Outcomes Improvement When the pub-lic is alerted to quality failures, such as prevent-able medication errors resulting in patient harm or death, concerns about the quality of health-care arise. Primary care is a critical element of a high-quality health system. See if you should add any from this list of 108 healthcare measures and metrics. Through its analytics platform and best-of-breed, ABC models, UPMC is improving quality and safety, reducing costs, and increasing value across service lines. Beth Israel was able to reduce readmissions, lengths of stay, incidents of deep vein thrombosis, infections, and complications, as well as patient mortality rates. Concerned specifically with a hospital's more cyclical activities, such programs aim to continually increase levels of performance (e.g. Health Catalyst offers a roadmap to use best practice, adoption, and analytics together to drive outcomes improvement. Additionally, using a data-driven approach can help engage stakeholders and make a … This example of clinical quality improvement in healthcare comes from UnityPoint Health, a healthcare system serving Iowa, western Illinois, and southern Wisconsin. Once these three things are in alignment, health systems can tackle clinical, financial, and operational quality improvement projects like the examples covered here and make incredible strides in the clinical, financial, and operational health of the organization. Integrating autism screening into well child visits in a primary care clinic. 12% reduction in hospital admissions per 1,000 members and a 10% reduction in emergency department visits per 1,000 members. Health professions students can play a critical role in quality improvement initiatives, both during their training and in their careers. Healthcare Mergers, Acquisitions, and Partnerships, Health Resources and Services Administration. A broad variety of such improvement methods exist. These are examples from leading healthcare organizations. Get a general overview of the Model for Improvement. 9% relative difference in mortality for patients that received the evidence-based protocols compared to those who did not—the evidence-based protocols substantially reduce mortality. $3 million in recurring benefit, the direct result of denials reduction. © Results also showed better communication with the patient’s support network to ensure the transition of care went smoothly after they left the hospital. Reductions in length of stay have allowed patients to return home earlier and spend more than 1,000 additional nights in their homes. Improve care through adopting the Chronic Care Model (CCM) and implementing practice redesign and quality improvement (QI) -Includes 3 major educational activities: (a) pre-course intro to QI and CCM; (b) 2-day forum on topic including QI, IT, chronic care model; (c) 6-month QI project with help of QI mentor - QI capacity involves a deep understanding of and commitment to improvement to undertake ongoing, continuous QI work beyond any particular project. HC Community is only available to Health Catalyst clients and staff with valid accounts. We develop, support and facilitate ways for primary care providers to build capacity and share knowledge to improve the quality of patient care. For example a ‘SMART’ aim looking at doing 6 week baby checks in a timely manner could be ‘To improve the percentage of 6 week baby checks performed between the start of week 6 and by end of week 8’. Below are three successful clinical examples of quality improvement in healthcare covering a wide range of issues facing many health systems today. The RCGP has created a simple visual representation of quality improvement for primary care to give you an overview of your quality improvement journey. But, health systems need to tackle the right projects at the right time for their organization. But engaging in care redesign is challenging for clinicians. Multiple months of data can now be run simultaneously. Three of the top areas of focus for 2018/2019 included: JBH’s 2018/2019 quality improvement plan comprises 10 indicators the hospital identified as critical areas of importance. The first example is a recent project to improve patient outcomes and reduce cost where Allina Health leveraged their analytics system to demonstrate the impact of their pharmacist-led medication therapy management (MTM) in reducing the total cost of care. With the right evidence, analytics, and methods, providers and improvement teams can transform healthcare, improving the quality of care delivered to the patients they serve and the bottom line. Health system leaders recognized that the common denominator to addressing threats to sustainability is to fully understand and effectively manage costs. Targeting processes such as chronic obstructive pulmonary disorder readmissions and medication reconciliation at discharge, these quality initiative examples are very different from SHSC, but still focused on improving care overall. Example: AHRQ IMPaCT Grantees' Work to Support Quality Improvement in Primary Care. All rights reserved. practice management, quality improve-ment, small primary care practices. Despite previous initiatives, The University of Kansas Health System’s claim denial rate of 25% was higher than best practice (five percent). A quality improvement project (QIP) should be a continuous process of learning, development and assessment, and part of a wider QI programme. But the process of identifying, prioritizing, and implementing these changes can be improved with the right tools and, process, and people. Davidoff F, Batalden P, Stevens D, Ogrinc G and Mooney S. Publication guidelines for quality improvement in health care: evolution of the SQUIRE project. Examples of prior quality improvement and research projects: Increasing access to naloxone in Primary Care for patients on chronic opioid therapy; Implementation of integrated Behavioral Health in a rural Primary Care clinic; Reducing inappropriate prescribing of proton pump inhibitors in Primary Care More information on QI Ready Contact us to learn more about how our software can help healthcare organizations. Primary Care Quality Improvement Toolkit . Many programs are organization-wide, ongoing, and long-term (as you’ll see in some of the quality improvement examples later in this article). Extended Examples of Quality Improvement Projects in Adult Immunization These extended examples will highlight the Residency Clinic and the Private Practice as vaccination settings. By adopting a systematic, data-driven, and multi-pronged approach, Memorial has achieved significant results in one year, including: The last example of financial and operational quality improvement projects comes from The University of Kansas Health System. Quality improvement projects — in healthcare or, more specifically, in nursing — can analyze and improve complicated processes. The indicators align with JBH’s strategic plan and accreditation requirements. The resulting report provides an engaging and cogent analysis of the key ... Getting leadership for quality improvement right requires a delicate combination of setting out . • Primary care practices handle a large variety oftests that involve both onsite and offsite ... guiding questions, examples, and links to additional resources. With lives at stake and specific standards that must be met, hospitals are held more accountable for excellence than your typical organization. Now more than ever, government and insurance reimbursement for patient care are based on health outcomes rather than procedures undertaken. Millions of clicks have been reduced for clinicians based on deployment of new sepsis screening tools. Make sure you customize each program and process that you implement based on your organization's goals. QI Ready is a free online tool to support GPs and practice teams in better understanding QI methodologies and undertaking QI activities, including an online learning network and a series of QI learning modules. Quality Improvement Methods. Reduced 60 human touchpoints and opportunity for error. In order to reduce medication-related adverse events the health system initially considered expanding the involvement of pharmacists performing medication therapy management (MTM) to a group of Medicaid patients covered by a shared-risk contract. QI projects are reactive and more focused on intervention. To effectively reduce revenue cycle and implement effective change, the health system needed to proactively identify issues that occurred early in the revenue cycle process. In this section, we provide two examples of quality improvement in healthcare that are specifically related to programs. T … By gathering and analyzing data in key areas, a hospital can effectively implement change. In order to thrive in an increasingly complex environment, financial and operational improvement projects are more important than ever. Hospital leaders knew additional methods of providing more efficient and cost-effective quality care were needed to maintain long-term success. For its 8th annual QI plan, Sunnybrook Health had four strategic goals that were supported by multiple activities to improve the quality of service. QI requires 1901 N. Moore Street, Suite 502 | Arlington, VA 22209 | 866-568-0590 | [email protected], Copyright © 2020 Ascendant Strategy Management Group LLC d/b/a ClearPoint Strategy |. It can also improve outcomes by minimizing the risk of hospital-acquired conditions. In comparison to the programs above, the following are examples of quality improvement projects in hospitals. Quality Improvement projects typically mean additional work everyone involved. We take pride in providing you with relevant, useful content. Quality improvement involves a combined effort among health care staff and stakeholders to diagnose and treat problems in the health care system. UC San Diego was able to improve the quality and consistency of discharge instructions. Our resident clinic at Beaumont Hospital, Royal … Gaps in the quality of medical care in the United States and evidence of significant variation in medical prac-tice are well documented. Improving Tobacco Use Screening and Smoking Cessation in a Primary Care Practi; Los Angeles Practice Uses EHR Functions for Quality Improvement; MedAllies and the Direct Project Support Secure Exchange of Clinical Information in EHR Systems; Meeting the Needs of a Diverse Patient Population through Patient Portals The second example of a clinical quality improvement project deals with an issue well-known to hospital systems. However, their processes for identifying patients with sepsis and initiation of care was fragmented and varied widely across the system, negatively impacting outcomes. Health Catalyst has focused on helping health systems identify, prioritize, and succeed in tackling quality improvement projects since 2008. Having a strategic management system like ClearPoint in place allows you to track your metrics for patient outcomes and patient care, identify areas that need improvement, and measure QI efforts and the resulting changes. improving patient safety or lowering patient mortality). In an effort to create a high-quality health care system in the United States, many payers, providers, delivery systems, and other organizations are supporting the use of quality improvement (QI) 1initiatives to improve the performance of primary care practices. While health systems need to consistently innovate in order to tackle these problems, many quality improvement projects fail to deliver on ROI. Mount Sinai’s “Lose the Tube” project focused on improving metrics around one specific medical device: catheters. The 2019/20 changes to the Quality and Outcomes Framework included the introduction of a quality improvement (QI) domain. The hospital was faced with declining revenue due to changes in Medicare and Medicaid reimbursements. Examples of Quality Improvement Projects in Reducing Medical Errors, Medication Errors, and Adverse Drug Events; Examples of Quality Improvement Projects in Reducing Hospital-Acquired Infections, Injuries, and Other Illnesses; Improving the Treatment of Sepsis; Examples of Quality Improvement Projects in the Continuity of Care for Patients Quality Improvement T H E A S H P D I S C U S S I O N G U I D E O N EXECUTIVE SUMMARY Providing high-quality, safe medical care is the primary goal of health systems. There has been much developed on how to assure quality and effectiveness when making changes in clinical and non-clinical settings. Compared to hospitals, so far there have been less requirements on primary care to demonstrate quality. The hospital had realized that catheters were being given to patients who didn’t need them, and that they were being left in too long. May we use cookies to track what you read? Identifying sepsis early can be challenging, as the patient’s physical response presents as a syndrome of non-specific symptoms, which delays recognition, diagnosis, and treatment–all of which increases mortality rates. However, health care professionals often lack training in quality improvement methods, which makes it challenging to participate in improvement efforts. Keywords. While there are many different definitions of quality improvement, the Health Resources and Services Administration (HRSA) defines it as “systematic and continuous actions that lead to measurable improvement in health care services and the health status of targeted patient groups.” In addition to a practical definition, health systems need a roadmap to help guide successful quality improvement projects forward. diabetes care from secondary to primary care, ... commonly encountered by project teams when doing improvement. New Approach to primary medical care: ... between primary care doctors and other home care Implementation of a health teaching intervention aimed at aiding in the recovery from acute myocardial infarction. Unlocking the Power of Patient-Reported Outcome Measures (PROMs), How to Evaluate Emerging Healthcare Technology With Innovative Analytics, Emergency Department Quality Improvement: Transforming the Delivery of Care, Improving Quality Measures Can Lead to Better Outcomes, I am a Health Catalyst client who needs an account in HC Community. Wound and Stoma Care Education for Primary Care Providers, Deanna Garza. Taking these steps led to the following improvements: The second example comes from Memorial Hospital at Gulfport. Primary Care Quality Improvement Plans ... For example, an ... organizations will be able to prioritize QI projects and develop improvement plans for the year. . Sepsis is a major driver of mortality in the U.S.–it’s estimated that up to half of all hospital deaths are linked to the infection. To address this, they implemented activity-based costing (ABC), facilitated by the Health Catalyst CORUS™ Suite, to deliver detailed and actionable cost data across the analytics environment, and support service line reporting, contract modeling, and clinical process improvement. (Remember, programs are ongoing, long-term, and proactive initiatives that span the organization.) quality in primary care and insufficient keeping to standards of good care (Seddon et al., 2001; Kirk et al., 2003). Enter: quality improvement projects in healthcare. What is quality improvement? The QI project included creating a board-level commission, establishing a best-practices group, replacing critical leaders, and introducing new clinical guidelines and policies to improve safety, communication, and transparency. PDF. Learn more about our work with primary care practices through the Practice Innovation Network. Is a Medical Writer the Missing Accelerant to Your Outcome Improvement Efforts? Emergency Department quality improvement is a journey that takes time and improving ED performance is much more than an emergency department initiative–it must involve the entire system of care. You can find more information on quality improvement projects in the s tudent handbook. More information. Quality in Primary Care 2008; 16:387–9. After a series of news stories revealed medical errors and poor quality healthcare at Beth Israel, the hospital embarked on a quality improvement program to address the issues. $2,085 mean total cost of care reduction per patient in the six-month period after the first pharmacist MTM encounter; over $590,000 extrapolated out over 283 MTM patients. These examples are provided to illustrate the practice improvement process, and that actual efforts devised by physicians and their team may differ based upon 1% relative reduction in mortality for patients with severe sepsis and septic shock. Ensuring patients receive care that is safe and of high quality is an essential part of modern healthcare. Greenhalgh T, Russell J and Swinglehurst D. Narrative methods in quality improvement research. This was a targeted intervention aimed at changing processes and the leadership structure to improve patient care. This program is effectively reducing the total cost of care. Faculty judges also selected runners up. Click To Tweet. Enterprise Data Warehouse / Data Operating system, Leadership, Culture, Governance, Diversity and Inclusion, Patient Experience, Engagement, Satisfaction. Broadly speaking, the below are best practices for most QI programs. QI projects are shorter term and more reactive than programs. However, they also realized that without understanding organizational strengths and weaknesses related to adopting change and improving outcomes, they would struggle to successfully implement initiatives that delivered the desired benefits and sustained improvements over time. They used this capability to effectively drive cost savings and improve clinical outcomes in many of its service lines, including Surgical Services, Women’s Health, Orthopedics, and Cardiovascular. Are you tracking the right KPIs? Something as simple as more regular and systematic check-ins was able to dramatically reduce infection for Mount Sinai. A QI program is a set of focused activities designed to monitor, analyze, and improve the quality of processes in order to improve the healthcare outcomes in an organization. Health Catalyst. We've defined QI programs and provided some current examples of quality improvement in leading healthcare organizations in the US and Canada. Everyone involved in improvement projects from doctors and nurses, to data analysts and administrators are busy with other projects. $2 million in cost savings, the result of decreased LOS and decreased utilization of supplies and medications. Primary care is often provided in a fragmented way, and in much smaller units of provision than the enterprises of hospitals. The QI project was aimed at decreasing the number of catheter-associated urinary tract infections (CAUTI) in the hospital. Primary Care Examples. 4% relative reduction in emergency department (ED) length of stay (LOS) for patients with severe sepsis and septic shock. 47-day percentage point reduction in LOS. It is your starting place for all QI tools, guidance and case studies. PDF. This allows a practice to systematically track and assess performance over time and regul… Annual COPC QI Reports Memo . At the 2015 IHI National Forum in December, the IHI Open School selected four student and resident projects from close to 100 submissions to highlight in a special storyboard session. An efficient accounting closing process delivers timely and accurate information to guide decisions and operational adjustments. 36% increase in sepsis screenings completed in the emergency department (ED). (Remember, programs are ongoing, long-term, and proactive initiatives that span the organization.) Despite their proliferation and importance, quality improvement programs aren’t something a patient would necessarily notice or observe in a hospital. Include project AIM statement • Example: By December 2012, ABC Health Center will achieve 70% of eligible patients screened for colorectal cancer. 1. Variable costs were reduced by more than $1.75 million based on the deployment of interventions in sepsis alerts, order sets, and other clinical decision support tools. For a practice, this requires (1) knowledge and understanding of QI approaches, and how to use data and feedback for QI; and (2) commitment of practice leadership and staff to dedicate time and resources to QI activities. 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