2013 Hen Wrap up 2014 Quality Preview
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2013 HEN WRAP UP 2014 QUALITY PREVIEW
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All Hospital Engagement Network’s goal:
To Reduce Hospital Acquired Conditions by 40% and reduce
preventable readmissions by 20% by January 1, 2014.
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ASHNHA Quality Review
• AHA HEN began in earnest May 2012• Combination of HEN and State Flex Funding supported all
Quality-related activities• Over 40 people traveled to the Improvement Leadership
Fellowship and Improvement Collaboratives• Mentors for Quality Program began• Hosted Weekly calls on a variety of Quality-related topics• Three Statewide meetings:
• Oct 3, 2012 HEN Kick-Off• March 5,6 Quality Summit• Dec 5, Quality Collaborative
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Mentors for Quality
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Review of past 22 months• Partnered with state to support NHSN Training and travel
to the APIC Conference for 14 participants
• Falls Prevention Expert, Dr. Pat Quigley, visited 13 hospitals/LTC
• Lean Training, funded by FLEX, provided to 5 member hospitals• Three full days of training for 3 participants from each hospital • One full day training on site for 15-20 participants at each hospital
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Working Together to Prevent Falls
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Data Reporting Success
• Eleven hospitals reporting on 6 or more quality topics• Falls• CLABSI• CAUTI• Pressure Ulcers• Surgical Site Infections• Early Elective Deliveries
• One hospital reporting on ALL 11 topics
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Data Challenges• Different hospitals used different measure definitions
• Not everyone began at the same time
• HRET defines the first data point as “baseline” when there is not more than 12 data points(months)
• Data is not validated
• Small numbers
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LET’S RUN THE NUMBERS
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Baseline
May-12
Sep-12
Feb-13
Sep-13
0
2
4
6
8
10
12
14
Combined Rate of Elective
Deliveries between
37-38 Weeks
Gestation
Reducing Early Elective DeliveriesSuccess to last a lifetime
Participating Hospitals: ANMC, Bartlett, Fairbanks Memorial, Mt. Edgecumbe, PeaceHealth, South Peninsula, Sitka Community Hospital and Yukon-Kuskokwim Health Center
6+ Months Since the Last EED!
Combined Alaska Percentage
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Preventing Pressure UlcersStage 1 or Higher
Participating Hospitals: Cordova, Maniilaq, Sitka, Yukon-Kuskokwim
1968 Discharges from 4 hospitals = 1 patient discharge= 1 patient with an ulcer
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Baseline
Jan-12
Feb-12
Mar-12
Apr-12
May-12
Jun-12
Jul-12
Aug-12
Sep-12
Oct-12
Nov-12
Dec-12
Jan-13
Feb-13
Mar-13
Apr-13
May-13
Jun-13
Jul-13
Aug-13
Sep-13
0
0.5
1
1.5
2
2.5
3
Preventing CLABSIAll Tracked Units, by Device Days
Rate/1000 Device Days
Participating Hospitals: ANMC, Bartlett, Central Peninsula, Fairbanks, Memorial, Mt. Edgecumbe, PeaceHealth, South Peninsula
Alaska Rate
HEN Rate
3 Hospitals had no CLABSIs!
4 AK Hospitals’ Average Performance
Outpaced the HEN’sAverage
Rate of CLABSI
Alaskan Hospitals
HEN
0.0
0.5
1.0
1.5
2.0
2.5
3.0
2.4
1.9
1.1 0.9
0.30 0 0
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Preventing CLABSIRate / 1000 Discharges
Participating Hospitals: Cordova, Maniilaq, Sitka, Petersburg, Yukon-Kuskokwim
1161 Discharges from 5 hospitals – No CLABSI = 1 patient discharge
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Participating Hospitals: ANMC, Bartlett, Central Peninsula, Fairbanks Memorial, Mt. Edgecumbe, PeaceHealth, South Peninsula
02468
10121416 15
8.4
3.72.4 1.9 1.4
0 0
Preventing CAUTIAll Tracked Units, by Catheter Days
Alaska Rate
Rate per 1000 Urinary
Catheter Days
HEN Rate
2 AK Hospitals’ Average Performance
Outpaced the HEN’s Average Rate of CAUTI
Alaskan Hospitals
HEN
Basel
ineJan
-12Feb
-12Mar-
12Ap
r-12May
-12Jun
-12Jul-12Au
g-12Sep
-12Oct-
12Nov
-12Dec-
12Jan
-13Feb
-13Mar-
13Ap
r-13May
-13Jun
-13Jul-13Au
g-13Sep
-130.00
4.00
8.00
12.00
2 Hospitals had no CAUTI!
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Falls and Injury PreventionFalls By Discharges
Cumulative Rate of Falls
Participating Hospitals: Cordova, Maniilaq, Petersburg, Sitka, Yukon-Kuskokwim
Dec-12 Mar-13 Jun-13 Sep-130
2
4
6
8
Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-130
0.05
0.1
0.15
0.2
0.25
0.3
0.35
Alaska Rate
Individual Hospital Rates
Absolute Values of Falls for All Hospitals
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Falls and Injury PreventionRate of Falls, With or Without Injury
Rate/ 1000 Patient Days
Participating Hospitals: ANMC, Central Peninsula, Fairbanks Memorial, PeaceHealth, South Peninsula
2011
Jan-12
Feb-12
Mar-12
Apr-12
May-12
Jun-12
Jul-12
Aug-12
Sep-12
Oct-12
Nov-12
Dec-12
Jan-13
Feb-13
Mar-13
Apr-13
May-13
Jun-13
Jul-13
Aug-13
Sep-13
Oct-13
0
1
2
3
4
5
6
7
Alaska Rate and trend line
HEN Rate
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2011Jan
-12Feb
-12Mar-
12Ap
r-12May
-12Jun
-12Jul-12Au
g-12Sep
-12Oct-
12Nov
-12Dec-
12Jan
-13Feb
-13Mar-
13Ap
r-13May
-13Jun
-13Jul-13Au
g-13Sep
-13Oct-
130.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
9.0
10.0
AK RateUCL+2 sigma+1 sigmaAverage-1 sigma-2 sigmaLCL
Falls and Injury PreventionRate of Falls, With or Without Injury
Rate/ 1000 Patient Days
Participating Hospitals: ANMC, Central Peninsula, Fairbanks Memorial, PeaceHealth, South Peninsula
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THE RESULTS ARE A CALL TO ACTION!
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Looking Ahead:• Increased quality reporting demands
• Increased consumer pressure for quality transparency
• Increased government “involvement” in quality /transparency/payment/clinical practice
• Increased Payor push for payment reform
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ASHNHA Quality Strategy
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Offensive or Defensive?
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Who’s got the ball?
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ASHNHAQuality Strategy
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Data• ASHNHA members walk the talk of Quality Transparency• ASHNHA members have control over data• ASHNHA members have collective ability to respond to
public, state• ASHNHA members have ability to benchmark against
state and national benchmarks• Relatively non-competitive market allows a “raise all
boats” mentality
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2014
ASHNHA Qualityan invitation to all members
ASHNHA Partnership for Patients(PfP)Statewide QI Effort Guided by Nat’l PfP effort Statewide direction by PfP Advisory Group Reporting Data to ASHNHA on 10 TopicsTo focus on streamlining data collection
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Future ASHNHA ResponseHospitals--working together to improve care in Alaska!