Transparency in Healthcare Quality Reporting East Midlands, National Health Service Alide Chase, SVP...
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Transcript of Transparency in Healthcare Quality Reporting East Midlands, National Health Service Alide Chase, SVP...
Transparency in Healthcare Quality ReportingEast Midlands, National Health Service
Alide Chase, SVP Medicare Clinical Operations and Population Care November, 2013
Objective
Develop an understanding about the importance of transparency in Quality Reporting in a Healthcare System.
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KP by the Numbers
7 regions serving 8 states and the District of Columbia
More than 9 million members More than 16,000 physicians and 174,000
employees (including 49,000 nurses) 38 hospitals (co-located with medical offices) Almost 600 medical offices and other
outpatient facilities 68 years of providing care
Our Markets and Membership (2012)
Mid-Atlantic Region Washington, DC Maryland Virginia482,000 members
Georgia Region234,000 members
Colorado Region540,000 members
NorthernCalifornia Region3.4 million members
Hawaii Region225,000 members
Northwest Region Portland, OR Vancouver, WA484,000 members
SouthernCalifornia Region3.6 million members
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Our Aspiration
Kaiser Permanente’s Strategic Vision is to be a Leader in Total Health by making lives better.
Total Health is a state of complete physical, mental and social well-being for all people.
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Transparency with Performance…A Challenging Uphill Climb
Health Care
Reporting
PatientsThe PressGov’t Regulations
Consumer Report Websites – (can be scary)More informal sites can publish misinformation. For example, Dead by Mistake
ie’s
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2005
Mid Staffordshire NHS trust inquiry report published• Causing death or harm to a patient 'should be offence'• 'Duty of candour' should be imposed on NHS staff• Senior staff who breach code of conduct 'should be disqualified'• No sacking of 'scapegoats' or reorganising the NHS• Cameron creates new post of chief inspector of hospitals• PM apologises for care scandal at Stafford hospital• Read the key points• Read the main news story: Report calls for sweeping changes• Read more: Mid Staffs hospital scandal: explainer• Read the full report• Read all our Mid Staffs coverage
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Is Transparency a Game Changer?
Agree or Disagree? Serious improvement begins with understanding reality. Transparency
and honesty are not just assets for better health care, they are preconditions (Don Berwick, MD 2009).
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The Benefits of Transparency
Allows demonstration of “Best” Motivates improvement Raises the bar on accountability Enables learning Increases recognition of risk in the microsystem Provides information for decision-making Builds trust Others?
Gains from Transparency
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Risks of Transparency
Personal liability and reputation Organizational liability and reputation
• Inability to close gaps• Managed care liability and medical malpractice• Brand management• Regulatory-related issues
Patients making poor decisions Others?
KP’s Transparency JourneyAudience Past Present Future Opportunity
Patient-Doctor Communications
Organization-Patient Communications
Organization-Staff Communications
Organization-Public Communications
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Patient-physician CommunicationsAudience Past Present Future Opportunity
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KP Guiding Principle re: Communicating about Adverse Outcomes“Patient safety and clinician welfare will be best served if we are honest about unanticipated adverse outcomes with our patients and open with our colleagues and ourselves and that we handle such occurrences with sympathy and empathy for our patients and our colleagues."
Policy Development
Training Modules/
Simulation
Leadership Endorsement
MD Staff Go Thru Training
(Track # Trained)
Event Documentation
Track Conversation
(Loop Closed)
Organization-Patient CommunicationsAudience Past Present Future Opportunity
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Surveys, focus groups …
Story telling, video ethnography, shadowing, touchpoint mapping …
Advisory councils, members on committees, grand rounds, subject matter experts …
Co-designers and partners in creating value and improving quality …
Co-Creating & Co-Designing
Advising &
ConsultingDiving
DeeperGathering Feedback
KP’s Evolution in Integrating Patients and Families
We leverage all these approaches today as we strive to actively listen and partner with our members and their families at every touchpoint in their journey and across all our quality improvement and innovation efforts.
Organization-staff CommunicationsAudience Past Present Future Opportunity
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Organization-staff Communications
Unblinded medical center level data shared with small audiences Near real-time sharing of event-related information, e.g., “days since
last…”
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Inpatient Mortality: All KFH HSMR continues below US Medicare benchmark.
HEDIS: KP performance continues to trend above the national 90th Percentile
Safety: Opportunities exist for SRAE verification incidents, infections, HAPUs, and falls
Service-METEOR: Health Care Rating showed a significant improvement of 3.7 points from the previous year.
Big Q Performance Metrics Top Level or Program View – August 15, 2013
Resource Stewardship: No threshold has been established for this top level metric, commercial HMO risk adjusted selected services cost PMPM.
Equitable Care: The gap between the Black or African American and White rates for 2012 Q4 was 29 points; the disparity has decreased 28% since 2010 Q4..
T JC: The combined TJC composite for all KFH hospitals continues to be less than one point from 100% - the national 90th percentile
Privileged and Confidential 20
Service-HCAHPS: Overall Rating demonstrated a significant 1.2 point increase from the previous year.. Nurse Communication also showed a significant improvement of .8 points from previous year.
Confidential
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Diving a Little Deeper
Patient Safety
Building Blocks
PressureUlcers
Surgical Care Improvement
Program
HSMR All Regions
TJCNational Average
FallsSRAE
Composite
Adult ICU Central Line
Associated BSI
All Cause 30-Day Readmissions
Worker Injuries
May 2013
Hospital Accreditation
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We Report on KP’s Website as WellOrange County - Mortality
We Report on KP’s Website as WellOrange County: The Leapfrog Group - Quality and Patient Safety
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We Report on KP’s Website as WellOrange County – Infections
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Orange County – HAPUs
We Report on KP’s Website as WellOrange County - Service
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In Quality, Quality Improvement and Patient Safety, we’ve come a long way, but there’s a long way to go!