Quality Improvement: Implications for CHCs Serving AA&NHOPIs … · use, accountable care...
Transcript of Quality Improvement: Implications for CHCs Serving AA&NHOPIs … · use, accountable care...
-
Quality Improvement: Implications for CHCs Serving AA&NHOPIs Practice Transformation Webinar Series - Webinar 1 April 1, 2015 | Moderator: June Kim, Program Director of Technical Assistance
-
About AAPCHO
• National association of 35 community health organizations serving Asian Americans, Native Hawaiians, and other Pacific Islanders (AA&NHOPIs).
• Dedicated to improving the health status and access of these medically underserved communities
| 2 Quality Improvement: Implica5ons for CHCs Serving AA&NHOPIs
-
Practice Transformation Webinar Series
• To provide latest information on practice transformation
• Information on quality improvement, meaningful use, accountable care organizations, and patient centered medical homes
• Impact on community health centers serving Asian Americans, Native Hawaiians and other Pacific Islanders
| 3 Quality Improvement: Implica5ons for CHCs Serving AA&NHOPIs
-
Speaker
Ignatius Bau Health Policy Consultant
| 4 Quality Improvement: Implica5ons for CHCs Serving AA&NHOPIs
-
Housekeeping
| 5 Quality Improvement: Implica5ons for CHCs Serving AA&NHOPIs
-
Questions
If you have questions during the presentation portion of the webinar, you can submit them by typing into the “Questions” field on your Control Panel. We will answer questions at the end of the webinar.
| 6 Quality Improvement: Implica5ons for CHCs Serving AA&NHOPIs
-
Webinar Slides
Slides and audio recording from today’s presentation will be emailed to registered attendees after the webinar.
| 7 Quality Improvement: Implica5ons for CHCs Serving AA&NHOPIs
-
Quality Improvement: Implica5ons for Community Health Centers Serving Asian Americans, Na5ve Hawaiians
and Other Pacific Islanders
Associa4on of Asian Pacific Community Health Organiza4ons April 1, 2015
-
• What do we know about the quality of health care in the U.S., especially for Asian Americans, Na5ve Hawaiians, and Other Pacific Islanders (AANHOPIs)?
• What are some key frameworks for quality improvement?
• How does the Affordable Care Act support quality improvement?
• What are the implica5ons for CHCs serving AANHOPIs?
Outline of Today’s Webinar
-
• Medical errors, especially in hospitals • Failure to follow clinical guidelines/evidence-‐based medicine
• Regional varia5ons in u5liza5on and costs unrelated to outcomes
• Waste/over-‐u5liza5on from fragmenta5on and defensive medicine
What do we know about the quality of health care in the U.S.?
-
Ins4tute of Medicine: Reduce Medical Errors
• First, do no harm • Overuse • Underuse
• Misuse • 44,000-98,000 preventable deaths/year
-
On average, people in the U.S. receive: • Appropriate acute health care services 80% of the 5me
• Recommended chronic disease management services 70% of the 5me
• Recommended preven5ve health care services 60% of the 5me
What do we know about the quality of health care in the U.S.?
-
• 11th year of these na5onal reports • Some progress on quality but improvement is very incremental and slow
• Con5nued dispari5es in quality of care for racial and ethnic minori5es, low-‐income, limited English proficient, including AANHOPIs
What do we know about the quality of health care in the U.S.?
-
• Ins5tute of Medicine • Ins5tute for Healthcare Improvement • Chronic Care Model ********************************** • HHS Na5onal Quality Strategy • HHS Partnership for Pa5ents
What are some key frameworks for quality improvement?
-
Ins4tute of Medicine: Improve Quality
• Safe • Timely • Effective
• Efficient • Equitable
• Patient-Centered
-
1. Care is based on con5nuous healing rela5onships
2. Care is customized according to pa5ent needs and values
3. The pa5ent is the source of control 4. Knowledge is shared and informa5on
flows freely 5. Decision-‐making is evidence-‐based
Ten “rules”
-
6. Safety is a system priority 7. Transparency is necessary 8. Needs are an5cipated 9. Waste is con5nuously decreased 10. Coopera5on among clinicians is a
priority
Ten “rules”
-
Ins4tute of Medicine: Reduce Health Dispari4es
• Increase awareness • Collect/monitor data • Change systems
• Improve communication/trust • Engage communities
-
Ins4tute of Medicine: Integrate Quality Improvement and
Dispari4es Reduc4on
• Highlight value and equity • Add access measures • Add care coordination and system infrastructure measures
• Add types of care • Establish national goals and objectives
-
ACCESS
QUALITY COST
-
PATIENT EXPERIENCE OF CARE
REDUCED COST POPULATION HEALTH
-
100,000 Lives Campaign Goals (2004 –2006)
• Save 100,000 lives • Enroll more than 2,000 hospitals in the
ini5a5ve • Build a reusable na5onal infrastructure for
change • Raise the profile of the problem (variability
in the quality of American health care)
-
The 100,000 Lives Campaign Results • An es5mated 122,300 lives saved by par5cipa5ng hospitals • Over 3,100 hospitals enrolled
– Over 78% of all discharges – Over 78% of all acute-‐care beds – Over 85% of par5cipa5ng hospitals sending IHI mortality data
• Par5cipa5on in campaign interven5ons: Rapid Response Teams: 60% AMI Care Reliability: 77% Medica5on Reconcilia5on: 73% Surgical Site Infec5on Bundles: 72% Ven5lator Bundles: 67% Central Venous Line Bundles: 65% All six: 42%
-
– 2008-‐2010 – Avoid five million incidents of harm over 24 months – Enroll more than 4,000 hospitals and their communi5es in this work
– Strengthen the na5onal infrastructure for change and transform it into a na5onal asset
– Raise the profile of the problem
-
Pa5ent Protec5on and Affordable Care Act
-
• Bemer Care
• Healthy People/ Healthy Communi5es
• Affordable Care
-
1. Making care safer by reducing harm caused in the delivery of care
2. Ensuring that each person and family are engaged as partners in their care
3. Promo5ng effec5ve communica5on and coordina5on of care
Na5onal Strategy for Quality Improvement
-
4. Promo5ng the most effec5ve preven5on and treatment prac5ces for the leading causes of mortality, star5ng with cardiovascular disease
5. Working with communi5es to promote wide use of best prac5ces to enable healthy living
6. Making quality care more affordable for individuals, families, employers, and governments by developing and spreading new health care delivery models
-
• Launched by HHS in 2011 • First federal government hospital pa5ent safety ini5a5ve
• 8,000 partners, including 3,700 hospitals, are par5cipa5ng
• Established and achieving specific goals for pa5ent safety improvements
-
$1,000,000,000 = $1 Billion! 107 three-‐year awards expected to save $1.9 billion
39 Additional Awards Announced in 2014
-
Awards to be announced in April 2015
-
• Have valid measures • Collect data on performance • Know baseline and set goals for improvement, using evidence/best prac5ces
• Try out improvements/measure results • Adjust/adapt • Repeat/sustain improvements
What works to improve the quality of health care?
-
• Community health centers have experience with quality improvement
• Some data showing effec5veness, e.g. in improving diabetes-‐related outcomes
• Keys seem to be good data, focus on pa5ent panels, engage all staff, track results
• Also importance of collabora5ves/peer support
What are the implica5ons for CHCs serving AANHOPIs?
-
• Limle published/known about quality improvement among Asian Americans, Na5ve Hawaiians, Pacific Islanders
• AAPCHO focus on enabling services and quality is an important founda5on
• Need more quality improvement experience and outcomes data
• Need to integrate dispari5es reduc5on
What are the implica5ons for CHCs serving AANHOPIs?
-
Future Webinars April 8: Health information technology April 22: Patient-centered medical homes April 29: Accountable care organizations May 6: Culturally and linguistically appropriate services
Questions and comments?
-
Q&A
You can submit questions by typing them into the “Questions” field on your Control Panel.
| 65 Quality Improvement: Implica5ons for CHCs Serving AA&NHOPIs
-
Thank you!
Next Webinar Health Information Technology: Implications for CHCs Serving AA&NHOPIs Wednesday, April 8, 2015 9am HST/12pm PDT/3pm EDT To register or for more information, go to http://bit.ly/PCMH2015webinars or visit AAPCHO’s website at www.aapcho.org.
| 66 Quality Improvement: Implica5ons for CHCs Serving AA&NHOPIs