Rural communities in the United States are facing dangerous changes in the healthcare available to them. The financial realities for full-service hospitals with a relatively small number of beds in small communities mean that enormous trade-offs will be made, just to ensure that the hospital in some form can survive.
According to the InDepth article “Rural Hospitals Look for Help To Survive” by Alex Kacik in Modern Healthcare, “The gulf between rural hospitals’ available beds and daily admissions widens every year, causing providers to scale down. Without help from the government or larger health systems, many more will likely close.”
As with organizations of all kinds – when facing financial pressures, ongoing lack of profitability and an inability to attract and retain talent, the search for solutions becomes all-important. Some rural hospitals are forming cooperative purchasing groups, hospital management organizations are finding ways to consolidate and prioritize the services offered, or reducing the number of hospital beds available.
The article continues, “Inevitably, rural communities will have to shutter hospital wings or otherwise pare down, said Lyndean Brick, president of the consultancy Advis Group.”
Yet, with all of these ongoing financial pressures, rural hospitals are still an incredibly critical part of the community ecosystem without which, it is possible that the loss of life and lack of access to healthcare would significantly degrade the quality of life for our small, rural communities.
“These independent hospitals need to find some way to gain scale and leverage to offset margin compression and achieve parity with everyone else who is consolidating around them,” Brenner said.
At the same time rural hospitals work on scaling their patient flow, increasing the effectiveness and efficiency of key process is a critical factor in improving both top-line and bottom-line finances. Technology can certainly play a role in positively impacting rural healthcare organizations in a way that enables them to provide quality care in a cost-effective way. For instance, telemedicine services may create opportunities for specialist consultations without long-distance travel.
As rural healthcare providers take on the challenge of diving more deeply into identifying and addressing the specific needs of their communities, an ability to derive real-time insight into the performance, and facilitate improvement of their organization, will be invaluable. The point to be communicated here is that all hospital have been addressing quality and safety reporting for decades, but now the critical imperatives are to (1) extend the goal from generation and delivery of reports to achieving real clinical performance improvement, and (2) address that goal far more efficiently than has been done in the past. Quality-safety applications like Prista’s ActionCue Clinical Intelligence enable insight and implementation of performance improvement plans that both impact reimbursement and increase care quality.
But let’s be clear. It is not simply the application of some technology that brings about more effectiveness and efficiency, but how that information technology is designed and the goals driving that design. Any software that merely captures basic information about safety events, requiring humans to then organize a PI action plan, go back to the setting of an event to ask questions, gather and process data into a usable and informative format and do numerous other manual and ad hoc administrative functions is not at all improving the efficiency of the overall process. Not until fundamental innovation in IT and process are undertaken, those tools that are simply “reporting” oriented are replaced by a functional platform that truly facilitates the performance improvement process, and saves its users significant time in that pursuit, will progress be made toward the triple aim. That is the only way clinical performance has can be optimized for better operational, regulatory and financial outcomes.
This advice is from Prista’s partner and advisor for HIPAA Compliance, Third Rock. Considering the vast number of individuals impacted by this breach event, and the seriousness of the issue, we thought it would be good to share this. Please consider these steps for your own effort. You can also see this article from their current newsletter, find other resources and subscribe to their newsletter here.
If you would like more insight or help with your organization’s HIPAA Privacy and Security compliance, you can direct any questions or follow-up to Robert Felps at Third Rock, via email or call 512-310-0020.
Stealing headlines from Hurricane Irma was the revelation that Equifax experienced a major data breach during the summer. Equifax is one of the “big three” credit monitoring services and therefore the data they collect on each of us is broad and deep. They estimate that data for 143 million people – nearly half the population of the United States – has been stolen!
What does this breach mean for you? Your financial history and ability to buy a home, new car, or even get healthcare could be at stake. Here are recommended steps to protect you and your family.
As a contribution to the celebration of all of those who work diligently and passionately in Healthcare Quality, we would like to plant a seed of thought, an innovative vision, of pursuing the goals of Quality (and its intimate partner, Safety) to get better outcomes, more consistently, while using less effort and cost, and feeling less frustration. In other words, an easier path to improvement.Historically, “Quality” has been tightly associated with “reporting” and it may be understandably difficult for many to separate their thinking in that regard from the collection and manipulation of data, research on and calculation of Performance Measures, visual analysis of number grids and graphs, generating and compiling reports, and sitting though hours of review meetings to share and discuss the information. And much of the effort in Quality reporting targets higher level management and especially external parties, rather than the clinical staff themselves. Many describe such responsibilities as overly mechanical and time-consuming, seriously reducing the time and brain power left over for the cognitive work of imagining, planning and confirming improvement in healthcare delivery. Even highly-respected overt methodologies, which supposedly serve that improvement goal, often add to the mechanical effort requiring procedural education, special forms, jargon, and more meetings.To a great degree, much of that is accepted, personally and organizationally, as being “the Quality job”, but perhaps there is vision of something different. A breakthrough.
The reason we talk about a breakthrough is important. There is a very strong tendency, while trying to improve processes, to simple tweak the same activities and artifacts that have been part of the process for a long time. That is definitely the case with quality. If we focus on the cognitive path, from observation to improvement, and design optimally for the digital/electronic medium to support that, then real progress can be made. This must not be equated to having users take on the mindset, language or skills of “techies”. It should be the case that the power of technology and especially the design expertise that is coupled to it, is delivered into the operative “space” of the targeted users.
When that is done well, much of the mechanics, physical activities and artifacts can be eliminated and the most precious resource of the clinical staff – their professional intellectual capabilities – are channeled toward the improvement goal. To put that in tangible terms, this vision is about one place where all the information involved in the Performance Measures of Quality Management, in Safety Event reporting and investigation, and in the Action Plans for Performance Improvement exist in intuitive, connected, workflows. The net effect is a design that radically reduces both labor and mental exertion to get actionable insights.
Realizing such a vision may be challenging because of departmental, process, policy and political barriers, the natural inhibitors of fear, ego and comfort, and the tyranny of time and money invested in the “old ways”. But why should you or your organization let those stand in the way of your passion to pursue Quality the way you’ve always known it should be done?
Prista and CIHQ are driving for the same goal – to radically improve the effectiveness and efficiency of quality-safety* efforts in healthcare delivery organizations. While the organizations differ in services and approach, their philosophies related to providing education, resources and tools to the healthcare community are well aligned.
Through a variety of communication vehicles, CIHQ provides education, shares perspectives on patient safety and compliance, and presents available resources and tools. Through its ActionCue Clinical Intelligence online application, Prista enables subscribers to significantly reduce and streamline the mechanics and manual data manipulation of the improvement processes for quality-safety.
Billie Anne Schoppman, Chief Mission Officer at Prista reflects “CIHQ is innovative, nimble and responsive just like Prista and makes a great partner to really help care providers break through some stasis and inertia to put best practices to work and drive quality and safety improvement like never before – effectively, efficiently and consistently.”
Rick Curtis, Chief Executive Officer of CIHQ, explains his perspective; “We’re excited to partner with Prista. Both our organizations share a common Mission and purpose. Our partnership will enable Prista clients to access our vast array of web-based support services, and our clients will benefit from access to Prista’s innovative quality and patient safety management platform. It’s not just a win/win for both companies, it’s a win/win for our respective clients.”
Be on the lookout for lots of content and opportunities to participate in demonstrations to learn how Prista’s ActionCue platform and CIHQ’s education, advice and content go hand-in-hand to advance our joint subscribers and members to the forefront of America’s healthcare organizations.
* – Quality-safety reflects Prista’s position that care quality and safety for patients are inseparable and should naturally be addressed together in an integrated improvement–centered management process.
The Center for Improvement in Healthcare Quality (CIHQ) is a membership-based organization comprised of over 300 acute care and critical access hospitals across the United States. Member organizations enjoy a comprehensive program of web-based and other support services designed to help them be successful in their accreditation and certification compliance efforts. CIHQ is also recognized as a deeming-authority by CMS for acute care and long-term acute care hospitals.
Prista provides the ActionCue® Clinical Intelligence online application, a very innovative platform integrating Quality Management, Event Reporting and Investigation, and Performance Improvement functionality. Beyond a dashboard or reporting tool, ActionCue provides a complete work environment for staff, management and executives to obtain immediate insights into all clinical issues and what is being done to improve them, to own and drive the improvement-centered quality-safety process as never before.
Six quality issues warrant the attention of healthcare leaders: misdiagnoses, star ratings, socioeconomic adjustment for readmissions, the end of Partnership for Patients programs, Medicaid parity expiration, and Disproportionate Share Hospital cuts.
Healthcare has experienced fascinating changes during the last few years, and 2015 will be no exception.
Major programs stemming from the Patient Protection and Affordable Care Act are well under way, dozens of new quality measures and data galore are flowing into the public domain, and quality of care remains in the spotlight for providers at all levels.
There are sure to be tweaks, especially where measures and performance commingle to affect payment. But here are six quality issues that warrant your attention in 2015.
1) Measuring misdiagnosis
If physicians’ diagnostic accuracy were like air travel, one in 20 planes would not land when or where it should, and one in 40 flights would put passengers at risk of significant harm, or even crash.
Those are estimations from an April 2014 report from Houston Veterans Affairs and Baylor College of Medicine researcher Hardeep Singh, MD, and colleagues who say that 12 million U.S. outpatient adults may be given incorrect or delayed diagnoses every year.
Singh says reducing misdiagnosis must be a major quality focus for 2015 because providers and patients should not tolerate error rates this high.
Singh’s report in BMJ Quality & Safety estimated that 5.08% of outpatients receive an inaccurate diagnosis, and that half of those errors have the potential to cause severe patient harm, such as a missed opportunity to treat cancer at an earlier, easier stage. These misdiagnoses can result in avoidable or extended hospitalizations or even death.
Though misdiagnoses may be a patient safety issue on a par with medication errors or infections, providers don’t measure or track them. It can be hard to assign blame: sometimes patients don’t know or fail to reveal relevant details. But sometimes the fault is the provider’s, for failing to take an adequate history or conduct a proper physical exam.
…Story continued on original site.
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