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Nursing Home INTERACT Pilot Project
Thomas P. Meehan, MD, MPHChief Medical Officer
Qualidigm
Progress in Decreasing Hospital Readmissions in Connecticut
Jun-09Sep-09
Dec-09Mar-10
Jun-10Sep-10
Dec-10Mar-11
Jun-11Sep-11
Dec-11Mar-12
Jun-12Sep-12
Dec-12Mar-13
Jun-13Sep-13
Dec-13
20
22
24
26
28
30
32
34
30-d
ay R
eadm
issi
ons
per 1
,000
FFS
Ben
efici
arie
s
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
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
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)
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
30-Day All Cause Nursing Home Readmission Rates
Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-140
5
10
15
20
25
NH A NH B NH C NH D NH E NH F NH G
Aggregate
Rolling 3-Month Time Period(label Indicates the last month of the time period)
Perc
ent (
%)
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