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Kate Brostoff, MD,  medical director, APPLE (Acute, Post-acute,  Pharmacy, Laboratory, Emergency) Patient Resources & Options,  Group Health Physicians Brenda Bruns, MD,  executive medical director, Health Plan Services, Group Health Physicians Barbara Trehearne, PhD, RN,  vice president of Clinical Excellence, Quality, and Nursing Practice, Group Health Barbie Wood, RN, MBA,  director, Care Management  Services, Group Health Emergency Department and Hospital Inpatient Initiative
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
PATIENT EXPERIENCE PATIENT EXPERIENCE
STRATEGIES ,[object Object],[object Object],[object Object],[object Object],EPRO Transition  Mgmt SNF  Discharge Palliative  Care
PATIENT EXPERIENCE PRE-ADMISSION ASSESSMENT  | Emergency Patient Resources and Options (EPRO)
PROVIDING ALTERNATIVES TO ED AND HOSPITAL ADMISSION  |  24/7 Telephonic Physician + Care Mgt RN Team ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],EPRO: 2011 Expansion  1/1/2011: Primary Care Pilot using EPRO for all hospitalizations EPRO
PATIENT EXPERIENCE PLACEMENT
PATIENT EXPERIENCE ADMISSION
PATIENT EXPERIENCE THE METHOD  | The Four Pillars Teach Medication Self- management Teach a patient about their condition and use of  a personal health record Provide knowledge  of warning symptoms  and how to respond Have a  patient set  up follow-up care with  their doctor
DAILY HUDDLE AND PATIENT IDENTIFICATION ,[object Object],[object Object],[object Object],[object Object]
TRANSITION MANAGEMENT |  How do we do it? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Transition  Mgmt SNF  Discharge
HOSPITALIST / CARE MANAGEMENT PARTNERSHIP  |   Collaborative Standard Work ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],HOSPITALISTS CARE MANAGERS
HOSPITAL BASED MD TRAINING ,[object Object],[object Object],[object Object],[object Object]
Would you be surprised if this patient died within the next 2 years?   PALLIATIVE CARE SUPPORT Disease Process Functional Status Level of Intervention + = Source: Pyramid tool adapted from Victoria Hospice Palliative Performance Scale; Disease Process Assessment adapted from a variety of hospital-based palliative care service tools. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Palliative  Care
PATIENT EXPERIENCE POST-DISCHARGE
CONNECTING BACK WITH OUR MEDICAL HOME ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],SEPT 2010 DEC 2009 91 st   percentile 74 th   percentile
GOALS AND MEASUREMENT  OBJECTIVES •  Reduce inpatient costs and    readmit rates by providing    consistent and reliable post-acute    care transitions •  Optimize post-acute    care processes •  Reduce unnecessary Emergency    Department (ED) utilization    and costs $51 million total savings for 2010 METRICS •  Readmit rate •  IP admit rates •  Hospital length   of stay (LOS) •  SNF admits/1,000 •  SNF LOS •  ED visits/1,000
$ 51 m HOSPITAL  COST SAVINGS
RESULTS
Medicare patient  readmission: NATIONALLY:  19.6 % WASHINGTON:  16.4 % GROUP HEALTH:  15%
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],OVERALL IMPROVEMENT
 

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Emergency Department/Hospital Inpatient Initiative

  • 1. Kate Brostoff, MD, medical director, APPLE (Acute, Post-acute, Pharmacy, Laboratory, Emergency) Patient Resources & Options, Group Health Physicians Brenda Bruns, MD, executive medical director, Health Plan Services, Group Health Physicians Barbara Trehearne, PhD, RN, vice president of Clinical Excellence, Quality, and Nursing Practice, Group Health Barbie Wood, RN, MBA, director, Care Management Services, Group Health Emergency Department and Hospital Inpatient Initiative
  • 2.
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  • 6. PATIENT EXPERIENCE PRE-ADMISSION ASSESSMENT | Emergency Patient Resources and Options (EPRO)
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  • 10. PATIENT EXPERIENCE THE METHOD | The Four Pillars Teach Medication Self- management Teach a patient about their condition and use of a personal health record Provide knowledge of warning symptoms and how to respond Have a patient set up follow-up care with their doctor
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  • 19. GOALS AND MEASUREMENT OBJECTIVES • Reduce inpatient costs and readmit rates by providing consistent and reliable post-acute care transitions • Optimize post-acute care processes • Reduce unnecessary Emergency Department (ED) utilization and costs $51 million total savings for 2010 METRICS • Readmit rate • IP admit rates • Hospital length of stay (LOS) • SNF admits/1,000 • SNF LOS • ED visits/1,000
  • 20. $ 51 m HOSPITAL COST SAVINGS
  • 22. Medicare patient readmission: NATIONALLY: 19.6 % WASHINGTON: 16.4 % GROUP HEALTH: 15%
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  • 24.