The document discusses the Iowa Healthcare Collaborative's 2007 work plan to promote transparency, accountability, and value-driven healthcare in Iowa. The plan focuses on education, public reporting of quality measures, patient safety initiatives, and clinical quality improvement projects like reducing healthcare-associated infections and engaging hospitals in the 5 Million Lives Campaign. The response argues that healthcare providers must lead these efforts through a spirit of innovation, ownership, collaboration, and by redefining professionalism around evidence-based quality improvement and transparency.

1. Healthcare Call to Action 2007 Tom Evans, M.D.

2. A New Era…

3. A new era of transparency and accountability… Development of evidence-based medicine Define and standardize clinical performance metrics Convergence around new measures Awareness of effectiveness Industry shifts in practice Changes in reimbursement Value Driven Health Care

4. Value-Driven Health System Connecting the System Standards to connect all health information systems Measure and Publish Quality Every case, every procedure Measure and Publish Price Standardize identical services and episodes of care Create Positive Incentives Reward those who offer and those who purchase high quality, competitively priced healthcare

5. Iowa Healthcare Collaborative 2003 Task Force of providers, payers, purchasers and consumers “ How will this era of transparency and accountability effect Iowa Healthcare with it’s unique challenges?” From joint IHA/IMS Task Force … … to provider-led statewide quality improvement initiative

6. Iowa Healthcare Collaborative Align & Equip Health Care Providers on Quality and Value Responsible Public Reporting Engage the Community for Clinical Improvement Raise the Standard of Care in Iowa

7. IHC Organizational Structure IHC Board IHC Advisory Council Data Committee Clinical Initiative Work Groups Education Committee

8. IHC 2007 Work Plan

9. Iowa Healthcare Collaborative 2007 Work Plan Education Public Reporting Patient Safety Clinical Initiatives

10. IHC 2007 Work Plan Education Conferences Patient Safety Summit Physician’s Forum LEAN in Health Care Conference Annual IHC Conference Website- www.ihconline.org Toolkits Anticoagulation, Medication Reconciliation, Health Literacy, Healthcare-associated Infection, Lean in Health Care, Safe Culture Physician Practice Toolkit

11. IHC 2007 Work Plan Public Reporting Driven by “Responsible Public Reporting” IHC Sources Both clinical and administrative data Publicly available and voluntary reported information sources Data suitable for comparative purposes CMS Hospital Compare AHRQ Administrative data set Subjective data, not suitable for comparative purposes NQF 30 Safe Practices information Healthcare Associated Infection (HAI) measures Spread Measures

12. Public Reporting The Iowa Report 2005 Report CMS Measures- Hospitals AHRQ Data- Statewide aggregate Survey on NQF Safe Practices 2006 Iowa Report CMS Measures- Hospital specific AHRQ Data- Hospital specific and some statewide aggregate Healthcare Associated Infection (HAI) measure section

13. Public Reporting The 2007 Iowa Report Impact stories 5 Million Lives Campaign Healthcare-associated Infection Rapid Response Processes Lean in Healthcare Medication Reconciliation CMS measures Expanded AHRQ measures, both hospital specific and statewide aggregate Expanded HAI Reporting- six new measures Spread of 5M Initiatives

14. IHC 2007 Work Plan Patient Safety Promote NQF 30 Safe Practices Medication Safety Anticoagulation Medication Reconciliation High Alert Medications Safe Culture Health Literacy Explore PSO designation

15. IHC 2007 Work Plan Clinical Initiatives Lean in Health Care IHI 5 Million Lives Campaign Healthcare-Associated Infection

16. Lean in Healthcare Annual Lean Conference Promote and endorse Share Iowa experiences “ Active” User Group Lean Collaborative 21 hospitals…

17. 5 Million Lives Campaign Strategy: All 12 initiatives, all 117 Iowa hospitals Clustered and aligned with existing IHC work Project Coordinator, goals Convene, share, track progress Breakthrough series model Learning sessions (9/11/07, 3/3/08, 9/9/08) Action periods between with calls and contacts

18. Campaign Initiatives Acute Myocardial Infarction Adverse Drug Events Surgical Site Infection Ventilator Assoc. Pnuemonia Central Line Infection Rapid Response Teams Congestive Heart Failure High Hazard Medications Surgical Care Improvement Project Pressure Ulcers Methicillin Resistant Staph Aureus Boards on Board

19. Healthcare Associated Infection Alignment with NQF Safe Practices and the 5M Campaign Engagement of ICP Community Statewide Influenza HCW Vac. Goal Introduced voluntary reporting of six statewide measures Influenza Vaccination of Healthcare Workers Central Line Infection- ICU Surgical site infection rates for Hip, Colon, CABG and Hysterectomy

20. Our Response…

21. Providers Need to Lead Brightest, most powerful component of the health care equation… Excuses: “ I don’t have time.” “ This isn’t my problem.” “ When the hospital gives me a cut of the action…” “ I don’t have a prescribing pen…no real influence…” Training and Mindset: See one, do one, teach one. We’re trained to not innovate

22. Leadership To lead, we need to develop… A spirit of innovation A sense of ownership A focus on ‘nimbleness’ A commitment to collaboration

23. Redefining Professionalism The New Era of Transparency and Accountability based on a Value-Driven Healthcare System… Evidence-based process measures & metrics Define and standardize clinical performance metrics Data used to improve quality and value Reliable information publicly available on quality and cost Rapid spread of best practice Engagement of patients as partners

24. Cornerstones for the future… Align & Equip Health Care Providers on Quality and Value Responsible Public Reporting Engage the Community for Clinical Improvement Raise the Standard of Care