Tag Archives for " Quality Improvement "

7 Steps to Increasing ROI with Performance Improvement

For a long time, Quality and Safety Event reporting have been recognized as important but often downplayed tasks when it came to getting the attention of executives and allocating resources. Shifting investments and allocating resources has become even more of a challenge as budgets continue to get tighter and tighter.

Quality-related reimbursement, as applied through Value-Based Purchasing (VBP), MACRO/MIPS, ACO programs and other components in the pay-for performance (P4P) model, have only increased the pressure without providing much guidance on how to actually improve quality.

Although the goal of submitting quality and safety reports and data to external organizations is becoming something more than just checking a “to-do” item off the list, much of the reporting and education efforts in hospitals and other healthcare organizations fall short of making real advancements in Performance Improvement.

The ROI that can perk up executives’ attention and guide their investment is to make Performance Improvement more effective and efficient. While Performance Improvement has been a focus for decades, most organizations focus on the wrong things, such as manually gathering information and data and over-educating staff on the theories and science of QI methodologies. Others are still wasting their time with more meetings, more documents and artifacts and more working overhead.
Worse still, all of these efforts suffer negligible support from innovative IT solutions that are specifically designed to support more efficient and effective Performance Improvement. This is the year, maybe even the quarter, to change that.

Start from the Top

Championing the shift from investing in reporting to investing in the Performance Improvement process itself has to come from the top. Senior management up to the C-suite needs to not only lead, inspire and set the direction, but also provide the resources and fully communicate the importance of creating a smarter and more efficient Performance Improvement process.
Instead of merely asking staff and managers to just “work harder and better,” the goal needs to be about making their job easier and more streamlined.

7 Steps to Better Performance Improvement

An efficient Performance Improvement system needs to be supported by innovative and intuitive IT and can be achieved by taking the following steps.

1. Abandon historically-rooted inefficiencies, including artifacts and activities of decades-old QI programs, functional and organizational boundaries that disrupt workflows and manual data gathering and processing.
2. Get everyone on the same page with tools that integrate improvement, all quality metrics and event reporting/investigation.
3. Ensure every internal reporting and analytic activity drives into improvement.
4. Focus on enabling the improvement work correctly instead of over-educating the staff.
5. Prioritize synergistic, internal, real improvement activities over external reporting.
6. Make sure the access and presentation of needed insight for executives is just right—not too deep and complex nor too shallow and impenetrable—so they can own and drive the effort appropriately.
7. Implement a technology-enabled PI workbench specifically for improvement efforts that does all of the above, streamlines and offloads manual efforts from staff and leaders, delivers results and ROI and supports a real culture of improvement in quality and safety.

Improving ROI with Technology

Each of these steps has the potential to be a project in its own right and a daunting task at that. Fortunately, a growing awareness of how Performance Improvement and Quality and Safety reporting can feed one another is prompting a shift in technologies and platforms to support this new focus.

ActionCue CI was built intentionally to increase ROI by changing how Performance Improvement is managed and facilitated using the steps outlined above. Learn more about how ActionCue can help executives, risk/quality managers and clinical staff bring Performance Improvement into the 21st century.

Eliminating Hospital Acquired Infections

Hand-hygiene helps. But, studies show hospital workers wash their hands less frequently by end of workday

A few weeks back we talked about how hand-hygiene can significantly decrease hospital-contracted infections, and by extension reduce healthcare organization costs — not to mention reduce unnecessary infection-related deaths. A new study out shows that hand washing frequency drops off near the end of healthcare professional worker’s shifts.

Led by Hengchen Dai, a Ph.D. candidate at the University of Pennsylvania, researchers analyzed three years of hand-washing data from more than 4,000 caregivers in 35 hospitals across the U.S. They discovered that hand-washing compliance rates plummeted an average of 8.7% by the end of a normal 12-hour shift.

Hospital-contracted infections account for nearly 100,000 deaths per year in the United States, making it a serious problem in need of attention. From December 2006 through December 2008, the Institute for Healthcare Improvement (IHI) initiated the 5 Million Lives Campaign with the aim of supporting the improving medical care, and significantly reducing levels of morbidity (illness or medical harm such as adverse drug events or surgical complications) and mortality.

Hospitals participating in the Campaign were asked to prevent 5 million incidents of medical harm over the two-year period. The IHI continues its efforts to reduce incidents of medical harm in the article What Zero Looks Like: Eliminating Hospital Acquired Infections.

There is no doubt that hospital-acquired infections are a serious issue. There are also large amounts of evidence that shows a few simple methods can significantly reduce their number.

The road to lower mortality rates, and reduced hospital costs, begins with establishing a commitment to a culture of quality. Then providing staff with the tools they need to easily record, measure and report their performance.

Top 14 Healthcare Stories of 2014

1) Healthcare.gov Gets Clean Bill Of Health… Kind Of.

Few health stories in 2013 captured as much news coverage and attention than the launch of the Federal Health Exchange website and its rocky beginnings. Many were excited by the prospect of lower health insurance costs, promised by the administration, and flocked to the website to sign up. But, due to technical difficulties, hundreds of thousands of customers were left out in the cold and unable to enroll in coverage. Insurance companies reported very few applications received even months after the site’s launch.

By November, 2014, the problems that plagued the site earlier had seemed to be fixed with the officials announcing 100,000 application submissions on the first day of open enrollment. But, higher than expected premium cost and lower coverage for consumers — combined with complicated and costly systems for hospitals — highlights just how much further ‘Obamacare’ has to go before it will be seen as a success.

2) The Ebola Outbreak: Death in Africa

While Ebola didn’t start in 2014, it sure came on like a lion then. The Centers for Disease Control and Prevention reported that, as of January 6, 2015, a total of 21,007 cases were reported, and nearly 9,000 deaths were attributed to the disease.

3) The Ebola Outbreak: Coming to America

The inevitable happened which captured headlines around the country, igniting a firestorm, sending people running for surgical masks and hazmat suites to protect themselves from the disease. But, was it much-ado-about-nothing? Within a few weeks, everything seemed back to normal again.

4) Enterovirus Grips The Nation

Enterovirus D68 (EV-D68) took the U.S. by surprise in 2014, with a confirmed total of 1,153 people within 49 states and the District of Columbia affected.

5) E-Cigarette Use Soars

Amid the ongoing debate whether e-cigarettes are a less dangerous alternative to smoking, the use of these devices soared in 2014. A U.S. National Institutes of Health survey found that more than double number of 10th graders are likely to have tried e-cigarettes, to those who will have tried traditional cigarettes.

6) War In The Lunchroom: Kids vs Healthy Eating

No matter where you land on the issue of healthy meals in public schools one thing is for sure, the kids weren’t happy in 2014. Championed by First Lady, Michelle Obama, federal regulations on what constitutes a healthy meal were met with opposition from the recipients of those lunches. Kids around the country took to social media, tweeting photos of their meals along with the trending hashtag #ThanksMichelleObama.

7) Right To Die

When most think about a patient seeking assisted suicide we picture a face of many more years than that of Brittany Maynard’s, an attractive 29-year old woman from California. Brittany suffered from cancer and moved to Oregon in 2014 to take advantage of the state’s “Death With Dignity Act” — at the same time capturing the nations attention to the serious subject of an individuals right to die.

8) Vaccines…pssh! Who Needs ‘Em? We Do, Apparently.

A small but growing number of parents who have shun vaccinating their children, based on beliefs that vaccines cause conditions like Autism, are unwittingly playing a role in the resurgence of once-rare childhood diseases. In 2014, California suffered its worst outbreak of pertussis, also know as ‘whooping cough’, in 70 years. CDC statistics also show that U.S. measles cases have reached a 20-year high.

9) Pot gets legalized

Although the legalization of marijuana in Washington state, Oregon, and Colorado was for recreational use, I have added it to this list for the social significance it points to. Namely, the changing tide in public sentiment toward pot and its use. Many states have already, up-till-now, had laws for its legal medical use. However, in many cases, the wider view of pot as a ‘bad thing’ stymied its spread as a potential option for those seeking a serious alternative to pharmaceuticals. This recent wave of states legalizing its use could signal a change in opinion, and open doors for patients looking for other options.

10) America Looses An Icon

America, and the world, was shocked when it learned that one of its beloved stars had committed suicide. Robin Williams took his own life after years of struggling with depression. After his death, Williams’ wife revealed he had also recently been diagnosed with Parkinson’s disease, and an autopsy revealed his brain showed signs of Lewd Body Disease, a form of dementia that can cause hallucinations and concentration problems.

Although it’s not confirmed these conditions played a role in William’s suicide, his death has shed light on several frequently misdiagnosed or understood disorders.

11) “I’ll have the small ‘650 calorie’ popcorn please.”

Restaurants and concession stands must now post calorie counts on their menus. Under newly finalized FDA rules, chain restaurants, vending machines, and theatre and amusement park snacks must post their calorie counts. Personally, I don’t want to know my ‘elephant ear’ is 1,500 calories… I just want to shove it in my face while spinning 800 rpm’s on the tilt-a-whirl.

I want to end this list on a high note, because, while there were some really terrible things that happened in 2014, there were some really heart-warming and amazing things that happened as well.

12) Grow-Your-Own Ears

By first depositing living cells encapsulated in a hydrogel with a 3D printer, scientists at Weill Cornell Medical College were able to construct and grow the first artificial ears that look and act like real ones. Using human cells, specifically from the same patient, reduces any possibility of rejection.

13) Congratulations Nurses!

Nurses once again topped the list of ‘professions with the highest ethical standards’ in Gallup’s 2014 survey on honesty and ethics. Way to go nurses… Whoop, whoop!

14) The Six-million Dollar Men: Bionic Eyes and Arms

A North Carolina man became the first patient in state history to receive a “bionic eye”, Argus II retinal prostheses, allowing him to see light for the first time in 30 years. Then, in the later half of the year, a double arm amputee was fitted with robotic arms that he was able to control… wait for it, with his mind! How freakin’ cool is that?

So, here is to 2015, and to the possibilities it holds. It will undoubtedly come with its own share of trials and tribulations, just as 2014 did. But, will surely be filled with amazing new health technologies to make life all a little easier as well.

Alarm Fatigue — Do You Have It?

I know you can relate to this situation. You’re walking through a parking lot when suddenly a car alarm starts going off and doesn’t stop, and (I’m willing to bet), you keep on walking without looking back. Sound familiar?

When car alarms first emerged back in the 80s they were few and far between. The ear splitting sounds of the alarms turned heads of onlookers, to what could be a serious situation in need of attention. It didn’t take too long, however, for us all to become desensitized to the familiar warbles and chirps, and we no longer paid any attention to them — defeating their purpose.

The same desensitization, or fatigue, happens with clinical alarms in hospitals. But, there are ways to help reduce alarm fatigue according to a study published in Pediatrics.

In the study researchers at Cincinnati Children’s Hospital Medical Center, led by Christopher Dandoy, M.D., of the hospital’s Cancer and Blood Diseases Institute, found that a standardized, team-based approach could dramatically reduce alarm fatigue — helping to eliminate the possibility of not responding to a true event.

The researchers created a standardized cardiac monitor care procedure for the hospital’s 24-bed pediatric bone marrow transplant unit.

As part of the project, Dandoy and his team developed a process for ordering monitor parameters according to age-appropriate standards, pain-free daily electrode replacement, personalized daily cardiac monitor parameter assessment and a reliable way of appropriately discontinuing monitors. Under these protocols, the median number of daily cardiac alarms fell from 180 to 40, while caregiver compliance increased from 38 percent to 95 percent.

“Cardiac monitors constitute the majority of alarms throughout the hospital,” Dandoy said in a hospital announcement. “We think our approach to reducing monitor alarms can serve as a model for other hospitals throughout the country.”

Fewer false alarms, he added, will allow hospital staff to devote more attention to significant alarms. Although the process was enacted in a pediatric unit, Dandoy and his team said it was applicable to “most units with cardiac monitor care.”

“Hospitals are greatly concerned about alarm fatigue because it interferes with patient safety, and it exposes patients–and the hospitals themselves–to grave harm,” said Michael Wong, executive director of the Physician-Patient Alliance for Health & Safety, who presented findings at the Society for Technology in Anesthesia, earlier this year that hospital staff are exposed to an average of 350 alarms per bed, per day based on a sample from an intensive care unit at the Johns Hopkins Hospital in Baltimore.

Cincinnati Children’s Hospital Medical Center says nationwide adoption could increase patient safety

You can read the full study here.

eHealth Initiative roadmap calls for alignment of HIT regulatory efforts

The eHealth Initiative has unveiled its 2020 roadmap for transforming health IT.

Calling it “much broader” than the Office of National Coordinator for Health IT’s interoperability roadmap, the eHealth plan calls for an extension of time between Stages 2 and 3 of the Meaningful Use program, and also says that compliance with ICD-10 by next October is mandatory.