Healthcare Call to Action 2007

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Presented at the National Academy for State Health Policy's 20th Annual State Health Policy Conference in Denver, Colorado. Author: Tom Evans

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Healthcare Call to Action 2007

  1. 1. Healthcare Call to Action 2007 Tom Evans, M.D.
  2. 2. A New Era…
  3. 3. A new era of transparency and accountability… <ul><li>Development of evidence-based medicine </li></ul><ul><li>Define and standardize clinical performance metrics </li></ul><ul><li>Convergence around new measures </li></ul><ul><li>Awareness of effectiveness </li></ul><ul><li>Industry shifts in practice </li></ul><ul><li>Changes in reimbursement </li></ul><ul><li>Value Driven Health Care </li></ul>
  4. 4. Value-Driven Health System <ul><li>Connecting the System </li></ul><ul><ul><li>Standards to connect all health information systems </li></ul></ul><ul><li>Measure and Publish Quality </li></ul><ul><ul><li>Every case, every procedure </li></ul></ul><ul><li>Measure and Publish Price </li></ul><ul><ul><li>Standardize identical services and episodes of care </li></ul></ul><ul><li>Create Positive Incentives </li></ul><ul><ul><li>Reward those who offer and those who purchase high quality, competitively priced healthcare </li></ul></ul>
  5. 5. Iowa Healthcare Collaborative <ul><ul><li>2003 Task Force of providers, payers, purchasers and consumers </li></ul></ul><ul><ul><li>“ How will this era of transparency and accountability effect Iowa Healthcare with it’s unique challenges?” </li></ul></ul><ul><li>From joint IHA/IMS Task Force … </li></ul><ul><li>… to provider-led statewide quality improvement initiative </li></ul>
  6. 6. Iowa Healthcare Collaborative <ul><li>Align & Equip Health Care Providers on Quality and Value </li></ul><ul><li>Responsible Public Reporting </li></ul><ul><li>Engage the Community for Clinical Improvement </li></ul><ul><li>Raise the Standard of Care in Iowa </li></ul>
  7. 7. IHC Organizational Structure IHC Board IHC Advisory Council Data Committee Clinical Initiative Work Groups Education Committee
  8. 8. IHC 2007 Work Plan
  9. 9. Iowa Healthcare Collaborative 2007 Work Plan <ul><li>Education </li></ul><ul><li>Public Reporting </li></ul><ul><li>Patient Safety </li></ul><ul><li>Clinical Initiatives </li></ul>
  10. 10. IHC 2007 Work Plan Education <ul><li>Conferences </li></ul><ul><ul><ul><li>Patient Safety Summit </li></ul></ul></ul><ul><ul><ul><li>Physician’s Forum </li></ul></ul></ul><ul><ul><ul><li>LEAN in Health Care Conference </li></ul></ul></ul><ul><ul><ul><li>Annual IHC Conference </li></ul></ul></ul><ul><li>Website- www.ihconline.org </li></ul><ul><li>Toolkits </li></ul><ul><ul><ul><li>Anticoagulation, Medication Reconciliation, Health Literacy, Healthcare-associated Infection, Lean in Health Care, Safe Culture </li></ul></ul></ul><ul><ul><ul><li>Physician Practice Toolkit </li></ul></ul></ul>
  11. 11. IHC 2007 Work Plan Public Reporting <ul><li>Driven by “Responsible Public Reporting” </li></ul><ul><li>IHC Sources </li></ul><ul><ul><ul><li>Both clinical and administrative data </li></ul></ul></ul><ul><ul><ul><li>Publicly available and voluntary reported information sources </li></ul></ul></ul><ul><ul><ul><li>Data suitable for comparative purposes </li></ul></ul></ul><ul><ul><ul><li>CMS Hospital Compare </li></ul></ul></ul><ul><ul><ul><li>AHRQ Administrative data set </li></ul></ul></ul><ul><li>Subjective data, not suitable for comparative purposes </li></ul><ul><ul><ul><li>NQF 30 Safe Practices information </li></ul></ul></ul><ul><ul><ul><li>Healthcare Associated Infection (HAI) measures </li></ul></ul></ul><ul><ul><ul><li>Spread Measures </li></ul></ul></ul>
  12. 12. Public Reporting <ul><li>The Iowa Report </li></ul><ul><ul><li>2005 Report </li></ul></ul><ul><ul><ul><li>CMS Measures- Hospitals </li></ul></ul></ul><ul><ul><ul><li>AHRQ Data- Statewide aggregate </li></ul></ul></ul><ul><ul><ul><li>Survey on NQF Safe Practices </li></ul></ul></ul><ul><ul><li>2006 Iowa Report </li></ul></ul><ul><ul><ul><li>CMS Measures- Hospital specific </li></ul></ul></ul><ul><ul><ul><li>AHRQ Data- Hospital specific and some statewide aggregate </li></ul></ul></ul><ul><ul><ul><li>Healthcare Associated Infection (HAI) measure section </li></ul></ul></ul>
  13. 13. Public Reporting <ul><li>The 2007 Iowa Report </li></ul><ul><ul><li>Impact stories </li></ul></ul><ul><ul><ul><ul><li>5 Million Lives Campaign </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Healthcare-associated Infection </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Rapid Response Processes </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Lean in Healthcare </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Medication Reconciliation </li></ul></ul></ul></ul><ul><ul><li>CMS measures </li></ul></ul><ul><ul><li>Expanded AHRQ measures, both hospital specific and statewide aggregate </li></ul></ul><ul><ul><li>Expanded HAI Reporting- six new measures </li></ul></ul><ul><ul><li>Spread of 5M Initiatives </li></ul></ul>
  14. 14. IHC 2007 Work Plan Patient Safety <ul><li>Promote NQF 30 Safe Practices </li></ul><ul><li>Medication Safety </li></ul><ul><ul><li>Anticoagulation </li></ul></ul><ul><ul><li>Medication Reconciliation </li></ul></ul><ul><ul><li>High Alert Medications </li></ul></ul><ul><li>Safe Culture </li></ul><ul><li>Health Literacy </li></ul><ul><li>Explore PSO designation </li></ul>
  15. 15. IHC 2007 Work Plan Clinical Initiatives <ul><li>Lean in Health Care </li></ul><ul><li>IHI 5 Million Lives Campaign </li></ul><ul><li>Healthcare-Associated Infection </li></ul>
  16. 16. Lean in Healthcare <ul><li>Annual Lean Conference </li></ul><ul><ul><li>Promote and endorse </li></ul></ul><ul><ul><li>Share Iowa experiences </li></ul></ul><ul><li>“ Active” User Group </li></ul><ul><li>Lean Collaborative </li></ul><ul><ul><li>21 hospitals… </li></ul></ul>
  17. 17. 5 Million Lives Campaign <ul><li>Strategy: </li></ul><ul><ul><li>All 12 initiatives, all 117 Iowa hospitals </li></ul></ul><ul><ul><li>Clustered and aligned with existing IHC work </li></ul></ul><ul><ul><li>Project Coordinator, goals </li></ul></ul><ul><ul><li>Convene, share, track progress </li></ul></ul><ul><li>Breakthrough series model </li></ul><ul><ul><li>Learning sessions (9/11/07, 3/3/08, 9/9/08) </li></ul></ul><ul><ul><li>Action periods between with calls and contacts </li></ul></ul>
  18. 18. Campaign Initiatives <ul><li>Acute Myocardial Infarction </li></ul><ul><li>Adverse Drug Events </li></ul><ul><li>Surgical Site Infection </li></ul><ul><li>Ventilator Assoc. Pnuemonia </li></ul><ul><li>Central Line Infection </li></ul><ul><li>Rapid Response Teams </li></ul><ul><li>Congestive Heart Failure </li></ul><ul><li>High Hazard Medications </li></ul><ul><li>Surgical Care Improvement Project </li></ul><ul><li>Pressure Ulcers </li></ul><ul><li>Methicillin Resistant Staph Aureus </li></ul><ul><li>Boards on Board </li></ul>
  19. 19. Healthcare Associated Infection <ul><li>Alignment with NQF Safe Practices and the 5M Campaign </li></ul><ul><li>Engagement of ICP Community </li></ul><ul><li>Statewide Influenza HCW Vac. Goal </li></ul><ul><li>Introduced voluntary reporting of six statewide measures </li></ul><ul><ul><ul><li>Influenza Vaccination of Healthcare Workers </li></ul></ul></ul><ul><ul><ul><li>Central Line Infection- ICU </li></ul></ul></ul><ul><ul><ul><li>Surgical site infection rates for Hip, Colon, CABG and Hysterectomy </li></ul></ul></ul>
  20. 20. Our Response…
  21. 21. Providers Need to Lead <ul><li>Brightest, most powerful component of the health care equation… </li></ul><ul><li>Excuses: </li></ul><ul><ul><li>“ I don’t have time.” </li></ul></ul><ul><ul><li>“ This isn’t my problem.” </li></ul></ul><ul><ul><li>“ When the hospital gives me a cut of the action…” </li></ul></ul><ul><ul><li>“ I don’t have a prescribing pen…no real influence…” </li></ul></ul><ul><li>Training and Mindset: </li></ul><ul><ul><li>See one, do one, teach one. </li></ul></ul><ul><ul><li>We’re trained to not innovate </li></ul></ul>
  22. 22. Leadership <ul><li>To lead, we need to develop… </li></ul><ul><ul><li>A spirit of innovation </li></ul></ul><ul><ul><li>A sense of ownership </li></ul></ul><ul><ul><li>A focus on ‘nimbleness’ </li></ul></ul><ul><ul><li>A commitment to collaboration </li></ul></ul>
  23. 23. Redefining Professionalism <ul><li>The New Era of Transparency and Accountability based on a Value-Driven Healthcare System… </li></ul><ul><ul><li>Evidence-based process measures & metrics </li></ul></ul><ul><ul><li>Define and standardize clinical performance metrics </li></ul></ul><ul><ul><li>Data used to improve quality and value </li></ul></ul><ul><ul><li>Reliable information publicly available on quality and cost </li></ul></ul><ul><ul><li>Rapid spread of best practice </li></ul></ul><ul><ul><li>Engagement of patients as partners </li></ul></ul>
  24. 24. Cornerstones for the future… <ul><li>Align & Equip Health Care Providers on Quality and Value </li></ul><ul><li>Responsible Public Reporting </li></ul><ul><li>Engage the Community for Clinical Improvement </li></ul><ul><li>Raise the Standard of Care </li></ul>

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