resilience  Deference to expertise

14. 2015 and Beyond: 3A  Adopt the Triple Aim Framework  Better care, better health, lower cost  Implement strategies to  Coordinate care across the continuum  Integrate prevention, preparedness and population health  Engage new partnerships  Physicians  Provider organizations  External stakeholders  Utilize  Evidence-based approaches  Data to analyze, guide and evaluate

15. 2015 and beyond: SAB  Safety = top priority of every hospital  Safety Across the Board  Establish a culture of safety  Engage the patient and family  Create safety across the board  Count all harms  Webinar: Wednesday, Jan. 28, from 12 to 1:00 p.m.: Clinical Excellence, Safety Across the Board

16. 2015 and beyond: Transparency  2015  Quality Dashboards developed for hospital review  Based on 2015 preferred measures  Consumer website development  2016  Public transparency for preferred measures and price  Consumer website available  Monday, Jan. 26, from 11 to 12:00 p.m: MHA Quality Transparency Plan

17. 2015 and beyond: PFE  MHA has a patient/family advisor to help guide strategy  Additional toolkits and resources will be made available in 2015  Goal = PFAC development in every hospital

18. HIDI  www.hidianalyticadvantage.com www.hidianalyticadvantage.com  Quality Collections – data reporting  Data reporting portal to house hospital abstracted data for reporting purposes  Analytic Advantage+ – report generator  Offers reports for participating hospitals’ specific reporting needs. Hospital staff has the ability to view, download and directly interact with data to assist with decisions in improving hospital operations  Focused quality reports defined and distributed by MHA

19. Upcoming Events  January  Monday, Jan. 26, from 11 to 12:00 p.m – Webinar: MHA Quality Transparency Plan – Participant dial-in number: 888/822-3280; participant code: 604620. – Register Register  Wednesday, Jan. 28, from 10 to 11:30 a.m. - Webinar: “Revenue Cycle Improvement: Tracking Reimbursement”Revenue Cycle Improvement: Tracking Reimbursement  Wednesday, Jan. 28, from 12 to 1:00 p.m. – Webinar: Clinical Excellence, Safety Across the Board – Participant dial-in number: 866/675-1560; Participant code: 9427102256 – Register Register

20. Upcoming Events, cont.  February  Feb. 4, from Noon to 1 p.m. - Lunch & Learn: What's Up Wednesday  HEN End of Project Report released  Falls Toolkit released  WUW|LNL – first Wednesday of the month from Noon to 1:00 p.m.  Regional workshops in April  Quality 101 Conference in May  Visit our website for additional events and links