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Count= 68
  
Infectious Diseases of America (IDSA)Partnership/Collaboration, Measure Development, Quality Initiative
Our goal is to make available a portfolio of NQF-endorsed quality measures for infectious diseases clinicians to satisfactorily report for P4P and public reporting programs.
Federal Agencies, Hospitals/Hospital Engagement Networks (HENs), Providers/Professionals, Purchasers/Payers, States/CommunitiesInfectious Diseases Quality Improvement Measure ConceptsIn progress
Thomas Kim
Infectious Diseases Society of America
Program Coordinator, Clinical Affairs
703.638.1502
tkim@idsociety.org
Providers; Health ProfessionalPatient SafetyNo presence informationThomas Kim4/14/2014 1:53 PM(National)4/14/2014 1:53 PMNo presence informationThomas Kim
IDSA has developed quality improvement measure concepts regarding infectious diseases and is seeking interested parties to collaboratively develop the concepts. Numerator, denominator, and exclusion statement have been developed as well as the supportive body of evidence. Please visit http://www.idsociety.org/QI_Measure_Concepts/ to view the measure concepts.
  
Health Information and Management Systems Society (HIMSS)Quality Initiative, Toolkit/Resource
1. Three hours prior to scheduled distribution, the medication order in the EHR generates
medication labels that include patient identifiers and medication names/doses. This information
is also included in a barcode on the label that is scanned by a point of care device.
2. Medications are filled, placed in a clear bag and loaded on racks for delivery to the nursing
floors. This improves over the previous system, which lacked sufficient organization. The old
process used heavy plastic carts that were difficult to move and maintain, and they often served
as a repository for erroneous doses and miscellaneous supplies.
3. Distribution occurs within a 30 minute window every two hours. The EHR creates workflow
efficiencies that enable the pharmacy to process orders at this increased frequency.
4. Nurses administer the medications as ordered during the two-hour window as prompted by the
EHR work lists and the point of care scanner.
Children's Medical Center was named a Davies Award winner in November, 2013. Their supply chain management case study will be presented on Feb. 25th, 2014 at the HIMSS Conference and Exhibition in Orlando.
By implementing the just-in-time medication process, the organization expected to realize financial
benefits through the reduction of wasted medications, as well as nonfinancial results through increased MENU CASE STUDY: CHILDREN’S SUPPLY CHAIN
- 6 -
 
 
 
access to medications for care delivery, reduced phone disruptions in the Pharmacy Department, fewer
medication storage areas on the unit and elimination of medication refrigerators. In addition to the
operational improvements, reduced medication preparation and administration time had the potential
to positively impact patient care and satisfaction. The project has proven to be successful for Children’s
in that the just-in-time process almost immediately resulted in a 90 percent reduction in dispensed dose
returns and cost of wasted doses, and a 90 percent reduction in phone calls to the department and trips
to the pharmacy by nurses seeking to obtain medications.
  1. Support your position with data: The Pharmacy Department learned the power of data and constant, consistent communication. Pharmacy team members reviewed the information, understood the gaps
    identified, and took action to address the problem.
  2. Staff to demand: The new procedure required work schedules to change in the pharmacy so that staffing levels were appropriate for the periods of higher demand. When pharmacy team members
    saw the facts and understood the potential benefits, they were supportive of changing their schedules to meet the organization’s needs and to provide better patient care delivery. Without good
    information, schedule changes could have been less palatable for staff and could have impacted the success of the project.
  3. Show your results: The immediate savings and success was directly attributable to the staff embracing the requested changes. Once the changes were deployed, benefits were immediate—and the
    organization shared the information with the team so they could see the results
Children's Medical Center- Dallas
X
Hospitals/Hospital Engagement Networks (HENs), Purchasers/PayersSupply Chain Case StudyClosed
Jonathan French
Director, Quality and Patient Safety
HIMSS
Hospitals/Hospital Engagement Networks (HENs)Patient SafetyNo presence informationJonathan French1/15/2014 2:37 PMTexas1/15/2014 2:37 PMNo presence informationJonathan French
The Children’s Medical Center (Children’s) pharmacy was able to use Electronic Health Record (EHR) technology with a redesigned medication administration process to save the organization $5.2M over
three years and decrease the time for dose availability. Children’s achieved an added bonus by
complying with the Environmental Protection Agency’s (EPA) initiative for pharmaceutical waste
destruction and becoming the first hospital in its region to meet the EPA’s medication destruction
requirements. The pharmacy has a long history of innovation with medication management starting in
1980s. With the implementation and organizational integration of the EHR at Children’s, it was a natural progression for the pharmacy to explore options that improve care delivery and decrease costs
  
American Nurses AssociationAdvocacy, Partnership/Collaboration, Toolkit/Resource
Engage AMSN in a national role and members as unit leaders to improve patient safety to reduce HACs and improve care transitions.
PfP education link added to the AMSN webpage, AMSN members were engaged via the extensive AMSN membership communications networks (e.g. Newsletter articles, Listserv, journal etc.), and fall 2013 conference.  
AMSN member engagment in PfP HAC reduction.  PfP presentation at annaul conference by PfP Co-Directors.  Link to ANA's NDNQI Pressure Ulcer Tutorial (staging/prevention) added to AMSN website. 

Solution:  Leading clinical prevention practices, best in class quality measures and actionable data reporting, and role maximization.

American Nurses Association (ANA), Academy of  Medical-Surgical Nurses (AMSN), and PfP
Hospitals, Hospital Engagement Networks (HENs)
Providers/ProfessionalsIn progress
Maureen Dailey PhD, RN, CWOCN
American Nurses Association
Health ProfessionalPatient Safetyi:0#.f|nqfmembershipprovider|maureen.dailey@ana.org12/13/2013 9:02 PM(National)12/13/2013 8:46 PMi:0#.f|nqfmembershipprovider|maureen.dailey@ana.org

The AMSN, an ANA Organizational Affiliate, is the only specialty nursing organization dedicated to the practice of medical-surgical nursing.  Medical-surgical nurses account for a large proportion of nurses working in hospitals.  The ANA and AMSN collaborated with the PfP leadership to advance achievement of the PfP goals. A strategy identified included education of AMSN members about the 1) national HAC reduction and readmission goals, 2) PfP Hospital Engagement Network (HEN) work and 3) effective use of evidence based tools. 

 

Information and links were provided on the AMSN website regarding the PfP and evidence-based tools (e.g., National Database of Nursing Quality Indicators® and Agency for Healthcare Research and Quality and Institute for Healthcare Improvement toolkits) to reduce HACs and improve care transitions.  Newsletter and journal items were disseminated via the AMSN’s extensive communication network.  The AMSN members were invited to share lessons learned and best practice solutions.

 

The AMSN put into place a system to foster research to improve patient safety, such as the early recognition of deteriorating patients or at-risk-patients through use of a Modified Early Warning System (or MEWS), effective deployment of  rapid response teams, and specific approaches to reduce HAI to go beyond protocols.  The PfP Co-Directors were included as AMSN annual 2013 conference presenters to articulate progress to date and further engage members in a national role to reduce harm reduction.
  
American Nurses AssociationAdvocacy, Partnership/Collaboration, Toolkit/Resource
Engage WOCN members as leaders to reduce HAPU and CAUTI.
PfP education link added to the WOCN webpage and WOCN members engaged via their extensive membership communications networks (e.g. Newsletter articles, Listserv etc.).  Professional resource materials identifed to reduce pressure ulcers and CAUTI.
More than 5,000 WOC nurses are engaged and educated regarding the PfP goals, strategies, and educational materials. 
Solution:  Evidence-based, state of the science measures and professional resource materials identified, actionable data reporting, leading clinical prevention practices identified and spread, and role maximization innovations shared.
Amerian Nurses Association (ANA); Wound, Ostomy, and Continence Nurses Society, and PfP
Hospitals and Hospital Engagment Networks
Providers/ProfessionalsIn progress
Maureen Dailey
American Nurses Association (ANA)
ProvidersPatient Safetyi:0#.f|nqfmembershipprovider|maureen.dailey@ana.org12/13/2013 8:59 PM(National)12/13/2013 8:59 PMi:0#.f|nqfmembershipprovider|maureen.dailey@ana.org

The ANA and WOCN, an ANA Organizational Affiliate (specialty nursing organization) partnered with the PfP to increase WOC nurse knowledge about the 1) PfP HEN work, 2) national HAC reduction goal, and 3) effective use of the National Database of Nursing Quality Indicators® (NDNQI®) and tools.  Specifically, > 5, 000 WOC nurses were engaged in the value of using data dashboards, such as the NDNQI dashboard, which employs effective use of clinically-enriched, gold-standard NQF-endorsed measures.  In addition, WOC nurses were engaged to promote use of evidence-based tools (e.g. NDNQI Pressure Ulcer Staging and Prevention Tutorial, WOCN guidelines and clinical tools, and other evidence-based toolkits).  Best practices for WOC nurse role integration and education of skin care resource teams in hospitals were also shared, which allows for better engagement of front line nurses and inter-professional team members.  In addition, WOC nurses are being made aware of the evidence regarding leading best-practice bundles for prevention practices identified in research conducted using NDNQI data.  These best practices were discussed in a 2013 PfP all-HEN pressure ulcer webinar presented by the ANA NDNQI team in collaboration with the PfP team. 

 

The WOCN is also developing a clinical/role integration Best Practices Compendium to share with the HENs, other hospitals, WOCN membership, and hospital administrators.   The WOCN members were surveyed to share lessons learned and best practice solutions.  The Compendium will include both best clinical practices and role integration strategies associated with HAC reduction that were published and presented at conferences, and shared in the survey. 
Attachment
  
March of DimesAdvocacy, Partnership/Collaboration, Policy Initiative, Quality Initiative, Toolkit/Resource
Support hospitals and hospital engagement networks in their quality improvement effort to reduce early elective deliveries.
 
Provide technical support to individual hospitals participating in the March of Dimes 39+ Weeks quality Improvement Initiative to reduce early elective deliveries.
 
Support hospital engagement networks using a learning collaborative model to reduce early elective deliveries.
 
Educate providers about the importance of at least 39 completed weeks of pregnancy.
Developed the 'Elimination of Non-medically Indicated (Elective Deliveries Before 39 Weeks Gestational Age' Toolkit in collaboration with the California Maternal Quality Care Collaborative (CMQCC), and the California Department of Public Health, Maternal, Child and Adolescent Health Division, with the Support of the American Congress of Obstetricians and Gynecologists (ACOG).
 
Made the 'Elimination of Non-medically Indicated (Elective) Deliveries Before 39 Weeks Gestational Age' Toolkit available to hospitals, hopsital engagement networks and, others.
 
Conducted a multi-state quality improvement program based on the Toolkit to decrease elective deliveries before 39 weeks gestational age.  Twenty-five hospitals in five states participated and over the 12 month study period, the rate of elective early term deliveries in these hospitals fell 83 percent.
 
Developed a 39+ Weeks Quality Improvement Service package to complement the Toolkit.  The Service Package was informed by the multi-state quality improvement program and aims to support additional hospitals in their implementation of a quality improvement initiative to reduce non-medically indicated delivereis before 39 completed weeks gestation.  Provided the 39+ Weeks QI Service Package to 100 hospitals nationally at no cost, except for the purchase of consumer education materials.
 
Developed a Hospital-based Learning Collaborative with the hospital engagement network to reduce early elective deliveries in 25 hospitals.
A study published by March of Dimes and others in Obstetrics & Gynecology showed that a quality improvement program reduced the rate of elective early term deliveries (i.e., inductions of labor and Cesarean sections without a medical reason) in a group of 25 participating hospitals.  The rate fell significantly from 27.8 percent to 4.8 percent during the one-year project period, an 83 percent decline.  "A multistate Quality Improvement program to Decrease Elective Deliveries Before 39 Weeks," appeared in the April 8 online edition of Obstetrics & Gynecology, Vol. 121, No. 5, May 2013.
 
100 hopsitals from 29 states are participating in the March of Dimes 39+ Weeks QI Service Package Initiative.  One hour in-person Grand Rounds provided to the hospital as part of the Service Package are currently being conducted by members of the March of Dimes National Speakers Bureau.  Hospital QI teams also have access to a secure March of Dimes web portal where they enter and review monthly early elective delivery statistics, view educational webinars, and other project resources.
 
Grand rounds and in-person mentoring sessions have been conducted at all 25 hospitals participating in the Hospital-based Learning Collaborative.  Hospitals will continue to have monthly networking calls and report on their early elective delivery data.
 
The 'Elimination of Non-medically Indicated (Elective) Deliveries Before 39 Weeks Gestational Age' Toolkit, available at no cost to hospitals, hospital engagement networks, and others, and has been downloaded over 2,000 times from www.prematurityprevention.org.
Engage hospital leaders early.  Initally, leaders at many hospitals did not feel that they had a problem with early elective delivery (EED) rates at their hospitals.  However, encouraging these leaders and other staff to closely review their own EED rates and engaging them in conversations about trends in EED rates nationally and the negative outcomes associated with early elective deliveries helped them realize they needed to take action within their own institutions.
 
Engage physicians early and keep them engaged even after the QI project ended.  It can be challenging to obtain the buy-in of all physicians to embark on a QI project to eliminate EEDs.  Presenting and discussing the evidence for reducing EEDs, as well as their own hospitals' EED rates, in different venues is a key step.  Including this information in staff meetings, Grand Rounds, and in personal meetings will help ensure that all physicians are presented with the evidence and data.  Also, having the Department Chair work one-on-one with physicians who are resistant to change can be useful in engaging them more fully.
 
Provide hospital with an easy-to-use data collection portal.  Hospitals participating in March of Dimes 39 weeks quality improvement projects have a secure web-based portal that is easy to use.  Hospitals enter data into the portal and receive monthly reports on EED rates.  Being able to review and share data with staff on a monthly basis, keeps staff engaged in the goal to eliminate EEDs.
California Maternal Quality Care Collaborative (CMQCC)
California Department of Public Health, Maternal, Child, and Adolescent Health Division
VHA Hospital Engagement Network
100 hospitals in 29 states
Additional Hospital Engagement Networks and Hospital Associations
Hospitals/Hospital Engagement Networks (HENs), Providers/Professionals39+ Weeks Quality ImprovementIn progress
Chapter Program Support Department, 39weeksQI@marchofdimes.com
Patient Family and ConsumerPerson- and Family-Centered Care, Effective Communication and Care CoordinationNo presence informationCynthia Pellegrini12/9/2013 5:14 PM(National); Alabama; Alaska; Arizona; Arkansas; California; Colorado; Connecticut; Florida; Georgia; Illinois; Indiana; Iowa; Kansas; Kentucky; Maryland; Michigan; Minnesota; Mississippi; Missouri; Montana; Nevada; New Mexico; New York; Oklahoma; Oregon; Pennsylvania; Puerto Rico; South Carolina; Tennessee; Texas; Virginia; Washington; Wisconsin; Wyoming12/9/2013 4:59 PMNo presence informationCynthia Pellegrini

Healthy Babies are Worth the Wait® is a March of Dimes initiative to encourge healthy, full term births.  Through education of women and health care providers, quality improvement activities with hospitals, and awareness activities, Healthy Babies are Worth the Wait helps to reduce risks and prevent premature birth and early term birth.

A key component of Health Babies are Worth the Wait is supporting hospitals, hospital engagement networks, and others in their implementation of quality improvement (QI) programs to reduce non-medically indicated deliveries before 39 weeks completed gestation.

  
Patient and Family Engagement NetworkPartnership/Collaboration, Toolkit/Resource
This inventory represents a growing list of tools and resources to engage patients and families in their care, and focused on the most vulnerable populations among us.  These tools are intended to serve as a critical resource to support the rapid spread of patient and family engagement best practices.
The Partnership for Patients hosted an online learning event titled "Achieving More Equitable Health Outcomes in Vulnerable Populations."  This inventory of tools and resources was distributed as a follow-up to the content made available in that webinar.
Since there are many tools and resources available online and from many organizations, the inventory will continue to be updated and expanded upon based on feedback and additional content provided.
These resources have been identified and collected through a survey of Hospital Engagment Networks, governmental Agencies and other stakeholders in the Partnership for Patients campaign.  The inventory has been developed by the PfP Affinity Group focused on patient and family engagment.
Providers/Professionals, Public/Consumershttp://www.healthcarecommunities.org/showcontent.aspx?pid=4295101489&id=4294983370In progress

Primary Contact: Elizabeth Stinson at Weber Shandwick (202-585-2295) or estinson@webershandwick.com

Hospitals/Hospital Engagement Networks (HENs); Health Professional; Patient Family and ConsumerPerson- and Family-Centered CareConsumer Awareness/Decision-making, Quality ImprovementNo presence informationSevera Chavez7/31/2013 11:58 AM(National)7/30/2013 2:46 PMNo presence informationLois Cross
Development of an inventory of tools to engage patients and families.
Patient and Family Engagement
Attachment
  
March of DimesMaternity Care/Adverse Obstetric EventsPartnership/Collaboration, Quality Initiative, Social Media, Toolkit/Resource
  • Educate pregnant women and providers about the importance of at least 39 completed weeks of pregnancy
  • Change norms through widespread awareness activities including advertising, social media, and publicity.  Increase the number of women and influencers who understand the importance of the last weeks of pregnancy to a baby's development, and the potential health consequences of early elective delivery.
  • Reduce early elective deliveries
  • Increase the number of hospitals with quality improvement initiatives to reduce early elective deliveries
 
  • The Department of Health and Human Services (HHS) purchased advertising time for March of Dimes Early Elective Delivery ads in November 2012 and April 2013.  The HHS logo and the American College of Obstetricians and Gynecologists logo appear on the March of Dimes patient education materials and advertising.
  • The March of Dimes and six other national health organizations co-signed a letter on May 1, 2013, calling upon the 3,000-plus maternity care hospitals nationwide to adopt new policies to reduce elective early deliveries.  The other co-signers to the letter were the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), The American College of Nurse Midwives (ACNM), the American College of Obstetricians and Gynecologists (ACOG), the American Hospital Association (AHA), and the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN).
  • A March of Dimes mobile app, called Cinemama, was launched in February 2013 and features Early Elective Delivery messaging.  Since then, it has been named a "new and noteworthy" app on itunes, one of twenty top new apps by CNN.com, and app of the week by parenting.com.  It currently has 18,000 active users.
  • March of Dimes Early Elective Delivery advertising created an estimated 864 million impressions since 2012, with millions more resulting from publicity and social media efforts.
  • Educational materials reached 1.7 million women and providers in 2012, through hospitals, health plans, HENs, health departments, health providers, and others.
  • The 'Elimination of Non-medically Indicated (Elective) Deliveries Before 39 Weeks Gestational Age' toolkit, available at no cost to hospitals, HENs, and others, and has been downloaded over 2000 times from www.prematurityprevention.org. This toolkit involves a patient education and awareness component.  Further details on quality improvement efforts in hospitals are provided in a separate entry.
  • The latest March of Dimes survey conducted by Harris interactive revealed a 12 point increase in moms that were aware of March of Dimes messaging regarding early elective deliveries.  This increase occurred in the fourth quarter of 2012, when HHS paid advertising and March of Dimes social media efforts were at their height.
  • A study published by March of Dimes and others in Obstetrics & Gynecology showed that quality improvement programs, which included March of Dimes Early Elective Delivery educational materials and awareness efforts, reduced the rate of elective early term deliveries (i.e., inductions of labor and Cesarean sections without a medical reason) in a group of 25 participating hospitals.  The rate fell significantly from 27.8 percent to 4.8 percent during the one-year project period, an 83 percent decline.  "A Multistate Quality Improvement Program to Decrease Elective Deliveries Before 39 Weeks", appeared in the April 8 online edition of Obstetrics & Gynecology, Vol. 121, No. 5, May 2013.  The 25 participating hospitals used the 'Elimination of Non-medically Indicated (Elective) Deliveries Before 39 Weeks Gestational Age' toolkit, developed by March of Dimes and others.
  • Extensive qualitative research and testing were conducted to ensure that educational materials are persuasive to the target audience.
  • Consistent messages, materials, and resources are used by providers, patients, and hospitals and are reinforced by advertising that appears on television, online, print, outdoor, and in television monitors in ob/gyn offices.
  • Partnerships with major national organizations, including the Association of State and Territorial Health Officials (ASTHO), the Department of Health and Human Services (HHS) and the American College of Obstetricians and Gynecologists (ACOG) have powerfully extended the reach of March of Dimes Early Elective Delivery messages and materials.  Through a joint effort with ASTHO, health departments are conducting outreach and their logos appear on March of Dimes Early Elective Delivery advertising and materials that appear in their state.
Association of State and Territorial Health Officials (ASTHO) and state health department in all states, the District of Columbia, and Puerto Rico.
 
Department of Health and Human Services (HHS).
 
American College of Obstetricians and Gynecologists (ACOG).
Hospital Engagement Networks have been invited to partner with March of Dimes on Early Elective Deliveries.  Outreach continues regarding partnership opportunities with birthing hospitals, health plans, and media outlets.
Hospitals/Hospital Engagement Networks (HENs), Providers/Professionals, Public/Consumers, Purchasers/Payers, States/Communitieshttp://www.Marchofdimes.com/catalogIn progress
Jennifer Nicoletti, jnicoletti@marchofdimes.com
Patient Family and ConsumerPatient Safety, Effective Communication and Care CoordinationConsumer Awareness/Decision-making, Quality ImprovementNo presence informationSevera Chavez7/31/2013 11:57 AM(National)7/1/2013 3:35 PMNo presence informationCynthia Pellegrini
The March of Dimes is driving an initiative to eliminate non-medically indicated deliveries before 39 weeks of pregnancy (early elective deliveries).  Resources available to hospitals, health plans, and health providers include: patient and provider educational materials; a consumer awareness campaign that includes advertising and media opportunities; reources to help hospitals implement a quality improvement (QI) program.
Maternity Action Team Member; NPP Partner
  
Society of Cardiovascular Patient CareMeasure Development, Quality Initiative
  1. To reduce mortality and morbidity from acute myocardial infarction, acute exasperation of heart failure, and acute complications of atrial fibrillation.
  2. To provide process improvement tools, evidence based medicine to hospitals nationally
  3. To knock down barriers between providers to enable rapid, efficient, and appropriate care to the patients we serve
  4. To facilitate community outreach to educate patients of early warning signs of MI and actions to be taken
  5. To work with hospitals nationally to reduce unnecessary hospital admissions and readmissions and to avoid RAC audits and penalties.

 

Launched an updated heart failure program with an accreditation conformance database attached to collect patient level data to measure against accepted and "pioneer" metrics
1. Eclipsed 900 hospitals
2. Working with hospitals in China, Saudi Arabia, and UAE
3.  Reduced door to coronary artery reperfusion
4.  Discharge to community resource of patient triaged with low risk of CVD
5.  Team oriented patient care from EMS to ED to cardiology
6.  Improved team culture focused on highly efficient, high quality care, and improved outcomes
Data collection to validate processes
  • sought industry partners with data extraction expertise
  • evaluated IT partners
  • boosted organizational IT capabilities and launched the data export capability internally - this will be expanded to other AMI and AF tools
American Heart Association
American College of Cardiology
Hospitals, hospital systems, payers, state health agencies
Hospitals/Hospital Engagement Networks (HENs), Policy makers, Providers/Professionals, Public/ConsumersSociety oc Cardiovascular Patient CareIn progress
Wil Mick, Chief Executive Officer
Health Professional; Hospitals/Hospital Engagement Networks (HENs); Patient Family and Consumer; Providers; Quality Measurement Research Improvement (QMRI)Prevention and Treatment of Cardiovascular Disease, Effective Communication and Care Coordination, Affordable CareQuality ImprovementNo presence informationSevera Chavez6/12/2013 10:51 AM(National)5/23/2013 4:30 PMNo presence informationWil Mick
To share how the SCPC uses and applies national standards, "pioneer" standards, and guideline driven care to over 900 hospitals in the US and internationally.
Attachment
  
PlanetreeAdverse Drug Events (ADE), Catheter-Associated Urinary Tract Infections (CAUTI), Central Line Associated Blood Stream Infections (CLABSI), Injuries from Falls and Immobility, Maternity Care/Adverse Obstetric Events, Pressure Ulcers, Readmissions, Surgical Site Infections (SSI), Venous Thromboembolism (VTE), Ventilator-Associated Pneumonia (VAP)Toolkit/Resource
Share information to support utilization of a low-cost tool that can support patient-caregiver communication
Collaborating with Kleen Slate at the Planetree annual conference and making whiteboards available to all participants
Information from prior initiatives utilizing this tool are presented in the slide deck.
Limited availability of whiteboard markers was considered to be the greatest barrier to use.
Study conducted at University of California, San Francisco
Kleen Slate welcomes collaboration with all healthcare partners, and Planetree wishes to facilitate these partnerships by making the slides available
Hospitals/Hospital Engagement Networks (HENs), Providers/Professionals, Public/ConsumersIn progress
Barry Hillman barry@kleenslate.com
ProvidersPerson- and Family-Centered Care, Patient Safety, Effective Communication and Care CoordinationConsumer Awareness/Decision-making, Quality ImprovementNo presence informationSevera Chavez5/8/2013 9:57 AM(National)4/23/2013 10:41 AMNo presence informationMichael Lepore
Slide deck sharing information and research findings about a low-cost tool to support patient-caregiver communications
Readmission Action Team Member; NPP Partner
  
March of DimesMaternity Care/Adverse Obstetric EventsEvent/Conference/Workshop/Webinar, Social Media, Toolkit/Resource

March of Dimes is committed to bringing together a coalition of individuals and organizations dedicated to promoting prematurity prevention. Using the Prematurity Prevention Network (PPN) concept as a platform, the March of Dimes provides an updated, relevant, and important tool for perinatal professional development.  The PPN’s tagline of ‘Join the Conversation’ best summarizes the goals of the Prematurity Prevention Network in its promotion and provision of various functionalities, electronic resources that are both current and relevant, tools, and opportunities that offer continuous, high-level professional engagement vital to addressing the most important perinatal issues.

Since its launch in January 2012, the Prematurity Prevention Network (PPN) has uploaded speaker presentations and related documents from the March of Dimes 2012 Prematurity Prevention Symposium.   The PPN has successfully hosted two major webinars.  The first, on July 10, 2012 was presented by Dr. Christopher Howson, Vice President of Global Programs for the March of Dimes, and entitled “Born Too Soon: Global Action Report on Preterm Birth.” The event garnered 476 registrants. The second webinar on October 26, 2012, hosted by the March of Dimes in collaboration with the National Medical Association, was presented by Dr. Washington Hill, Clinical Professor at both the Department of Obstetrics and Gynecology at the University of South Florida and the Department of Clinical Services OB-GYN Clerkship Director at Florida State University College of Medicine, and entitled “The Puzzle of Doing all we can to Detect Preterm Labor Early and Prevent Preterm Birth.” This event attracted 822 registrants. Feedback and evaluations from both webinars was uniformly excellent. Both Webinars are archived and available at the links below.  Currently, there are plans to roll out 2-4 webinars per year, and there will be an inclusion of at least 1 webinar series. 

Archived Webinars:

BORN TOO SOON: Global Action Report on Preterm Birth: https://www1.gotomeeting.com/register/263365024

The Puzzle of the Early Detection of Preterm Labor and Prevention of Preterm Birth: https://www1.gotomeeting.com/register/891578128

As of February 2013, the Prematurity Prevention Network (PPN) serves more than 7,400 members.  Of these, approximately 5,700 are registered users at the prematurityprevention.org website.  Membership has continuously increased since the site’s commencement in May 2011, and on average, has grown by 285 new users each month it’s been in existence.  Users are comprised of both national and international registrants.  Our constituents include an active audience interested in prematurity who want one-stop resources and to engage in meaningful conversations.

Online Platform: The Prematurity Prevention Network (PPN) currently directs users to a modest space within the March of Dimes Prematurity Prevention Resource Center (www.prematurityprevention.org), which was built on a legacy web platform. The platform provides basic space for document downloading, a multi-step procedure for checking documents in and out for editing, and a limited discussion board. Based on overwhelming uptake of the web-based resources housed in the PPRC, and recognizing that professionals have become accustomed to much more advanced social networking functionality similar to that offered by popular and professional websites such as Facebook and LinkedIn, March of Dimes seeks a better solution for its PPN platform and interface.

Maintaining Engagement: A priority of the Prematurity Prevention Network (PPN) Project is to remain true to the desired conversation topics and interests of its members. No attempt will be made to “seed” postings to incite short-lived or disingenuous conversations because these strategies have been shown rarely to work or are unsustainable in the online space. Instead, the major strategy for recruitment and retention in the work spaces and conversation spaces will be to “transplant” conversations that start in the real world into the PPN virtual space to continue, to grow, and to spawn related conversations.  The need for a project like this is due to the realities that in-person meetings also bring about issues such as time constraint, resource limitations, and scheduling conflicts. The two greatest obstacles to succeeding in virtual space are lack of compelling content and, particularly, lack of engagement from members. March of Dimes has already invested substantially in amassing, cataloguing, and grouping highly desired content for professional audiences in the Prematurity Prevention Resource Center and in recruiting members for the PPN. The PPN’s membership is growing by hundreds each month, sustainably for nearly two years. Moreover, these members are engaged: as compared to a consumer-oriented site hosted by March of Dimes, these members click on average three times as often.

 

Professional Organizations, Government Agencies, Non-profit and Advocacy Groups, Private Sector Companies/Organizations, Online Media/Resource Providers, and Educational Institutions that play an important role in the perinatal field.

Federal Agencies, Hospitals/Hospital Engagement Networks (HENs), Media, Policy makers, Providers/Professionals, Purchasers/Payers, States/CommunitiesPrematurity Prevention Resource Center (PPRC) and Prematurity Prevention Network (PPN)In progressPatient Family and ConsumerEffective Communication and Care CoordinationQuality ImprovementNo presence informationSevera Chavez4/17/2013 10:24 AM(National)4/12/2013 12:45 PMNo presence informationCynthia Pellegrini

The Prematurity Prevention Network (PPN) is a place for active online conversations and interactions among perinatal professionals who are primarily concerned with preventing preterm birth and reducing its associated harms.  Located at the website www.prematurityprevention.org, the PPN brings together multiple disciplines of perinatology and actively fosters, promotes, and hosts meaningful conversations, debates, and engagement opportunities around topics in perinatology. Its virtual work spaces and the conversations it hosts are embedded with and surrounded by easily accessible electronic resources (e.g., articles, white papers, videos, toolkits, and web links) that are catalogued and continuously updated and supplemented.

Maternity Action Team Member; NPP Partner
  
Health Information and Management Systems Society (HIMSS)ReadmissionsQuality Initiative, Toolkit/Resource
HIMSS Goal is to disseminate case studies on the utilization of EHR enabled quality and patient safety improvement aligned with NPP priorities.
Mount Sinai has observed 56 percent reduction in 30 day readmission rates, and these gains have been sustained at 60 and 90 days of discharge. Ninety-one percent of patients enrolled in PACT (n= 615) made follow up appointment within seven to 10 days, with 84 percent of patients keeping their appointment. Finally, MSMC and its partners have received generous grant funding to continue to evolve this ground breaking program. Further, the PACT program is expected to be a centerpiece of MSMC’s emerging Accountable Care Organization (ACO) program.
All HIMSS Analytics Stage 7 or 6 hospitals and ambulatory facilities that meet qualifying criteria are encouraged to apply for the HIMSS Davies Award, http://apps.himss.org/davies/
Hospitals/Hospital Engagement Networks (HENs), Providers/Professionals, Public/Consumers, Purchasers/PayersMount Sinai Case Study on Preventable AdmissionsClosed
Please contact Jonathan French at jfrench@himss.org for more information
Health Professional; Patient Family and Consumer; Hospitals/Hospital Engagement Networks (HENs); Health Plan; Providers; Supplier/Industry; Quality Measurement Research Improvement (QMRI); Purchaser; Public Community Health AgencyPerson- and Family-Centered Care, Effective Communication and Care CoordinationInfrastructure/HIT, Quality ImprovementNo presence informationSevera Chavez4/5/2013 12:01 PMNew York4/1/2013 10:57 AMNo presence informationJonathan French
HIMSS Davies Enterprise Award Winner Mount Sinai Medical Center Case Study on leveraging Health IT to enable their Preventable Admissions Action Team (PACT) initiative.

The ability to prevent avoidable readmissions by patients with certain chronic conditions within 30 days of discharge is a primary success factor for hospitals to be able to adhere to forthcoming changes in the reimbursement model used by Medicare. The Mount Sinai Medical Center (MSMC) set out to establish an electronic health record (EHR) based process whereby patients at risk of being readmitted into the hospital are efficiently and accurately identified and managed.

Once identified, these patients are enrolled into MSMC’s Preventable Admissions Care Team (PACT) program, where psychosocial drivers of readmission are assessed and addressed through a 35 day social work-lead intervention that begins upon discharge. By incorporating the identification process into the design and implementation of the Epic EHR, MSMC has effectively been able to hard wire key workflow processes required to reduce readmissions, improve care, and lower the costs of care.

The program has been very successful. A 56 percent reduction in 30 day readmission rates has been observed, and these gains have been sustained at 60 and 90 days of discharge. Ninety-one percent of patients enrolled in PACT (n= 615) made follow up appointment within seven to 10 days, with 84 percent of patients keeping their appointment. Finally, MSMC and its partners have received generous grant funding to continue to evolve this ground breaking program. Further, the PACT program is expected to be a centerpiece of MSMC’s emerging Accountable Care Organization (ACO) program

NPP Partner
  
Anesthesia Quality InstituteQuality Initiative

The mission of the AQI is to develop and maintain an ongoing registry of case data that helps anesthesiologists assess and improve patient care. Organize the registry so that anesthesiology practice groups desire to submit their case information, and so that individual anesthesiologists, practice groups, researchers, and professional societies find the data useful for improving the quality of care.​

We've surpassed 8M cases from 15K aneshtesia providers at 1500 facilities.   This data is being used to provide quality reports back to the groups and individual providers.   We've also created dashboards for anesthesia thought leaders.   We've received several government grants.​

Our approach to reveive data is a bit different.  Our data is collected only electronically with no extra work on the providers.   We have no abstracters and do not sample cases.  Every Case - Every Day from you electronic systems.​

Hospitals/Hospital Engagement Networks (HENs), Providers/ProfessionalsAQI homepageIn progressProvidersPatient SafetyQuality ImprovementNo presence informationSevera Chavez3/21/2013 10:31 AM(National)3/14/2013 9:29 AMi:0#.f|nqfmembershipprovider|rdutton

The vision of the AQI is to become the primary source of information for quality improvement in the clinical practice of anesthesiology​

  
Jewish Healthcare FoundationReadmissionsQuality Initiative


Create a 7-hospital network.

Target 25,000 Medicare beneficiaries in southwestern Pennsylvania with COPD, CHF, and CAD.

Prevent 1,445 Medicare admissions per year.

Save about $74 million in Medicare savings over three years.

Train 450 workers in quality improvement.

Federal Agencies, Policy makers, Providers/Professionals, Hospitals/Hospital Engagement Networks (HENs), States/CommunitiesAccountable Care Network
Hospitals/Hospital Engagement Networks (HENs); ProvidersPrevention and Treatment of Cardiovascular Disease, Person- and Family-Centered Care, Effective Communication and Care CoordinationQuality Improvement, Workforce DevelopmentNo presence informationSevera Chavez3/11/2013 3:44 PMPennsylvania; West Virginia3/9/2013 5:35 PMNo presence informationNancy Zionts
The Pittsburgh Regional Health Initiative (PRHI) was awarded $10.4 million to implement Primary Care Resource Centers (PCRC) in seven hospitals in Pennsylvania and West Virginia to reduce 30-day hospital re-admissions. In southwestern Pennsylvania, 50% of chronic obstructive pulmonary disease (COPD) discharges also have congestive heart failure (CHF) and/or coronary artery disease (CAD) based on PRHI’s analysis of PHC4 data from 2007 to 2008, and one in five COPD patients are readmitted within 30 days (PHC4, 2012).

Thus, in response to this current condition, the PCRC was designed as a place in a hospital where primary care ancillary services are centralized and coordinated. These services may include patient education, smoking cessation classes, pharmacist consultation, inhaler instruction, diagnostic spirometry, and home monitoring, among other services. In the PCRC model, hospital-employed nurse care managers provide intensive disease management and care coordination to patients with COPD, CHF, and CAD. The care managers also make at least one home visit and establish connections to community services.

Patients are referred to the PCRC upon hospital discharge or by primary care practice. This is especially helpful for small primary care practices that may not have the capacity to meet the complex needs of hard-to-serve patient populations. The PCRC project is expected to save Medicare $74 million over three years.
Readmission Action Team Member
  
Jewish Healthcare FoundationPartnership/Collaboration, Quality Initiative
At the clinic level, the primary goal of PRHI and our partner health centers is to realize improved patient outcomes, quality of care delivery and patient and staff satisfaction via practice transformation to patient-centered medical homes. To that end, health centers will strive to:

Improve partnerships between patients and care teams

Improve clinical outcome measures for patients with chronic diseases

Increase knowledge of how to “mine” data to inform quality improvement efforts

Improve teamwork to yield enhanced staff morale and patient care delivery

Reduce avoidable hospital readmissions, yielding improved patient care and a demonstrated return on investment

Improve efficiency of care delivery processes

Improve knowledge and skills related to quality improvement to decrease no-show rates, improve patient access and reduce non-value added work
In Pennsylvania, Five sites achieved NCQA recognition as a PCMH; others pending.
Federal Agencies, Policy makers, Providers/Professionals, Purchasers/Payers, States/CommunitiesSafety Net Medical Home Initiative
Health Plan; Patient Family and Consumer; ProvidersPerson- and Family-Centered Care, Effective Communication and Care CoordinationNo presence informationSevera Chavez3/11/2013 3:43 PMPennsylvania3/9/2013 5:18 PMNo presence informationNancy Zionts

As one of the regional coordinating centers, the Pittsburgh Regional Health Initiative (PRHI) provides training and coaching assistance to 10 community health centers in their transformation to the Patient-Centered Medical Home. The project is funded by The Commonwealth Fund and other foundations, including the Jewish Healthcare Foundation. The initiative is led by Qualis Health and the MacColl Center for Health Care Innovation at the Group Health Research Institute.
Readmission Action Team Member
  
Jewish Healthcare FoundationPartnership/Collaboration, Payment Model, Quality Initiative, Toolkit/Resource
Develop and deploy communication plan and implementation toolkit

Increase the number of practices providing IMPACT and SBIRT services

Increase the number of patients screened

Increase the number of positive patients who engage in IMPACT and SBIRT

Reduce symptoms of depression and unhealthy substance use

Disseminate the implementation platform through NRHI

Capture lessons learned about dissemination
Federal Agencies, Policy makers, Providers/Professionals, Public/Consumers, Purchasers/Payers, States/CommunitiesPartners in Integrated Care
Robert Ferguson
Program Manager
Jewish Healthcare Foundation
ferguson@jhf.org
Health Plan; Providers; Patient Family and Consumer; PurchaserPerson- and Family-Centered Care, Effective Communication and Care CoordinationNo presence informationSevera Chavez3/11/2013 3:42 PMMinnesota; Massachusetts; Pennsylvania; Wisconsin3/9/2013 4:52 PMNo presence informationNancy Zionts
Partners in Integrated Care (PIC) is an AHRQ-funded initiative to disseminate evidence-based models of care for identifying and addressing depression and unhealthy alcohol and other drug use in primary care offices: IMPACT and SBIRT, respectively. The multi-state consortium is led by the Pittsburgh Regional Health Initiative and includes the Institute for Clinical Systems Improvement, the Wisconsin Initiative to Promote Healthy Lifestyles, the Wisconsin Collaborative for Healthcare Quality, the Network for Regional Healthcare Improvement, and the Massachusetts Health Quality Partners. The consortium implemented the models in over 50 primary care offices.
Readmission Action Team Member
  
PlanetreeAdverse Drug Events (ADE), Catheter-Associated Urinary Tract Infections (CAUTI), Central Line Associated Blood Stream Infections (CLABSI), Injuries from Falls and Immobility, Maternity Care/Adverse Obstetric Events, Pressure Ulcers, Readmissions, Surgical Site Infections (SSI), Venous Thromboembolism (VTE), Ventilator-Associated Pneumonia (VAP), Other Hospital-Acquired ConditionsToolkit/Resource

Goal: To facilitate health care organizations to become more patient-centered by providing concrete suggestions for practices, programs and policies that engage patients and families and address a broad range of patient, families and staff needs.

Picker Institute
Federal Agencies, Hospitals/Hospital Engagement Networks (HENs), Media, Policy makers, Providers/ProfessionalsPatient-Centered Care Improvement GuideIn progress
Sara Guastello
Director, Designation and Resource Development
Planetree
Health Professional; Hospitals/Hospital Engagement Networks (HENs); Patient Family and Consumer; ProvidersPerson- and Family-Centered Care, Patient SafetyQuality ImprovementNo presence informationSevera Chavez3/1/2013 3:57 PM(National)11/8/2012 9:41 AMNo presence informationSara Guastello
This comprehensive guide is a compilation of practical tools and resources designed to help hospitals implement practices to become more patient-centered.  It features premier practices and addresses common barriers to implementing patient-centered care, as well as a self-assessment to support organizations in identifying improvement opportunities and prioritizing patient-centered initiatives. Topics addressed in the Guide include the myths of patient-centered care; strategies for engaging leadership, staff, physicians, volunteers, patients and families; practical approaches for personalizing care, promoting continuity of care, caring for the community, creating a healing environment and cultivating a supportive work environment. Specific tools and practices from top patient-centered hospitals around the country are included.  The guide is available to download at no cost.
Readmission Action Team Member; NPP Partner
  
PlanetreeAdverse Drug Events (ADE), Catheter-Associated Urinary Tract Infections (CAUTI), Central Line Associated Blood Stream Infections (CLABSI), Injuries from Falls and Immobility, Maternity Care/Adverse Obstetric Events, Pressure Ulcers, Readmissions, Surgical Site Infections (SSI), Venous Thromboembolism (VTE), Ventilator-Associated Pneumonia (VAP), Other Hospital-Acquired ConditionsQuality Initiative, Toolkit/Resource
To provide health care organizations with an actionable pathway to patient-centered care

To recognize health care organizations that have implemented and maintained a comprehensive patient-centered culture
A review of CMS’s publicly reported hospital quality data demonstrates that Planetree Designated Patient-Centered Hospitals have lower rates of avoidable readmissions than their peers. Designated Patient-Centered Hospitals also outperform national averages on the CMS process of care core measures and all ten publicly-reported domains of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient perception of care survey.
Federal Agencies, Hospitals/Hospital Engagement Networks (HENs), Media, Policy makers, Providers/ProfessionalsPlanetree Patient-Centered Hospital Designation ProgramIn progress
Sara Guastello
Director, Designation and Resource Development
Planetree
sguastello@planetree.org
Hospitals/Hospital Engagement Networks (HENs); Patient Family and Consumer; Providers; Quality Measurement Research Improvement (QMRI)Person- and Family-Centered Care, Patient SafetyQuality ImprovementNo presence informationSevera Chavez3/1/2013 3:57 PM(National)11/8/2012 9:54 AMNo presence informationSara Guastello
The Patient-Centered Hospital Designation Program® recognizes health care organizations that have embraced and implemented patient-centered care in a comprehensive manner, improving quality and operational outcomes. The program is organized around a set of 63 experience-based and evidence-based criteria derived from focus group work with patients, long-term care residents, family members and health care professionals. Collectively, these criteria raise the bar for what consumers and staff can expect from a patient-centered provider, including shared access to medical records, opportunities for family members’ participation in care, and systems to maximize patients’ independence, dignity and choice. For many health care providers, implementation of processes to realize these concepts requires a shift not merely in operations, but fundamentally in their culture. The Planetree Designation Program provides a practical blueprint for that work by translating high-level concepts into actionable, attainable and sustainable practices. The Patient-Centered Hospital Designation criteria and self-assessment tool can be downloaded at www.planetree.org
Readmission Action Team Member; NPP Partner
  
PlanetreeReadmissionsToolkit/Resource
1. To activate patients in their healthcare
2. To enhance patient confidence in managing their health
3. To improve patients’ experiences when transitioning from one care setting to anothe
The Picker Institute
Case Management Society of America
How's Your Health
Providers/Professionals, Hospitals/Hospital Engagement Networks (HENs), Media, Policy makers, Public/ConsumersSame Page Transitions ToolkitIn progress
Michael Lepore, Ph.D.
Director of Quality, Research & Evaluation
Planetree
mlepore@planetree.org
Patient Family and Consumer; Hospitals/Hospital Engagement Networks (HENs); ProvidersEffective Communication and Care CoordinationConsumer Awareness/Decision-making, Quality Improvement, Workforce DevelopmentNo presence informationSevera Chavez3/1/2013 3:56 PM(National)11/8/2012 9:58 AMNo presence informationSara Guastello
Same Page Care is experienced by patients when all members of their health care team—including the patient him/herself, any informal caregivers and their health care providers—all share a common understanding of the patient’s health care history, needs, priorities and wellness goals. The Same Page Transitional Care Initiative equips patients, their loved ones and health care providers with practical tools to facilitate everyone being on the same page, including:
 Resources to support family members’ involvement as Care Partners who are integrated as important members of the care team
 The How’s Your Health (HYH)survey that queries patients about their priorities for their health and wellness and generates actionable information to be used by providers
 Tools to enhance patients’ ability to understand their plan of care and manage their health
 Resources for training healthcare professionals to support Same Page Transitions.
Readmission Action Team Member; NPP Partner
  
PlanetreeReadmissionsPublication
Hospitals/Hospital Engagement Networks (HENs), Media, Policy makers, Providers/Professionals, States/CommunitiesAdvancing PCC Across the Continuum of Care White PaperIn progress
Sara Guastello Director, Designation and Resource Development Planetree sguastello@planetree.org
Hospitals/Hospital Engagement Networks (HENs); Patient Family and Consumer; Health Professional; Providers; Quality Measurement Research Improvement (QMRI)Person- and Family-Centered Care, Patient SafetyConsumer Awareness/Decision-making, Quality Improvement, Workforce DevelopmentNo presence informationSevera Chavez3/1/2013 3:56 PM(National)11/8/2012 10:03 AMNo presence informationSara Guastello
This white paper details the development of the Patient-Centered Hospital Designation Program®, the only program to assess PCC excellence across the health care continuum, and explores how the program’s inclusive and integrated approach is advancing the practice of PCC by accelerating innovation and inter-organizational, cross-setting learning. Finally, this paper demonstrates how the designation program is positioning organizations for success at a time when PCC has emerged as a national health care priority.
Readmission Action Team Member; NPP Partner
  
PlanetreeReadmissionsToolkit/Resource

To provide long-term care providers with tools and resources that will propel them to take action to enhance the resident/family/staff experience within their community.

​​

Media, Policy makers, Providers/Professionals, States/CommunitiesLong-Term Care Improvement GuideIn progress
Sara Guastello Director, Designation and Resource Development Planetree, Inc. sguastello@planetree.org
Health Professional; Quality Measurement Research Improvement (QMRI)Person- and Family-Centered Care, Patient SafetyQuality Improvement, Workforce DevelopmentNo presence informationSevera Chavez3/1/2013 3:56 PM(National)11/8/2012 10:10 AMNo presence informationSara Guastello
This comprehensive guide, which can be downloaded at no charge, features more than 250 specific practices and tools for operationalizing a person-directed, relationship-centered approach to care across the health care continuum, and demonstrates how person-centered culture change makes an impact on operational, clinical and financial outcomes.  The Guide features a self-assessment tool to help organizations prioritize initiatives and decide where to start, and examines a defined process for engaging all stakeholders in creating, implementing and anchoring a vision for person-centered change.
Readmission Action Team Member; NPP Partner
  
Pacific Business Group on HealthMaternity Care/Adverse Obstetric EventsAdvocacy, Partnership/Collaboration, Payment Model, Quality Initiative
Improve maternity care in California by reducing the rate of non-medically indicated Cesarean sections.
Working with CMQCC to establish the California Maternal Data Center (CMDC), which enables electronic reporting of data elements needed for relevant performance measures -- e.g., elective deliveries between 37 and 39 weeks gestation.
Increasing numbers of California hospitals are participating in CMDC.
California Maternity Quality of Care Collaborative (CMQCC)
Commercial health plans
 
Medi-Cal (Medicaid program for California)
Hospitals/Hospital Engagement Networks (HENs), Providers/Professionals, Public/Consumers, Purchasers/PayersCalifornia Maternal Data CenterIn progress
PurchaserPatient Safety, Affordable CarePayment, Workforce DevelopmentNo presence informationSevera Chavez3/1/2013 3:55 PMCalifornia11/27/2012 1:25 PMNo presence informationDavid Hopkins
The Pacific Business Group on Health (PBGH) is working in partnership with the California Maternal Quality Care Collaborative and California Maternal Data Center to provide quality improvement coaching and data center support to reduce medically unnecessary cesarean sections in commercially-insured populations. Additionally, PBGH is pursuing opportunities to work collaboratively with health plans to implement payment reforms in maternity care that reward high quality care and good patient outcomes, and use bundled payment to discourage overuse or unnecessary obstetrical practices.
Maternity Action Team Member; NPP Partner
  
National Quality ForumReadmissionsEvent/Conference/Workshop/Webinar, Partnership/Collaboration, Quality Initiative, Toolkit/Resource
1) Reduce avoidable admissions and readmissions across all care settings by 20 percent by 2013; and
2) Increase uptake of patient-centered, team-based care delivery models by 50 percent in all settings.
December 2012: Building off of the discussion that began during the October web meeting, Action Team members and 225 public conference call participants continued the conversation about innovative efforts underway to reduce avoidable admissions and readmissions across all care settings. This discussion encouraged sharing of best practices and identifying opportunities for alignment and collaboration. Featured examples of success focused particularly on engaging patients, families and caregivers in their care, as well as levering community partnerships. Several of these examples may be found in NQF’s Online Action Registry.
 
October 2012: The Readmissions Action Teams hosted a public web meeting aimed at sharing their work and engaging a broad group of interested stakeholders.  500 individuals participated in this meeting, signaling the high-level of interest in this important topic area and eagerness to align efforts. According to the meeting evaluation, 66 percent of participants felt they gained new knowledge as a result of these meetings and 54 percent agreed they would be able to implement something new in their organization or community as a result of what they learned. Questions and comments submitted during the call served as the foundation for continued relationship-building and collaborative action.
 
 
September, 2012: This monthly Action Team call served as a forum for continuing to build relationships and make connections to achieve common goals relevant to reducing avoidable admissions and readmissions.  Several members of the Action Team shared how their engagement in this focused effort has directly contributed to their work in improving patient safety. For example, Susan Frampton, president of Planetree, spoke during the September call about six new collaborative efforts underway at her organization facilitated by her participation in the NPP Readmissions Action Team, including work with American Nurses Association, Leapfrog, the California Department of Health Care Services, and HealthLeaders Media, to identify and execute promising tactics for reducing avoidable readmissions through patient-centered care. Similarly, Ascension Health, a Hospital Engagement Network representing acute care hospitals and nursing homes, has established a system-wide goal around safely reducing avoidable readmissions, as well as an organizational commitment to implementing palliative care.  Ascension is engaging its health ministries and other interested stakeholders to support these goals and encourage increased uptake of INTERACT.
 
August, 2012: During two days of in-person meetings focused on generating results in safely reducing avoidable readmissions, the group defined several opportunities for leveraging their existing stakeholder affiliations to accelerate positive change, such as:
  • Promoting patient and family awareness of high-quality care to patients, families, consumers, purchasers, plans, and policymakers through:
    • spread of existing checklists/resources
    • transparency of health plan preferred provider network status
  • Including patients and families in all Patient, Family, and Resident Advisory Councils and in established governance structures
  • Utilizing healthcarecommunities.org and other clearinghouses to harvest core tools and resources for our respective stakeholder groups to spread implementation of patient-centered models
  • Identifying existing programs to reward and recognize high-performing providers and professionals who implement patient-centered models and improve readmission rates
  • Developing a patient-centered care curriculum for nurses (ANA, Planetree)
  • Encouraging reframing of reducing readmissions to safely reducing readmissions  to emphasize the importance of minimizing unintended consequences
  • Emphasizing shared accountability for all healthcare professionals, patients, consumers, caretakers, policymakers and messaging this beyond healthcare institutions)

July, 2012: Susan Frampton, Action Team co-chair, presented to the Measure Applications Partnership Safety and Care Coordination Task Force to ensure alignment of efforts aimed at tracking performance improvement in reducing avoidable admissions and readmissions.


July, 2012: During a monthly Action Team call, members of the group began to identify specific opportunities for collective action aimed at the spread of patient-based and team-based care delivery models that can be used across the continuum, such as INTERACT II and the New York Visiting Nurse Services' advanced illness management program.

Several activities are underway among members of the Action Team aimed at a collective approach to generating results and driving change:

The Directors of Case Management at Sutter Health and the American Case Management Association (ACMA) Board of Directors are exploring opportunities for training case managers in Interventions to Reduce Acute Care Transfers (INTERACT). These organizations also are contributing to the spread of INTERACT and the promotion of high-quality care for patients with advanced illness by sharing their work broadly with hospitals in their region and participating in a number of pilot programs aimed at increasing the uptake of comprehensive and patient-centered models of care delivery (Advanced Illness Management, Patient-Centered Medical Homes, Palliative Care, etc.).

 

Ascension Health consists of 70 hospitals across 21 states that have utilized a four-pronged approach to reducing avoidable readmissions, including 1) discharge care coordination from acute care sites; 2) elimination of barriers to primary care access; 3) collaboration across settings and providers; 4) use of nurse led transitional care models; and

Visiting Nursing Services of New York has demonstrated success in developing and testing “SPARK,” a new home and community-based care delivery model to improve clinical management and quality of life, and reducing avoidable hospital admissions for high-risk and high-cost patients.

With support from The Commonwealth Fund, Joseph Ouslander and colleagues are updating the Interact II curriculum as well as exploring options for train-the-trainer modules, and adaptations for use in home care settings and independent living. To further uptake, the American Health Care Association is promoting Interact II as a model for nursing homes to adopt to reduce avoidable readmissions.

OPM released its FEHB Carrier Letter to its nearly 100 carriers, which emphasized the need for increased member access to primary care providers and medical homes, and programs focused on models of care coordination and disease management.


 

identified solutions: analyzing performance data to identify gaps in quality, implementing effective care delivery models, sustaining effective care through workforce building and training
Planetree, NBGH, AARP, AHHQI, ACMA, AHCA, ANA, ASHSP, Ascension, CMMI, CAPC, CCHIT, HPCC, HQA, IBX, JHF, LeadingAGe, LTQA, NPWF, NRHI, PCPCC, PQA, Commonwealth Fund, TJC, OPM, Arizona State and Florida Atlantic Universities

Action Team members have suggested opportunities for raising awareness about the dangers of being in the hospital unnecessarily through collaboration with Consumer Reports.  Choosing Wisely was also identified as potential partner in raising awareness about informed patient decision-making regarding their healthcare needs.

Federal Agencies, Hospitals/Hospital Engagement Networks (HENs), Policy makers, Providers/Professionals, Purchasers/Payers, States/CommunitiesIn progress
Emma Nochomovitz at enochomovitz@qualityforum.org
Patient Family and Consumer; Health Plan; Health Professional; Hospitals/Hospital Engagement Networks (HENs); Providers; Public Community Health Agency; Purchaser; Quality Measurement Research Improvement (QMRI); Supplier/IndustryPatient Safety, Effective Communication and Care CoordinationConsumer Awareness/Decision-making, Quality Improvement, Workforce DevelopmentNo presence informationSevera Chavez3/1/2013 3:54 PM(National)8/13/2012 11:37 AMNo presence informationTanika Williams
The NPP Readmissions Action Team was formed as a complement to the Partnership for Patients focus on reducing hospital readmissions and the many efforts underway focused on improving care transitions from the hospital setting. This multistakeholder group, comprised of approximately 30 public and private organizations, seeks to promote shared accountability across the continuum of care to safely reduce avoidable admissions and readmissions, emphasizing the importance of post-acute and community-based partners in this work. While many factors influence avoidable readmissions, the Action Team has focused on the development and implementation of a strategic plan to encourage widespread uptake of team-based care delivery models across all care settings with demonstrated success in providing care concordant with patient preferences and reducing avoidable admissions and readmissions
Readmission Action Team Member; NPP Partner
  
National Quality ForumMaternity Care/Adverse Obstetric EventsPartnership/Collaboration
1. Reduce the percentage of babies electively delivered prior to 39 weeks gestation to 5 percent or less; and
2. Reduce cesarean births in low-risk women to 15 percent or less.
August 2012 -- Following the August 8 Maternity Action Team meeting during which the Action Team decided to explore the potential engagement of the Surgeon General in the Action Team's work, Paul Jarris of ASTHO spoke to Howard Koh of ASH who requested to meet with Dr. Jarris to be briefed. Dr. Koh also requested that Dr. Jarris, the Maternity Action Team co-chairs and a representative from action team member March of Dimes meet with Dr. Benjamin directly.
July 2012 – March of Dimes released a new PSA messaging the importance of waiting until 39 weeks to give birth, but to wait for spontaneous labor if the baby is healthy.
June 2012 – Maureen Corry presented about Action Team efforts on the June NQF all-member call. The Action Team’s work was presented in conjunction with NQF’s perinatal measures project, which included a presentation about Louisiana’s work to improve maternity care. The presentations illustrated how the many maternity improvement efforts are aligning and are achieving success through collective action.
June 2012 – Maternity Action Team co-chairs wrote a memo to the MAP Safety and Care Coordination Task Force alerting MAP to the Action Team’s goals and measurement priorities. The Task Force tentatively included the elective delivery and c-section measures in its safety family of measures.
June 2012 – Action Team members provide feedback to ACOG regarding measures and related data elements to inform its reVITALize effort to standardize perinatal data definitions.
June 2012 – Pacific Business Group on Health wrote a letter to Chair of The Joint Commission’s Performance Measurement Committee advocating for the mandatory reporting of TJC’s Perinatal Care Core Measure Set for all hospitals that meet certain volume thresholds.
June 2012 – OPM released its FEHB Carrier Letter to its nearly 100 carriers, which cited NPP’s efforts and included requests to report on NICU days, overall c-section rates, and whether plans require evidence of perinatal quality from network hospitals offering maternity services, such as TJC Perinatal Core measures, “Baby Friendly” designation, ACOG checklists, hard-stop policies, or toolkits like those available through March of Dimes, AHA or IHI.
May 2012 – Childbirth Connection and ASTHO shared tools and resources with Hospital Engagement Networks during the May Hospital Engagement Network virtual convening. Paul Jarris of ASTHO offered to connect the HENs with state leaders in order to encourage partnership and approach improved maternity care a bit more upstream.
 
February 2012 – ACOG wrote a letter to The Joint Commission advocating for a phased approach to the increased uptake of its Perinatal Care Core Measure Set and PBGH letters to TJC.
The Joint Commission moving forward with recommending strategies to its board to increase reporting of its Perinatal Care Core Measure Set. Currently, only about 4 percent of hospitals report on this voluntary measure set.
As part of the development of its action pathway, the Action Team identified barriers to achieving appropriate, high-quality maternity care and identified its three high-leverage strategies to address these challenges. Identified major barriers include: variation in provider practice due to misaligned incentives; discomfort with practicing differently than peers; lack of aligned payment and reporting requirements and policies; gaps in provider, patient/consumer, and purchaser knowledge due to inconsistent messaging about evidence-based practices; and lack of hospital board engagement and an improvement culture.
Childbirth Connection; PCPI; AAFP; ABOG; ANM; ACOG; AMIA; AHIP; ASTHO; AWHONN; CMS; Fairview Health Services; HRSA; AHA; IHI; Leapfrog; MOD; NAMD; NAPH; NBGH; NCQA; NICHQ; National Partnership; NRHI; PBGH; SMFM; TCH; TJC; OPM
Catalyst for Payment Reform; National Governor's Association; individual state Medicaid agencies
Federal Agencies, Policy makers, Providers/Professionals, Purchasers/Payers, States/CommunitiesIn progress
Laura Kate Zaichkin, NQF, lzaichkin@qualityforum.org
Health Plan; Health Professional; Hospitals/Hospital Engagement Networks (HENs); Patient Family and Consumer; Providers; Public Community Health Agency; Purchaser; Quality Measurement Research Improvement (QMRI); Supplier/IndustryPatient SafetyQuality ImprovementNo presence informationSevera Chavez3/1/2013 3:54 PM(National)8/13/2012 11:39 AMNo presence informationTanika Williams
NPP convened a multistakeholder task force—the Maternity Action Team—comprised of nearly 30 public and private stakeholders—to develop an action pathway to address inappropriate maternity care, focusing specifically on reducing elective deliveries by general induction and reducing cesarean section in low-risk women. To that end, the Action Team established two aspirational goals to improve maternity care for mothers and babies, and to achieve the National Quality Strategy aims of better health, better care, and lower costs and the Partnership for Patients goal to reduce harm. The Action Team identified three high-leverage strategies to achieve these goals, with a major focus on measurement, use of evidence-based tools and practices, and consistent provider and consumer messaging. These three strategies are interrelated and together offer a cohesive pathway to facilitate action and achieve safe reductions in inappropriate elective deliveries and cesarean sections.
Maternity Action Team Member; NPP Partner
  
March of DimesMaternity Care/Adverse Obstetric EventsQuality Initiative, Toolkit/Resource
Enabling more hospitals and other birthing facilities to eliminate elective deliveries before 39 weeks of gestation.
The QISP has been made available at no charge to 100 hospitals.  Additional hospitals can access the package at cost, which amounts to $10,000 per facility. 
The package has been warmly received.  No empirical data yet.
The QISP itself is a barrier solution; it was designed to provide further support to hospitals wishing to implement the March of Dimes' toolkit on ending early elective deliveries.
None
Hospitals
Providers/ProfessionalsIn progressPatient Family and ConsumerPatient SafetyQuality ImprovementNo presence informationSevera Chavez3/1/2013 3:53 PM(National)8/22/2012 2:50 PMNo presence informationCynthia Pellegrini
Marchof Dimes has assembled a package of services designed to support birthing hospitals and other birthing facilities in implementing a hard stop on elective deliveries prior to 39 weeks' gestation.  The service package includes a data portal, grand rounds, access to experts, and more.
Maternity Action Team Member; NPP Partner
  
LeapfrogCentral Line Associated Blood Stream Infections (CLABSI), Injuries from Falls and Immobility, Pressure Ulcers, Venous Thromboembolism (VTE), Other Hospital-Acquired ConditionsSocial Media, Toolkit/Resource
We want consumers to use the app to both locate the safest hospitals in their community or when traveling, and to use the app while at the hospital to help with a safer hospital stay.  Consumers deserve to know the safety of the hospitals in their community, and we hope they will use the app as one key factor in choosing a hospital when there are multiple hospitals in the nearby area.  Upon arrival, we hope patients will use the app to access key questions to ask their doctor and other precautions to take to ensure safety at the hospital.
Hospital Safety Score app for iPhone and iPad was launched on November 28th.
Hospital Safety Score app for Android devices was launched on November 29th.
One day after the launch of the app, we have received 8 5-star reviews on the App Store.  We are eagerly awaiting additional metrics from Apple and Android on downloads and usage.
1. Selecting a developer: We reccomend selection of an app developer with background and knowledge of the healthcare space. We were pleased to work with Ringful Health to develop this app, and their previous work on other apps for healthcare proved extremely helpful in launching this app.
2. Achieving downloads: We have prominently featured the app in all of our news releases and announcements surrounding the Hospital Safety Score, and have displayed it prominently on our website. We are highly encouraging all of our members, partners, affiliates, and friends to download the app and submit reviews in order to increase our presence in the app stores.
3. Publishing app on app stores: Once the app had been developed and submitted to Apple, we had no control over the timing of its approval and subsequent availability on the app store. Fortunately it was approved in time to line up with our public announcement, but this was really just pure luck. Getting an app on the Google Play store (for Android devices) is an easier process, but there is still little control over timing. The Android app was released one day later than we had hoped.
We worked with Ringful Health to develop the app.
We hope all consumer-facing organizations will encourage consumers to download this app and use it in choosing a hospital.
Public/Consumers, Purchasers/Payers, MediaHospital Safety Score App DownloadIn progressPatient Family and ConsumerPatient SafetyConsumer Awareness/Decision-making, Infrastructure/HIT, Quality ImprovementNo presence informationSevera Chavez3/1/2013 3:53 PM(National)11/29/2012 10:34 AMNo presence informationErica Mobley

The Hospital Safety Score grades hospitals on how safe they are for patients. Each A, B, C, D, or F score assigned to a hospital comes from expert analysis of infections, injuries, and medical and medication errors that frequently cause harm or death during a hospital stay.  Our new Hospital Safety Score app uses GPS tracking to advise users on the grades of nearby hospitals, or permit searching in other areas. To download the free app, visit www.hospitalsafetyscore.org.

Maternity Action Team Member; NPP Partner
Attachment
  
Institute for Healthcare Improvement (IHI)ReadmissionsQuality Initiative, Toolkit/Resource, Partnership/Collaboration
* To help teams reduce their 30 day all-cause hospital readmission rates by 10%
* To work with payers and policy makers to mitigate barriers to implementing improved care transitions processes across the continuum of care.
Hospitals/Hospital Engagement Networks (HENs), Providers/Professionals, Policy makers, States/Communities, Purchasers/Payershttp://www.ihi.org/explore/Readmissions/Pages/default.aspxIn progress
Mr. Azeem K. Mallick, MBA
617.301.4906
 
Health Professional; Hospitals/Hospital Engagement Networks (HENs); Providers; Patient Family and ConsumerPatient SafetyQuality ImprovementNo presence informationSevera Chavez3/1/2013 3:27 PM(National)11/2/2012 1:25 PMNo presence informationSaranya Loehrer

Avoidable rehospitalizations are a disservice to patients and families, a costly burden to the health care system and a source of frustration for providers. Fortunately, they are also actionable for improvement.  IHI employs a multi-stakeholder approach to improve care transitions and reduce rehospitalizations by working with providers in acute and post-acute care settings as well as with state-level leaders to reduce barriers to implementing safer and more effective transitions in care.

Maternity Action Team Member; NPP Partner
  
Association of State and Territorial Health Officials (ASTHO)Maternity Care/Adverse Obstetric EventsToolkit/Resource
To create a clearinghouse of resources, tools, and case studies to share state-specific initatives that are focused on improving birth outcomes.
Policy makers, Providers/Professionals, Public/Consumers, States/CommunitiesASTHO's Healthy Babies Website
Patient Family and Consumer; Providers; Health ProfessionalPatient SafetyQuality ImprovementNo presence informationSevera Chavez3/1/2013 2:37 PM(National)11/27/2012 11:03 AMNo presence informationKristen Wan
The Healthy Babies website includes resources and common state strategies, organized by the socio-ecological model, which can be used to reduce prematurity and infant mortality. The policies and programs are differentiated by the target life stages, including preconception, prenatal, birth to 28 days, and first year of life.
Maternity Action Team Member; NPP Partner
  
Association of State and Territorial Health Officials (ASTHO)Maternity Care/Adverse Obstetric EventsPublication
Public health agencies and MCH programs encounter a wide range of technical, legal, organizational, and funding challenges when addressing health information technology. MCH participation in statewide HIE initiatives provides important opportunities to embed public health data needs and tools into state strategies, as well as to ensure that MCH systems take part in statewide HIE reforms.
Providers/Professionals, Public/Consumers, States/CommunitiesMCH and Health Information Exchange Issue Brief
Patient Family and Consumer; ProvidersPatient Safety, Effective Communication and Care CoordinationInfrastructure/HITNo presence informationSevera Chavez3/1/2013 2:37 PMIndiana; Michigan; Minnesota; Missouri; New Jersey; Rhode Island; Utah; Wisconsin; (National)11/27/2012 11:25 AMNo presence informationKristen Wan
This issue brief provides an overview of federal and state health information exchange (HIE) challenges and opportunities for maternal and child health. It highlights several states' strategies for accelerating electronic health records adoption and electronic HIE.
Maternity Action Team Member; NPP Partner
  
Association of State and Territorial Health Officials (ASTHO)Maternity Care/Adverse Obstetric EventsPublication
Disparities lead to increased adverse health outcomes and excess medical expenses. Reducing infant health disparities is a critical step toward reducing disparities in the rest of the population. The state stories featured in this issue brief demostrate strategies to address maternal and infant health inequities.
Providers/Professionals, Hospitals/Hospital Engagement Networks (HENs), Public/Consumers, States/CommunitiesMaternal and Infant Disparities Issue Brief
Patient Family and Consumer; Providers; Health Professional; Hospitals/Hospital Engagement Networks (HENs); Public Community Health AgencyPatient Safety, Affordable CareConsumer Awareness/Decision-making, Quality ImprovementNo presence informationSevera Chavez3/1/2013 2:36 PM(National); Alaska; California; Colorado; Illinois; Massachusetts; Rhode Island; West Virginia11/27/2012 11:41 AMNo presence informationKristen Wan
This issue brief explores the importance of maternal and infant health disparities by delving into topics such as racial and ethnic disparities, economic impact, infant mortality, maternal disparities, and prenatal care as well as highlights different programs states have implemented to address these issues.
Maternity Action Team Member; NPP Partner
Attachment
  
American Nurses AssociationCatheter-Associated Urinary Tract Infections (CAUTI), Central Line Associated Blood Stream Infections (CLABSI), Injuries from Falls and Immobility, Pressure Ulcers, Ventilator-Associated Pneumonia (VAP)Quality Initiative
Enabling more hospitals to use NDNQI data comparisons and data reporting
Quarterly Data has been sent to the CMS Contractors for Analysis for falls/pressure ulcers ; Informational webinars presented to the Hospital Engagement Networks (HENs) 
Partnership for Patients (PfP) HENs are using NDNQI data and resources ; PfP is using NDNQI national comparisons
The NDNQI is a knowledge solution to dashboard reporting :  NDNQI supports nursing and interprofessional quality initiatives with online business intelligence dashboard decision-support and reporting at the unit, hospital, and system levels.  NDNQI supports the nursing quality programs of more than 1,900 hospitals throughout the United States.
ANA Organizational Affiliates ; Partnership for Patients (PfP) HEN leadership and participating hospitals
Partnership for Patients (PfP) HENs
Providers/Professionals, Hospitals/Hospital Engagement Networks (HENs)https://www.nursingquality.org/In progress
Isis Montalvo (Isis.Montalvo@ana.org)
Health ProfessionalPatient SafetyQuality ImprovementNo presence informationSevera Chavez3/1/2013 2:09 PM(National)11/28/2012 6:25 PMi:0#.f|nqfmembershipprovider|maureen.dailey@ana.org
NDNQI aids patient safety and quality improvement efforts by providing research-based comparative data on nursing care and its relationship to patient outcomes.
Readmission Action Team Member; NPP Partner
  
American Health Care AssociationReadmissionsAdvocacy, Event/Conference/Workshop/Webinar, Measure Development, Partnership/Collaboration, Quality Initiative, Toolkit/Resource
1. Safely Reduce 30-day Hospital Readmissions by 15% by March 2015; 2. Reduce turnover among nursing staff (RN, LPN, CNA) by 15% by March 2015; 3. Increase customer satisfaction (% of customers "willing to recommend") to 90% by March 2015; 4. Safely reduce off-label use of antipsychotic drugs by 15% by December 2012.
Numerous educational programs presented at national and state levels; measure development and validation underway in multiple areas; participated in development of data collection tools and improvement resources now available on Advancing Excellence website.
AHCA state affiliates, Advancing Excellence
Providers/Professionals, Federal Agencies, Media, Policy makers, Public/Consumers, States/Communities, Purchasers/Payers, Hospitals/Hospital Engagement Networks (HENs)http://www.ahcancal.org/quality_improvement/qualityinitiative/Pages/default.aspxIn progress
ProvidersPatient SafetyQuality ImprovementNo presence informationSevera Chavez3/1/2013 2:08 PM(National)11/30/2012 2:26 PMNo presence informationRuta Kadonoff
The Quality Initiative, launched by AHCA in February 2012, focuses on 4 goals: Safely Reducing Hospital Readmissions, Improving Customer Satisfaction, Reducing Nursing Staff Turnover, and Safely Reducing Off-Label Use of Antipsychotic Drugs.
Readmission Action Team Member; NPP Partner
  
Association of State and Territorial Health Officials (ASTHO)Maternity Care/Adverse Obstetric EventsPolicy Initiative
To estimate the Medicaid cost savings for states in they reduce the rate of prematurity by 8 percent.
Providers/Professionals, Purchasers/PayersMedicaid Cost Savings Methodology Template
Health Plan; ProvidersAffordable CarePaymentNo presence informationSevera Chavez3/1/2013 1:04 PMTexas12/10/2012 3:46 PMNo presence informationKristen Wan
This methodology can be used for states to estimate the Medicaid cost savings if they are to reduce the rate of prematurity by 8 percent. The template includes how Texas used this methodology.
Maternity Action Team Member; NPP Partner
  
Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN)Maternity Care/Adverse Obstetric EventsQuality Initiative
To enhance standardized interpretation and communication of fetal heart monitoring data for application of clinical interventions to promote and support fetal oxygenation.
Expansion of case studies and test items within the Fetal Heart Monitoring Case Assessment and Testing (FHMCAT) online product.
Hospitals/Hospital Engagement Networks (HENs), Providers/Professionals, States/Communities, Federal AgenciesAWHONN Fetal Heart Monitoring ProgramIn progress
Carol Elaine Brown, RN, BC, MN, C-EFM
Nurse Program Development Specialist
202-261-2400
fhm@awhonn.org
Health Plan; Health Professional; Hospitals/Hospital Engagement Networks (HENs); Patient Family and Consumer; Providers; Quality Measurement Research Improvement (QMRI)Patient Safety, Effective Communication and Care CoordinationQuality Improvement, Workforce DevelopmentNo presence informationSevera Chavez3/1/2013 1:02 PM(National)1/8/2013 1:05 PMNo presence informationBrea Onokpise
AWHONN has been a leader in the area of fetal heart monitoring (FHM) education since the inception of the FHM Program in 1993.  Currently, the program includes web-based, instructor-led, and self-paced learning experiences for both novice and experienced clinicians.  Two of the instructor-led courses provide both continuing nursing education contact hours and continuing medical education hours.

The framework of the FHM Program is to provide clinicians with the opportunity to build their expertise in FHM technologies and practices over a continuum of learning.  The evidence-based courses provide interdisciplinary education experiences and collegial discussion about fetal heart monitoring with emphasis on standardization of terminology and definitions, knowledge enhancement and safe practice for pregnant women.

The benefits of the AWHONN program include clinician confidence, consistency in communication and demonstration of credibility in the practices of FHM.  The Learning Pathway serves as a guide for individuals and organizations that develop education templates related to initial and ongoing FHM education.
Maternity Action Team Member
Attachment
  
Institute for Healthcare Improvement (IHI)Maternity Care/Adverse Obstetric EventsPublication, Quality Initiative, Toolkit/Resource
Share evidence and best practices
National and International engagement of hospitals and systems in reducing adverse obstetrical events
Reduction in EED and Obstetrical Harm by individual hospitals
Reliable delivery of evidence based care, use of clinical bundles, team based work including patients and families
Providers/Professionals, Hospitals/Hospital Engagement Networks (HENs), Public/Consumers, States/CommunitiesIHI Prevent Obstetrical Adverse EventsIn progress
Sue Gullo
Providers; Hospitals/Hospital Engagement Networks (HENs); Patient Family and ConsumerPatient SafetyQuality ImprovementNo presence informationSevera Chavez3/1/2013 12:50 PM(National)1/9/2013 10:51 AMNo presence informationSue Gullo
How to Guide on Preventing Obstetrical Adverse Events
Maternity Action Team Member; NPP Partner
  
Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN)Maternity Care/Adverse Obstetric EventsEvent/Conference/Workshop/Webinar, Policy Initiative, Quality Initiative, Toolkit/Resource
1) Establish and maintain AWHONN as the standard-bearer for determining perinatal staffing guidelines and developing resources on perinatal nurse staffing among stakeholders.
2) Evaluate and support the implementation of effective and efficient staffing by linking staffing to outcomes and tracking the impact of staffing on outcomes from a safety, quality and cost perspective.
1) AWHONN's Guidelines for Professional Nurse Staffing for Perinatal Units; has been endored by 9 collegial organizations: AAP, March of Dimes, ANA, NANN, ACNM, AORN, NAPNAP, USLCA, ILCA
2) The AWHONN Perinatal Staffing Data Collaborative Report; a national, multi-hospital level Perinatal Nurse Staffing Collaborative that assists nurse leaders in hospitals with strategic planning, benchmarking, and risk management.
3) Webinars
4) 2013 AWHONN Leadership Summit on Perinatal Staffing
1) Guidelines for Perinatal Nurse Staffing prior to 2010 were outdated and did not adequately reflect the changes in the perinatal nursing environment (i.e. increased comorbidities, increased cesarean rates).  As a result of these outdated guidelines, AWHONN developed the Guidelines for Professional Nurse Staffing for Perinatal Units.
2) Limited data are being collected in relation to perinatal staffing that adequately understand the current state of perinatal staffing and how staffing is affecting outcomes.  AWHONN developed the Perinatal Staffing Data Collaborative to create a forum to being collecting these data and addressing these issues.
Federal Agencies, Hospitals/Hospital Engagement Networks (HENs), Media, Policy makers, Providers/Professionals, Public/Consumers, Purchasers/Payers, States/CommunitiesAWHONN Staffing InitiativesIn progress
Debra Bingham, DrPH, RN, LCCE
Vice-President: Research, Education, Publications
 
Catherine Ruhl, MS, CNM
Director, Women's Health
 
Ben Scheich
Associate Director, Data Analytics
202-261-2400
Health Plan; Hospitals/Hospital Engagement Networks (HENs); Patient Family and Consumer; Providers; Public Community Health AgencyPatient SafetyQuality Improvement, Workforce DevelopmentNo presence informationSevera Chavez3/1/2013 12:49 PM(National)1/9/2013 5:28 PMNo presence informationBrea Onokpise
AWHONN's Perinatal Staffing Initiative focuses on Perinatal Nurse staffing and collaborations with healthcare partners to promote effective and efficient nurse staffing.  The goals are to lower hospital-related perinatal morbidity and mortality, decrease adverse patient event and decrease inpatient stays.
Maternity Action Team Member
Attachment
  
Colorado Foundation for Medical CareReadmissionsEvent/Conference/Workshop/Webinar
To reach our intended audience: Health & Human Services, QIOs, healthcare providers, partners, and consumers regarding improving healthcare through reducing hospital readmissions.
Federal Agencies, Hospitals/Hospital Engagement Networks (HENs), Providers/Professionals, Public/Consumers, States/CommunitiesShining Stars Across the Nation Webinar Event ListingIn progress

Kaylie Witting

Administrative Assistant

 

Colorado Foundation for Medical Care

23 Inverness Way East, Suite 100

Englewood, CO 80112

303-784-5777

kwitting@cfmc.org

Hospitals/Hospital Engagement Networks (HENs); Health Professional; Patient Family and Consumer; Providers; Public Community Health AgencyQuality ImprovementNo presence informationSevera Chavez3/1/2013 12:48 PM(National)1/23/2013 3:07 PMNo presence informationShenita Freeman
Free webinar series calling attention to local communities that have been successful in improving healthcare through reducing hospital readmissions. We will feature communities from different initiatives— those communities that are lead by the QIOs, those that are part of Aligning Forces For Quality, those that have received state funding, Robert Woods Johnson awardees, CCTP awardees, Beacon communities, ACOs and more.
  
American Case Management AssociationReadmissionsEvent/Conference/Workshop/Webinar, Policy Initiative
To spread information on tools that have been identified with successful outcomes.
Presentations  have been given at state and national conferences.
Hospitals/Hospital Engagement Networks (HENs), Providers/ProfessionalsIn progressHospitals/Hospital Engagement Networks (HENs); Supplier/IndustryPatient Safety, Affordable Care, Effective Communication and Care CoordinationQuality Improvement, Workforce DevelopmentNo presence informationSevera Chavez3/1/2013 12:25 PM(National); California; Florida; South Carolina2/5/2013 2:13 PMNo presence informationLois Cross

The American Case Management Association (ACMA)Chapters are exploring opportunities for training case managers in Interventions to Reduce Acute Care Transfers (INTERACT). These organizations also are contributing to the spread of INTERACT and the promotion of high-quality care for patients with advanced illness by sharing their work broadly with hospitals in their region and participating in a number of pilot programs aimed at increasing the uptake of comprehensive and patient-centered models of care delivery (advanced illness management, patient-centered medical homes, palliative care, etc.). The Florida Chapter will be hosting a presentation from the INTERACT development team during their education session in March. The ACMA Public Policy Committee will be highlighting NQF recommendations during their presentations at various State Annual Conferences and the National ACMA Conference in San Diego in April.

Readmission Action Team Member
  
Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN)Maternity Care/Adverse Obstetric EventsPublication, Toolkit/Resource
1)  Increase health care provider and consumer awareness of risks for late preterm infants (LPI).
2)  Ensure evidence-based educational awareness of risks for late preterm assessment and care.
3) Reduce LPI morbidity and mortality.
2013 (In production),  Assessment and Care of the Late Preterm Infant Implementation Toolkit

2010,  Assessment and Care of the Late Preterm Infant Evidence-Based Clinical Practice Guideline
 
2008-2011, Late Preterm Infant Research-Based Practice Project
Medoff-Cooper, B., Holditch-Davis, D., Verklan, M. T., Fraser-Asking, D., Lamp, J., Santa-Donato, A., Onokpise, B.,...Bingham, D.  (2012).  Newborn clinical outcomes of the AWHONN late preterm infant research-based practice project.  Journal of Obestetric, Gynecologic and Neonatal Nursing, 41(6), 774-85.   doi: 10.1111/j.1552-6909.2012.01401.x.
Historically, many Late Preterm Infants (LPI) were treated the same as full-term newborns; however, in recent years, clinicians and researchers have identified an in increase in hospital readmissions and potentially life threatning complications among LPIs.

Therefore, the focus of the initiative and activites is to increase clinician awareness and vigilance in assessment and care of this vulnerable population.
Federal Agencies, Hospitals/Hospital Engagement Networks (HENs), Media, Policy makers, Providers/Professionals, Public/Consumers, Purchasers/Payers, States/CommunitiesLate Preterm Infant Initiative Research-Based Practice ProjectIn progress
Anne Santa-Donato, RNC, MSN
Director, Childbearing and Newborn Programs
Brea Onokpise, MPH, CHES
Research Project Manager
202-261-2400
latepreterm@awhonn.org
Health Professional; Patient Family and Consumer; Providers; Public Community Health Agency; Health PlanPatient Safety, Effective Communication and Care CoordinationQuality Improvement, Workforce DevelopmentEmma Nochomovitz2/5/2013 3:02 PM(National)1/7/2013 4:31 PMNo presence informationBrea Onokpise
The AWHONN Late Preterm Infant Initiative is a multi-year endeavor addressing the special needs of infants born between 34 and 36 completed weeks of gestation.  Goals include increasing health care provider and consumer awareness of the risks and ensuring evidence-based educational resources for health care providers to provide appropriate assessment and care for these vulnerable newborns.
Maternity Action Team Member
  
Health Information and Management Systems Society (HIMSS)Adverse Drug Events (ADE), Catheter-Associated Urinary Tract Infections (CAUTI), Central Line Associated Blood Stream Infections (CLABSI), Injuries from Falls and Immobility, Maternity Care/Adverse Obstetric Events, Pressure Ulcers, Readmissions, Surgical Site Infections (SSI), Venous Thromboembolism (VTE), Ventilator-Associated Pneumonia (VAP), Other Hospital-Acquired ConditionsEvent/Conference/Workshop/Webinar
raise awareness and promote action
webex sessions
webex conduted; an internal community established
Hospitals/Hospital Engagement Networks (HENs), Providers/Professionals, Purchasers/PayersIn progress
Louis.diamond Louis.diamond1@gmail.com 301 468 1166 Jonathin French jfrench@himss.org 703 562 8822
Health Plan; Health Professional; Hospitals/Hospital Engagement Networks (HENs); Providers; Purchaser; Quality Measurement Research Improvement (QMRI); Supplier/IndustryEffective Communication and Care CoordinationConsumer Awareness/Decision-makingNo presence informationSevera Chavez1/30/2013 12:50 PM(National)11/14/2012 4:39 PMNo presence informationLouis Diamond
establish an internal community of interest; conduct recurring webex sessions.
NPP Partner
  
Society of Hospital MedicineAdverse Drug Events (ADE), Other Hospital-Acquired Conditions, ReadmissionsEvent/Conference/Workshop/Webinar, Quality Initiative, Toolkit/Resource
Educate about SHM's experience and tools gleaned from over 100 quality improvement teams related to glycemic management.
Over 100 quality improvement teams have completed participation in SHM's award-winning "mentored implementation program".  Additionally, SHM has built a data registry to assist organizations with measuring parameters of glycemic control.
HENs
Hospitals/Hospital Engagement Networks (HENs), Providers/Professionals, States/CommunitiesRegister for SHM's webinar today!In progressHospitals/Hospital Engagement Networks (HENs); Health Professional; ProvidersPrevention and Treatment of Cardiovascular DiseaseQuality ImprovementNo presence informationSevera Chavez1/30/2013 12:50 PM(National)11/19/2012 1:22 PMNo presence informationWendy Nickel
Webinar scheduled on December 5th at 3:00 p.m. EST presented by Dr. Gregory Maynard, quality improvement and glycemic management expert. Webinar will focus upon utilizing best practices from over 100 improvement teams to better manage glycemic control, insulin related events and associated readmissions.  Webinar will also showcase SHM's data management system to produce real-time glucometrics reportts.,
  
American Society of Health-System PharmacistsReadmissionsPartnership/Collaboration, Publication, Toolkit/Resource, Quality Initiative
Identify and profile best practice models for medication management in care transitions to reduce preventable harm and readmissions. These models should be scalable and principles applicable to a variety of care settings.
Eight medication management in care transitions best practice models have been selected and formally announced.
Brief descriptions of the 8 models can be found on the press release at the following address:
Cultivating partnerships and efficient use of resources in a multidisciplinary environment to overcome barriers of limited resources and discordant communcation conduits
The American Pharmacists Association (APhA) and the American Society of Health-System Pharmacists (ASHP)
Health-Systems
Hospitals/Hospital Engagement Networks (HENs), Providers/Professionals, States/Communities, Public/ConsumersLink to press releaseIn progress

Shekhar Mehta, Pharm.D.,M.S.

Director, Clinical Guidelines and Quality Improvement

American Society of Health-System Pharmacists

7272 Wisconsin Ave.

Bethesda MD 20814

Phone: (301)664-8815

Fax: (301)634-5915

Email: smehta@ashp.org

Health Professional; Hospitals/Hospital Engagement Networks (HENs); Patient Family and Consumer; ProvidersPatient Safety, Effective Communication and Care CoordinationQuality ImprovementNo presence informationSevera Chavez1/30/2013 12:50 PM(National)11/26/2012 10:34 AMi:0#.f|nqfmembershipprovider|smehta
The American Society of Health-System Pharmacists and the American Pharmacist Association collaborate to improve patient outcomes by facilitating the involvement of pharmaicst in the care transitions period. The Medication Management in Care Transitions Project focuses on identifying and profiling best practices models that are scalable for broad adoption. An expert panel reviews potential submissions and selects programs to develop into official case studies. The expert panel will highlight key elements for successful programs, describe implementation barriers, and recommend strategies to address the barriers. A formal report will be available.
Readmission Action Team Member
  
Sutter HealthReadmissionsQuality Initiative
To support  the patients who are in their last year of life and their caregivers.  This program supports them across the continuum of care as they deal with end of life issues.  We help them to establish their goals for care, provide education support. In addition we help them with coordinating their care as they progress in their illness.
The success of this pilot program in reducing avoidable admissions by 68% after 30 days of enrollment, as well as reducing visits to the ICU by 80%, has established a foundation for it's expansion to five additional Sutter regions through the Healthcare Innovations Award (HCIA).
Providers/Professionals, Hospitals/Hospital Engagement Networks (HENs)Hospitals/Hospital Engagement Networks (HENs)Person- and Family-Centered Care, Patient SafetyConsumer Awareness/Decision-making, Quality ImprovementNo presence informationSevera Chavez1/30/2013 12:49 PMCalifornia10/31/2012 5:32 PMNo presence informationLois Cross
Sutter Health System has used a variety of delivery models to improve care transitions and promote patient self-management including the Care Transitions Program, Disease Management Programs, Patient Centered Medical Homes and the Program for All-Inclusive Care for the Elderly (PACE).  Sutter's Advanced Illness Management Program (AIM) program in particular has demostrated meaningful results in providing  seamless home-based transitional and palliative care that reduces hospitalizations and ICU stays.
Readmission Action Team Member
  
Ascension HealthAdverse Drug Events (ADE), Catheter-Associated Urinary Tract Infections (CAUTI), Central Line Associated Blood Stream Infections (CLABSI), Injuries from Falls and Immobility, Maternity Care/Adverse Obstetric Events, Pressure Ulcers, Readmissions, Surgical Site Infections (SSI), Venous Thromboembolism (VTE), Ventilator-Associated Pneumonia (VAP), Other Hospital-Acquired ConditionsMeasure Development, Partnership/Collaboration, Quality Initiative

FY12: Provide high reliability training to all associates, leaders, and active medical staff as a preparatory step for reducing serious safety events.  FY13: Reduce serious safety event rate (sum of serious safety events at Ascension Hospitals/10,000 adjusted patient days) by 15% and hospital readmissions by 20%.  FY14: Reduce safety event rate by 40% from Ascension-level true baseline.

Most recent activities have identified three key areas of focus: Surgical error reductions, Adverse Drug Event reductions, and reduction of safety events associated with In-hospital Care transitions.  These efforts are led by the High Reliability Steering Committee, while PfP efforts  continiue to progress across the hospital-led Partnerships for the remaining areas of focus.

FY12: Training completed for ~87K associates, 4.2K leaders, and 14.4K active medical staff.  FY13: Identified areas of focus for reductions in events associated with Surgeries, ADEs, and Care transitions.   To date, Serious Safety Event Rate is meeting, and even exceeding, the targeted goals.  In progress to establish baselines for Readmissions across the Ascension hospitals.

Ensuring buy-in to this cultural change from all hospital leaders and from physicians has been key to successful error reductions in patient safety events.  Engaging hospital-level associates, leaders, and physicians in improvement processes has provided expertise as well as cultural buy-in.  We have learned the importance of separating the technical aspects from the adaptive (cultural) aspects of the improvement work.​

Hospitals/Hospital Engagement Networks (HENs), Providers/ProfessionalsIn progressHealth Professional; Hospitals/Hospital Engagement Networks (HENs); Providers; Patient Family and ConsumerPatient SafetyQuality ImprovementNo presence informationSevera Chavez1/30/2013 12:49 PM(National)11/29/2012 10:19 AMNo presence informationSherlyn Renner

Ascension Health has 68 acute care hospitals focused on 40% reduction in serious safety events by the end of FY14 (June 30, 2014). These hospitals voluntarily submit records of patient safety events into a single system that provides Ascension with the ability to aggregate all events and to analyze data to determine event patterns and common causes of safety events, regardless of area of focus.  Additionally, System-wide and hospital-level data are gleaned from other sources and are utilized to create reporting that informs providers of their relative performance across the System and within safety event categories. These analytics support identification of areas of focus for hospital-level improvements.  In some instances, System-level collaborative efforts, including Partnerships in support of the PfP work, are initiated; in others, the local hospitals identify individual improvement plans for reducing the number of events.  In all cases, the identification of best practices  is encouraged for spread to augment significant event reduction at each hospital.

Readmission Action Team Member
  
Center to Advance Palliative CareReadmissionsToolkit/Resource
To provide tools and resources for the provision of emergency department palliative care.
Support is provided by the Olive Branch Foundation.
Hospitals/Hospital Engagement Networks (HENs), Providers/ProfessionalsIPAL- Emergency MedicineIn progressProviders; Patient Family and ConsumerPatient Safety, Effective Communication and Care CoordinationQuality Improvement, Workforce DevelopmentNo presence informationSevera Chavez1/30/2013 12:49 PM(National)11/14/2012 1:26 PMNo presence informationEmily Warner

Patients with serious or life-threatening illness are likely to find themselves in an emergency department at some point along their trajectory of illness, and they should expect to receive high-quality palliative care in that setting. In the last five years, emergency medicine has increasingly taken a central role in the early implementation of palliative care. Widespread integration of palliative care into the day-to-day practice of emergency medicine, however, is often jeopardized by the demands of many competing priorities.

 

IPAL-EM was designed to help. It offers a central portal for sharing essential expertise, evidence, tools and practical resources to assist clinicians and administrators with the successful integration of palliative care and emergency medicine.

Readmission Action Team Member
  
Childbirth ConnectionMaternity Care/Adverse Obstetric EventsAdvocacy, Partnership/Collaboration, Publication, Quality Initiative, Toolkit/Resource, Social Media
To enable maternity care professionals, childbearing women, and other key stakeholders to understand current knowledge about the hormonal physiology of childbearing, including benefits to women and fetuses/newborns of physiologic childbearing and adverse effects of many common maternity care interventions. To provide tips for protecting, promoting, and supporting physiologic birth.
A draft of the full report for health professionals is nearing completion. Anticipated release date for the report is late winter 2013.
A consistent picture is emerging is the growing body of research about the hormonal physiology of childbearing. When protected, promoted, and supported, major hormone systems appear to offer many benefits to childbearing women and their fetuses/newborns. Many common maternity care practices appear to interfere with these physiologic processes and their benefits for mothers and babies.
1. These results are relevant to virtually all maternity care stakeholders, and adequate dissemination is a challenge. We will reach out to Maternity Action Team members and others, carry out media outreach (including social media), and make the report and companion materials available on the websites of the partnering organizations. 2. The subject of this report is poorly understood among health professionals, women, and other stakeholders, and the material is challenging. We are working to foster broad access through clear consistent formatting and organization, concise presentation, and plain language.
This is a project of Childbirth Connection, in collaboration with Lamaze International and DONA International. The partnering organizations will develop resources to enable childbirth educators and doulas in training to understand key results and will support educators and doulas in communicating these matters to childbearing women.
The knowledge in the new report and companion materials is foundational for maternity care policy, practice, education, and research, and is poorly recognized and understood at present. These resources are relevant to virtually all maternity care stakeholders.
Federal Agencies, Hospitals/Hospital Engagement Networks (HENs), Media, Policy makers, Providers/Professionals, Public/Consumers, Purchasers/Payers, States/CommunitiesIn progress
Contact Carol Sakala, PhD, MSPH, Director Programs, sakala@childbirthconnection.org.
Patient Family and ConsumerPatient Safety, Effective Communication and Care CoordinationQuality Improvement, Workforce DevelopmentNo presence informationSevera Chavez1/30/2013 12:49 PM(National)11/13/2012 10:00 AMNo presence informationCarol Sakala

Report for maternity care professionals reviews current understanding of how four major hormone systems function from late pregnancy through the early postpartum period, both when protected, promoted, and supported and when disturbed by common practices, including labor induction and cesarean section. Identifies steps that maternity care professionals can take to enable women and their fetuses/newborns to benefit from physiologic childbearing. The hormones covered in this report are oxytocin, beta endorphin, epinephrine/norepinephrine, and prolactin. Companion resources for childbearing women and other derivative products will also be prepared.
Maternity Action Team Member
  
Childbirth ConnectionMaternity Care/Adverse Obstetric EventsPartnership/Collaboration, Payment Model, Publication
To describe comprehensive national average maternity care costs in 2010, with breakdowns by payments for maternal and newborn care, commercial and Medicaid payers, vaginal and cesarean birth, phase of care, and type of service. Includes separate analyses of payments for NICU care, maternal cost variation across five selected states, and comparison of maternal costs in 2004 and 2010. The aim is to foster widespread payment reform and the reliable provision of high-quality, high-value maternity care.

The analyses are completed, the report is drafted, and we are making plans for the release of this report. The report will be released in December 2012 or in 2013.
We will be pleased to make available recent comprehensive national average maternity care payment data, with numerous subgroup and ancillary analyses.
We are comfortable with the content of the report. We face challenges in reaching all of the relevant stakeholder groups. To get the word out, we will carry out media outreach (including social media) with our partners, will issue a press release and hold a media briefing, and will make the report freely available on our three websites.
The report was commissioned by Childbirth Connection, Catalyst for Payment Reform, and Center for Healthcare Quality and Payment Reform. Analyses were carried out by Truven Health Analytics using their MarketScan Commercial and Medicaid databases.
We are eager to reach and inform all relevant stakeholder groups about current maternity care payment levels, and to foster payment reform and the reliable provision of high-quality, high-value maternity care.
Federal Agencies, Hospitals/Hospital Engagement Networks (HENs), Media, Policy makers, Providers/Professionals, Public/Consumers, Purchasers/Payers, States/Communitieslink for obtaining The Cost of Having a Baby in the United State report when availableIn progress
At Childbirth Connection, contact Maureen Corry, Executive Director, corry@childbirthconnection.org. At Catalyst for Payment Reform, contact Suzanne Delbanco, Executive Director, sdelbanco@catalyzepaymentreform.org. At Center for Healthcare Quality and Payment Reform, contact Harold Miller, Executive Director, miller.harold@gmail.com.
Patient Family and ConsumerPatient Safety, Affordable CarePayment, Quality ImprovementNo presence informationSevera Chavez1/30/2013 12:49 PM(National); California; Illinois; Louisiana; Minnesota; Massachusetts11/12/2012 8:31 PMNo presence informationCarol Sakala

Analysis of comprehensive national average maternity care costs in 2010, with breakdowns by payments for maternal and newborn care, commercial and Medicaid payers, vaginal and cesarean birth, phase of care, and type of service. Includes separate analyses of payments for NICU care, maternal cost variation across five selected states, and comparison of maternal costs in 2004 and 2010.
Maternity Action Team Member
  
Childbirth ConnectionMaternity Care/Adverse Obstetric EventsQuality Initiative

Develop, implement, evaluate, and update suite of rigorous evidence-based decision aids and other maternity care shared decision making tools. Note that many planned tools are relevant to Maternity Action Team aspirational goals, including the first three that will be available on decisions in following situations: elective induction, suspected big baby, birth after previous cesarean.
We are currently refining our prototype, developing our website, and beginning work on new tools.

We are far along with a prototype, a website, formative research for key topics, development of decision quality tools, and recruitment of clinical and consumer advisors. Initial tools will be released in 2013.
1. The rigorous development and updating process is expensive. We are exploring diverse models of sustainability. 2. Many childbearing women and maternity care clinicians lack experience with and understanding of shared decision making. We are working to raise awareness and reach out to maternity care professionals, are developing a website and outreach strategy for women, and will partner on implementation with groups that are enthusiastic about bringing shared decision making to maternity care.
The Informed Medical Decisions Foundation and Childbirth Connection are partnering to develop and implement consumer decision aids and other decision tools for childbearing women. Many organizations are expressing an interest in collaborating.
We seek support from health professional organizations, consumer advocacy organizations, and funders and are exploring implementation with diverse stakeholders, including Medicaid programs, health plans, employers, and EHR venders.
Federal Agencies, Hospitals/Hospital Engagement Networks (HENs), Media, Policy makers, Providers/Professionals, Public/Consumers, Purchasers/Payers, States/Communitiestemporary project websiteIn progress
At the Informed Medical Decisions Foundation, contact Molly Beinfeld, Director of Independent Production, mbeinfeld@imdfoundation.org. At Childbirth Connection, contact Maureen Corry, Executive Director, corry@childbirthconnection.org.
Patient Family and ConsumerPerson- and Family-Centered Care, Patient Safety, Effective Communication and Care CoordinationConsumer Awareness/Decision-making, Quality ImprovementNo presence informationSevera Chavez1/30/2013 12:49 PM(National)11/12/2012 7:18 PMNo presence informationCarol Sakala

Program to develop, implement, evaluate, and update rigorous evidence-based decision aids and other tools for shared maternity care decision making.
Maternity Action Team Member
Attachment
  
Johnson & Johnson Health Care Systems, Inc.Readmissions, Other Hospital-Acquired ConditionsPartnership/Collaboration, Quality Initiative
(1) Develop and implement a program for patient safety that meets the goals of the Partnership for Patients (PfP).  (2)  Reduce hospital readmission rates and healthcare acquired conditions for Johnson & Johnson employees, covered dependents and eligible retirees. 
550 Johnson & Johnson employees have received a financial incentive for participating in the CareConnect Patient Safety Program through August, 2012.
Results for 2012 will be available 2Q 2013.
Data mining and hospital reporting challenges.
National Health Plans for Johnson & Johnson Employee Health Program (Aetna, Cigna).
(1) Hospitals / Hospital Engagement Networks, (2) Providers/Professionals.
Public/Consumers, Providers/Professionals, Hospitals/Hospital Engagement Networks (HENs), Purchasers/PayersIn progress
Dave Domann (ddomann@its.jnj.com), Rosa Sexton (rsexton@its.jnj.com), Steve Phillips (sphilli5@its.jnj.com)
Supplier/IndustryPerson- and Family-Centered Care, Patient Safety, Effective Communication and Care CoordinationConsumer Awareness/Decision-making, Public Reporting, Quality ImprovementNo presence informationSevera Chavez1/30/2013 12:48 PM(National)11/12/2012 5:09 PMi:0#.f|nqfmembershipprovider|ddomann
The CareConnect Patient Safety Program was launched for Johnson & Johnson's US employees and retirees to meet the goals of the Partnership for Patients (PfP).  The Care Connect Program includes specific goals focused on keeping patients from getting injured or sicker during hospitalization, as well as helping patients heal without complications.  The program encourages employees and retirees to speak with a registerd nurse before and/or after being admitted to the hospital to receive information about the steps they should take to keep themselves safe before, during and after hospitalization.  A financial incentive is deposited to the employees HRA fund if they meet the requirements of the program.   We are willing to share our framework and experience with the program including communcation materials.
NPP Partner
  
Center to Advance Palliative CareReadmissionsAdvocacy, Policy Initiative
The aims of these bills are to rectify a palliative care and hospice provider shortage, to educate consumers about the availability of palliative services, and to engage stakeholders in strategizing how to bring about higher quality, patient-centered care for people with serious illness.
Thanks to the efforts ACS-CAN, these bills have 60 cosponsors combined.
American Cancer Society
The more support for this legislation, the better. We particularly would hope to receive support from patient and consumer advocacy organizations.
Policy makersIn progressProviders; Patient Family and Consumer; Health ProfessionalPerson- and Family-Centered Care, Patient SafetyConsumer Awareness/Decision-making, Quality Improvement, Workforce DevelopmentNo presence informationSevera Chavez1/30/2013 12:48 PM(National)11/12/2012 3:57 PMNo presence informationEmily Warner

CAPC has worked in concert with the American Cancer Society to develop federal legislation that will increase access to high quality palliative care for people with serious illness.  Two of these bill are currently introduced.

 HR 6155/ S 3407, if passed, would increase the number of faculty in palliative care at accredited medical, nursing, and other programs, and would promote education in palliative care and hospice. The bill would also support the development of faculty careers in academic palliative medicine.

HR 6157, if passed, would create a patient-centered quality of care initiative for seriously ill patients through the establishment of a stakeholder strategic summit, quality of life education and awareness initiative, health care workforce training, an advisory committee, and palliative care focused research.

Readmission Action Team Member
Attachment
  
American Board of Internal Medicine Foundation (ABIMF)Adverse Drug Events (ADE), Maternity Care/Adverse Obstetric Events, Readmissions, Other Hospital-Acquired ConditionsEvent/Conference/Workshop/Webinar, Funding Opportunity, Partnership/Collaboration, Policy Initiative, Quality Initiative, Social Media, Toolkit/Resource
The campaign's goals are to educate physicians and patients about overuse and help patients and physicians engage in conversations about waste.
Nine specialty societies released lists of overused tests and/or procedures in April 2012. We are currently working with 15 additional societies on lists they are developing for release in February 2013.
The campaign has been featured across the popular and trade press and in 39 journal articles since the release of the first set of society lists in April 2012.  Several specialty societies, hospital systems, and regional health collaboratives are engaging in advancing the campaign's recommendations.
AARP, Alliance Health Networks, American Academy of Allergy Asthma & Immunology, American Academy of Family Physicians, American Academy of Hospice and Palliative Medicine, American Academy of Neurology, American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics, American College of Cardiology, American College of Obstetricians and Gynecologists, American College of Physicians, American College of Radiology, American College of Rheumatology, American Gastroenterological Association, American Geriatrics Society, American Society for Clinical Pathology, American Society of Clinical Oncology, American Society of Echocardiography, American Society of Nephrology, American Society of Nuclear Cardiology, American Urological Association, Consumer Reports, The Leapfrog Group, Midwest Business Group on Health, Minnesota Health Action Group, National Business Coalition on Health, National Business Group on Health, National Center for Farmworker Health, National Hospice and Palliative Care Organization, National Partnership for Women and Families, National Physicians Alliance, Pacific Business Group on Health, SEIU, Society for Vascular Medicine, Society of Hospital Medicine, Society of Nuclear Medicine and Molecular Imaging, Society of Thoracic Surgeons, Union Plus, The Wikipedia Community
Hospitals/Hospital Engagement Networks (HENs), Media, Providers/Professionals, Public/Consumers, Purchasers/Payers, States/Communitieshttp://choosingwisely.org/In progress
Tim Lynch
Director of Foundation Programs
ABIM Foundation
 
Health Professional; Providers; Patient Family and Consumer; PurchaserEffective Communication and Care CoordinationConsumer Awareness/Decision-makingNo presence informationSevera Chavez1/30/2013 12:48 PM(National)11/5/2012 11:16 AMNo presence informationTim Lynch
The ABIM Foundation, in partnership with dozens of medical specialty societies and Consumer Reports, has launched the Choosing Wisely campaign, which is designed to help patients and physicians engage in conversations about the overuse of particular tests and procedures and support physician efforts to help patients make smart and effective care choices.  As part of the campaign, participating societies will develop lists of five tests and/or procedures in their specialty that physicians and patients should question before employing.  In April 2012 at a Washington press conference we released the first nine specialty society lists.  Future releases will occur in 2013.  Please visit www.choosingwisely.org for more information.
  
AFL-CIOAdverse Drug Events (ADE), Catheter-Associated Urinary Tract Infections (CAUTI), Central Line Associated Blood Stream Infections (CLABSI), Injuries from Falls and Immobility, Maternity Care/Adverse Obstetric Events, Pressure Ulcers, Readmissions, Surgical Site Infections (SSI), Venous Thromboembolism (VTE), Ventilator-Associated Pneumonia (VAP), Other Hospital-Acquired ConditionsPartnership/Collaboration, Quality Initiative, Toolkit/Resource
Educate private purchasers on how pioneer private purchasers have overcome barriers to changing from volume purchasing to value purchasing
Website went live on July 18, 2012
Target date for posting is September 30, 2012
Educating employees/consumers
Banding together with other purchasers at the local level
Adopting an assertive approach on behalf of consumers and purchasers in dealing with plans and providers
See list of partners at www.buyingvalue.org
Local purchasers
Public/Consumers, Purchasers/PayersBuying Value -- Purchasing HealthCare That's Proven to WorkIn progress
PurchaserPatient Safety, Affordable CarePaymentNo presence informationSevera Chavez1/30/2013 12:48 PM(National)8/22/2012 11:11 AMNo presence informationGerald Shea
Adding material to the Buying Value website, http://www.buyingvalue.org on how private purchasers can overcome barriers to value purchasing
NPP Partner
  
The Empowered Patient CoalitionAdverse Drug Events (ADE), Catheter-Associated Urinary Tract Infections (CAUTI), Central Line Associated Blood Stream Infections (CLABSI), Injuries from Falls and Immobility, Pressure Ulcers, Surgical Site Infections (SSI), Venous Thromboembolism (VTE), Ventilator-Associated Pneumonia (VAP), Other Hospital-Acquired ConditionsAdvocacy, Publication, Toolkit/Resource
To inform, engage, and empower patients, family members, and caregivers so they can participate in medical decisions and care and experience better outcomes and greater satisfaction.
Our website was recently optimized for mobile devices. We offer a free Patient Journal that allows patients and advocates to keep track of medical providers, tests, and medications in the hospital setting. We have dozens of free fact sheets and checklists on our website and a survey with over 650 responses that seeks to capture medical events from the patients point of view. Our latest project is the development of a decision support phone app.
Feedback from patients who use our materials is overwhelmingly positive. People report that it immediately transforms their hospital experiences when they have a foundation of information, knowledge, and confidence. Patients continue to take our survey and share their experiences and solutions.
1. Social media to overcome the barrier of reaching more people and making them aware of our numerous resources
2. Working with PfP and HENS to overcome the barrier of bringing the patient voice to all health care discussions.
3. Working with other advocates and advocacy groups to overcome the barrier of being a small organization that does not have resources such as full-time staff, IT experts, and funding.
Consumers Union Safe Patient Project
Office of the National Coordinator (ONC)
Centers for Medicare and Medicaid (CMS)
Health and Human Services (HHS)
Federal Agencies, Hospitals/Hospital Engagement Networks (HENs), Media, Policy makers, Providers/Professionals, Public/Consumers, Purchasers/Payers, States/CommunitiesEmpowered Patient Coalition PublicationsIn progress
Julia Hallisy
President
The Empowered Patient Coalition
595 Buckingham Way # 305
San Francisco, CA 94132
(415) 681-1011
Julia@EmpoweredPatientCoalition.org
Patient Family and ConsumerPerson- and Family-Centered Care, Effective Communication and Care CoordinationConsumer Awareness/Decision-making, Quality ImprovementNo presence informationSevera Chavez1/30/2013 12:48 PM(National)11/30/2012 5:34 PMNo presence informationJulia Hallisy
A free guide to all phases of hospital care from diagnosis to discharge. Subjects covered include advocates, diagnosis, informed consent, preparing for surgery, second opinions, preventing errors, and much more.
  
Safe Care CampaignAdverse Drug Events (ADE), Catheter-Associated Urinary Tract Infections (CAUTI), Central Line Associated Blood Stream Infections (CLABSI), Injuries from Falls and Immobility, Maternity Care/Adverse Obstetric Events, Pressure Ulcers, Readmissions, Surgical Site Infections (SSI), Venous Thromboembolism (VTE), Ventilator-Associated Pneumonia (VAP), Other Hospital-Acquired ConditionsToolkit/Resource
Meeting all the CMS goals from SSI prevention to preventing adverse obstetric events.
All goals are addressed in detail within the institute guidebook.
Final release of the guidebook.
QR Code program to educate patients via videos on their own mobile devices. Available for free to all hospitals for use by patients at the bedside 24/7.
Inclusion of all stakeholders.
Open platform ideology.
Problem solving with CMS goals at forefront.
Joint Commission, Kimberly Clark, CDC, the Patient Channel. Georgia Hospital Association.
National Partnership for Women and Families, IPFCC, NPSF, etc.
Providers/Professionalshttp://www.h2pi.org
Victoria Nahum 770-819-8787
Martin Hatlie
Patient Family and ConsumerPerson- and Family-Centered Care, Patient SafetyQuality ImprovementNo presence informationSevera Chavez1/30/2013 12:47 PM(National)8/22/2012 3:45 PMNo presence informationVictoria Nahum
The online, module-based guidebook takes the HENs through a logical and effective step by step path to working successfully with patients and their families. The institute has created 6 targeted guides for everyone from HEN Leadership to Physicians, Board of Directors, Patients and their Families, Healthcare Staff and the C-Suite.
  
Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN)Maternity Care/Adverse Obstetric EventsAdvocacy, Social Media, Toolkit/Resource
1) Increase the percentage of women who complete at least 40 weeks of pregnancy.
2) Decrease the percentage of women who choose elective induction or cesarean.
3)Increase nurses' effectiveness to reduce elective induction or cesareans.
"Wait for labor to start on its own" Pledge campaign - November 2012: Take the pledge to complete 40 weeks when all is healthy and well and support women to do the same at www.awhonn.org/full40pledge . Campaign materials available at no cost to download at website.

3000 of the targeted 50,000 signatures received - November 30, 2012.
Pledge widely disseminated via Facebook and Healthy Mothers, Healthy Babies/text4baby - November 2012.
 
Widespread dissemination of campaign through social media and featured in the HHS Strong Start Mother's Day campaign.
Federal Agencies, Hospitals/Hospital Engagement Networks (HENs), Media, Policy makers, Providers/Professionals, Public/Consumers, Purchasers/Payers, States/CommunitiesDon't Rush Me...Go the Full 40In progress
Carolyn Cockey, MLS
Director, Publications/Project Manager
877-377-5326
carolyndc@awhonn.org
 
Catherine Ruhl, MS, CNM
Director, Women's Health Programs
202-261-2408
Providers; Health Professional; Health Plan; Public Community Health Agency; Hospitals/Hospital Engagement Networks (HENs); Patient Family and ConsumerHealth and Well-Being, Patient SafetyConsumer Awareness/Decision-making, Quality ImprovementNo presence informationSevera Chavez1/30/2013 12:47 PM(National)11/30/2012 3:07 PMi:0#.f|nqfmembershipprovider|cruhl@awhonn.org
Don't Rush Me...Go at least the full 40 consumer campaign educates women about the importance of waiting for labor to start on its own when all is well with the pregnancy.
 
Babies need a full term pregnancy, and waiting for labor to start on its own is best for both moms and babies. Through this public health information campaign, AWHONN gives consumers 40 Reasons to Go The Full 40 Weeks of pregnancy. As a result, the campaign promotes shared decision-making, patient wellness, healthy pregnancies and optimal outcomes. 
 
The campaign is comprised of public health ads that run in AWHONN’s free Healthy Mom&Baby consumer media, posters, buttons, badge holders worn by clinicians, and a national pledge to “Wait for Labor to Start on its Own”—all encouraging women to strive for full-term pregnancies that finish healthy and well through spontaneous labor. AWHONN chose 40 weeks because estimated dates of delivery have been and continue to be 40 weeks.     
 
The campaign materials are available in English and Spanish. 
Resources:
40 Reasons Article: http://www.GoTheFull40.com

Pledge to “Wait for labor to start on its own:” http://www.awhonn.org/full40pledge

Campaign Resources: http://www.health4mom.org/a/go_the_full_40_campaign_resources_847
Posters, Flyers, and Pledge Campaign materials in bulk purchase: AWHONN store: www.awhonn.org
Maternity Action Team Member
  
Childbirth ConnectionMaternity Care/Adverse Obstetric EventsPublication, Quality Initiative, Toolkit/Resource


To describe the childbearing experiences of women in the United States and their knowledge, attitudes, beliefs, and preferences. To chart trends through continuing items from previous LIstening to Mother surveys, and to include new items of special relevance to the myriad efforts for maternity care quality improvement across the country. To issue recommendations based on survey results. With respect to aspirational goals of the Maternity Action Team, the surveys include numerous items relating to labor induction, cesarean section, and women's views and preferences about decision making, maternity care quality, etc.
The Listening to Mothers III survey is being fielded, and the investigator team, with guidance from a National Advisory Council and from Harris Interactive, is developing the content of the follow-up survey that will be directed to Listening to Mothers III survey participants.

The Listening to Mothers III: Pregnancy and Childbirth report will be released late in February 2013. Listening to Mothers III: New Mothers Speak Out and Listening to Mothers III: Survey Highlights and Recommendations reports will be released in May 2013. Results of previous Listening to Mothers surveys have been widely used to inform policy, practice, research, and education.

Childbirth Connection is eager to ensure that all stakeholders have access to survey results. In addition to carrying out media outreach (including social media), we will collaborate with National Advisory Council members to reach specific audiences. The reports, questionnaires, and other material will be freely available on our website.
Through the LTM III National Advisory Council, Childbirth Connection partners with individuals from a broad array of organizations and agencies on survey content and dissemination. Harris Interactive provides guidance on survey development, fields the surveys, applies demographic and propensity score weighting, analyzes results, and prepares draft reports.

From preconception care to pregnancy care to intrapartum care to postpartum care and outcomes, the Listening to Mothers surveys have topics of relevance to virtually all maternity care stakeholders. Many items are not otherwise collected at the national level, and some items are known to be substantially undercounted in official data sources. Childbirth Connection is eager to reach all stakeholder groups with this unique source of information about women's childbearing experiences.
Federal Agencies, Hospitals/Hospital Engagement Networks (HENs), Media, Policy makers, Providers/Professionals, Public/Consumers, Purchasers/Payers, States/Communitieslink for LTM III survey reports, questionnaires, and related documents, when available, and previous LTM survey documentsIn progress
At Childbirth Connection, contact Carol Sakala, PhD, MSPH, Director of Programs, sakala@childbirthconnection.org.
Patient Family and ConsumerHealth and Well-Being, Effective Communication and Care CoordinationConsumer Awareness/Decision-making, Quality ImprovementNo presence informationSevera Chavez1/30/2013 12:47 PM(National)11/12/2012 11:16 PMNo presence informationCarol Sakala


To carry out and report national surveys to describe the experiences of childbearing women from before pregnancy through the postpartum period, as well as their attitudes, beliefs, knowledge, and preferences about maternity care and childbearing.
Maternity Action Team Member
  
Childbirth ConnectionMaternity Care/Adverse Obstetric EventsPublication, Quality Initiative, Toolkit/Resource
To update a review comparing outcomes of vaginal and cesarean birth, and develop and disseminate resources for communicating results to professional and consumer audiences.
A report for professionals (Vaginal or Cesarean Birth: What Is at Stake for Women and Babies? A Best Evidence Review), an updated consumer booklet (What Every Pregnant Woman Needs to Know About Cesarean Section), and updated web resources (www.childbirthconnection.org/cesarean/) are being released in December 2012.
A very large number of outcomes differ by mode of birth, with implications for short- and long-term health of childbearing women, their babies, and babies in future pregnancies. Results will help Maternity Action Team members and others understand and communicate about these matters, which are central to the Team's aspirational goal of reducing the cesarean section rate in low-risk women to less than 15%.
The major barriers we face are in reaching all of the relevant stakeholders and in communicating complex clinical and methodologic matters. We will share the materials with Maternity Action Team members and others, including over 30 organizations that endorsed the original cesarean booklet in 2004. We will carry out media outreach (including social media) and make the materials freely available on our website. We use standardized formatting and plain language to communicate the complex subject matters.
None.
These new resources are relevant to virtually all maternity care stakeholders. Childbirth Connection encourages very broad update and distribution.
Federal Agencies, Hospitals/Hospital Engagement Networks (HENs), Media, Policy makers, Providers/Professionals, Public/Consumers, Purchasers/Payers, States/Communitieslink for the report for professionals with review resultsIn progress
Contact Amy Romano, CNM, MSN, Associate Director of Programs romano@childbirthconnection.org.
Patient Family and ConsumerHealth and Well-Being, Patient SafetyQuality ImprovementNo presence informationSevera Chavez1/30/2013 12:47 PM(National)11/13/2012 9:28 AMNo presence informationCarol Sakala
Updates a best evidence review comparing outcomes of cesarean and vaginal birth and prioritizing systematic review results when available. Presents review results in a report for professional stakeholders, in a consumer booklet, and in an updated section on www.childbirthconnection.org.
Maternity Action Team Member
  
Childbirth ConnectionMaternity Care/Adverse Obstetric EventsPolicy Initiative, Publication, Quality Initiative, Toolkit/Resource

​To carry out a best evidence update of the impact of the liability system on maternity care and of the likelihood that improvement strategies that have been proposed and/or implemented can impact the diverse aims of a high-performing liability system in maternity care. To report results thorough journal articles, a full report, and a series of fact sheets.​

​Three articles and an invited commentary by national health policy scholars are now in press for publication in an open access Policy Matters feature within the January/February 2013 issue of Women's Health Issues (see http://whijournal.com).​ The full report is being finalized for concurrent release and will be available at the URL listed below.

​A series of widely-held beliefs about maternity care and liability and about policy strategies for improvement are not supported by our best evidence framework prioritizing maternity-related empirical legal studies and health services research. The report and final article identify 10 strategies with the potential to meet multiple aims of a high-performing liability system in maternity care.

​The largest barrier is the historically divisive nature of the issue and widely held beliefs about liability matters in maternity care. For those who are ready to move forward, the report points the way to strategies that might provide safer care for childbearing families and reduce the persistent fear, confusion, and malaise about liability matters among clinicians, facilities, and health systems that provide maternity care. For those with an open mind, the report has the potential to change the entrenched discourse about these matters. Some of the most promising solutions require strong leadership and a culture change, but can move forward without new regulatory or legislative measures or new infrastructure.

​We will coordinate with the Jacobs Institute of Women's Health, publisher of Women's Health Issues, on media outreach.

​​As indicated below under Target Audience, this issue is relevant to virtually all maternity care stakeholders. These persistent troubling concerns call for substantive solutions that have the potential to improve care and outcomes, reduce costs, and reduce professional malaise and discontent.

Federal Agencies, Hospitals/Hospital Engagement Networks (HENs), Media, Policy makers, Providers/Professionals, Public/Consumers, Purchasers/Payers, States/Communitieslocation of full report and fact sheets, when availableIn progress
Patient Family and ConsumerHealth and Well-Being, Prevention and Treatment of Cardiovascular Disease, Patient Safety, Effective Communication and Care CoordinationConsumer Awareness/Decision-making, Public Reporting, Quality ImprovementNo presence informationSevera Chavez1/30/2013 12:47 PM(National)12/9/2012 11:33 AMNo presence informationCarol Sakala
​An updated best evidence review of the impact of the liability system on maternity care and of the likelihood that improvement strategies that have been proposed and/or implemented can meet the criteria for a high performing liability system for maternity care. Publication of results in a series of journal articles, a major report, and a series of fact sheets.
Maternity Action Team Member
  
National Business Coalition on HealthAdverse Drug Events (ADE), Catheter-Associated Urinary Tract Infections (CAUTI), Central Line Associated Blood Stream Infections (CLABSI), Injuries from Falls and Immobility, Maternity Care/Adverse Obstetric Events, Pressure Ulcers, Readmissions, Surgical Site Infections (SSI), Venous Thromboembolism (VTE), Ventilator-Associated Pneumonia (VAP), Other Hospital-Acquired ConditionsPartnership/Collaboration, Policy Initiative, Quality Initiative, Toolkit/Resource
Standardize data collection and reporting efforts.
RFI finalized, working on timeline.
Buying Value website launched including 2012 NBCH eValue8 data. Currently planning for further work on RFI alignment in 2013.
Regular communications; team meetings/calls; working sessions to discuss RFI questions.
AFL-CIO; Catalyst for Payment Reform (CPR)
All health plans across the country
Federal Agencies, Policy makers, Providers/Professionals, Purchasers/Payers, States/CommunitiesBuying Value websiteClosed
Colleen Bruce - cbruce@nbch.org
PurchaserPatient Safety, Affordable CarePaymentNo presence informationSevera Chavez1/30/2013 12:46 PM(National)8/23/2012 8:49 AMNo presence informationColleen Bruce
Continuing to work with Buying Value organizations and CPR to align reporting efforts. Also working with NQF MAP to gather input.
  
Carolinas HealthCare SystemAdverse Drug Events (ADE), Catheter-Associated Urinary Tract Infections (CAUTI), Central Line Associated Blood Stream Infections (CLABSI), Injuries from Falls and Immobility, Maternity Care/Adverse Obstetric Events, Pressure Ulcers, Readmissions, Surgical Site Infections (SSI), Venous Thromboembolism (VTE), Ventilator-Associated Pneumonia (VAP)Quality Initiative, Toolkit/Resource, Partnership/Collaboration, Measure Development
Reduce patient harm by 40% and readmissions by 20% by the end of 2013.
As of August 2012, our System has reduced our early elective delivery rate by 47% relative to our 2011 baseline.
Hospitals/Hospital Engagement Networks (HENs), Federal Agencies, Providers/Professionals, Public/ConsumersIn progressHospitals/Hospital Engagement Networks (HENs); Providers; Health ProfessionalPatient SafetyQuality ImprovementNo presence informationSevera Chavez1/30/2013 12:46 PMNorth Carolina; South Carolina11/30/2012 3:28 PMNo presence informationJason Byrd
As a contractor through the Partnership for Patients (PfP) and CMS, we are striving to achieve reductions in patient harm across the board by 40% and readmissions by 20% by the end of 2013.
  
Iowa Healthcare CollaborativeAdverse Drug Events (ADE), Catheter-Associated Urinary Tract Infections (CAUTI), Central Line Associated Blood Stream Infections (CLABSI), Injuries from Falls and Immobility, Maternity Care/Adverse Obstetric Events, Pressure Ulcers, Readmissions, Surgical Site Infections (SSI), Venous Thromboembolism (VTE), Ventilator-Associated Pneumonia (VAP)Event/Conference/Workshop/Webinar
share best practices
Share leading safety practices from Patient Safety Award winners
Secured all keynote speakers and breakout agenda/objectives complete.
IHA, Telligen, IMS
Hospitals/Hospital Engagement Networks (HENs)Iowa Healthcare Collaborative websiteIn progressHealth Professional; Hospitals/Hospital Engagement Networks (HENs); Patient Family and Consumer; Providers; Public Community Health AgencyPatient SafetyConsumer Awareness/Decision-makingNo presence informationSevera Chavez1/30/2013 12:46 PMIowa12/17/2012 2:42 PMNo presence informationMeg Nugent
The Patient Safety Conference will bring together health care professionals from across the state to learn about current patient safety topics prevalent in today’s health care environment. Best practices will be shared and discussed to increase knowledge of those in attendance.
  
Society of Hospital MedicineAdverse Drug Events (ADE)Partnership/Collaboration, Quality Initiative, Toolkit/Resource
Specific goals are: 1.) to share the resources SHM has built over a number of years in support of a 100-hopsital collaborative on glycemic control, 2.) to learn from others how they are collecting data and what measures they are using related to glycemic events
8-17-12 Participation in Medication Safety Affinity Group and National Content Developer calls - we will be meeting with leaders of the Medication Safety Affinity group on 8/20/12.
 
11-19-12 Conducted webinar on SHM tools related to glycemic management and insulin-related adverse events (10/9/12).
We will be conducting a webinar with the Medication Safety Affinity group leaders to highlight our tools and resources available for glycemic control.
 
11-19-12 Approximately 40 individuals participated in call.
Not applicable - just started.
 
I anticipate that the only real barrier to our goals is the ability to share information with a large group of disparate HENs, but I believe we can address this by conducting webinars and teleconferences to share information and respond to questions.
PfP Medication Safety Affinity Group
Interested HENs
Federal Agencies, Providers/Professionals, Purchasers/Payers, States/CommunitiesClosedHealth ProfessionalPatient SafetyQuality ImprovementNo presence informationSevera Chavez1/30/2013 12:46 PM(National)8/17/2012 10:42 AMNo presence informationWendy Nickel
After participating in calls with the National Content Developer and the PfP Medication Safety Affinity Group, there was recognition that SHM has tools that could support HEN work related to glycemic events and control.  We will be working with the leaders fo the Medication Safety Affinity Group to determine best ways to share this information with the HENs.
  
Hennepin County Medical CenterReadmissionsQuality Initiative

The project goal is to reduce hospital readmissions and improve customer satisfaction by reducing medication errors at discharge.

Based on this study results, a manuscript has been accepted for publication at the American Journal of Health System Pharmacy. The project is expanded into a close loop transition of care that allows pharmacist intervention along inpatient and outpatient patient flow- we have inpatient pharmacy staff conduct medication reconciliation upon patient admissions, clinical pharmacists work with inpatient physicians for pharmacotherapy consults, the same pharmacist conduct discharge medication reconciliation with clinical nursing coordinators, after patients’ discharge,   ambulatory care pharmacist to provide medication therapy management with home visiting and clinic follow up. This transition of care model is able to reduce hospital admission by 42% and ER visit by 37%. This result is reported separately in NPP registry.

In the pilot phase our discharge medication error rate was reduced from 92% to essentially 0%. Similarly, the rate of errors likely to cause harm was reduced from approximately 1 in every 3 discharges to essentially 0%. In the intervention group, our 30-day related readmission rate for combined Minor, Moderate, and Severe SOI was 5.4% (4/74), compared to 9.5% (169/1780) in the control group.  After the pilot was completed and evaluated, the program was implemented hospital-wide.  We have maintained our related readmission rate around 6.7% ever since.

1.      The biggest challenge is the upfront staffing cost that is needed to conduct medication reconciliation. In the meantime, the potential savings from reduced readmissions is not yet realized.  The support from the hospital steering committee is critical for the success of the program.

2.      Implementing the above change in a larger scale requires standardization of the process and systemic staff training. It takes determined minds, abundant patience and resources.

3.      Interdepartmental communications can be a challenge. An internal leadership team is also essential for quality improvement. Excellent communication among each team member is the solution.

Hospitals/Hospital Engagement Networks (HENs), Providers/Professionals, Policy makers, Federal AgenciesIn progressHealth ProfessionalPatient Safety, Effective Communication and Care CoordinationQuality Improvement, Workforce DevelopmentNo presence informationSevera Chavez1/30/2013 12:46 PMMinnesota11/27/2012 5:36 PMNo presence informationYun Lu

A multidisciplinary team that includes paired clinical pharmacists and clinical nursing coordinators works with physician residents to generate error free discharge orders for skilled nursing facility discharges. The work flow starts when a skilled nursing facility (SNF) discharge is identified in rounds and a nursing clinical coordinator and social worker are assigned to a SNF bed. In the meantime, a resident physician starts to work on discharge orders. Once a patient’s discharge orders are completed by a physician, the clinical nursing coordinator then contacts a clinical pharmacist on the team for medication reconciliation. This pharmacist shall discuss all medication errors with the inpatient physician. A complete corrected medication list will be generated in a patient’s chart before the SNF discharge. All pharmacist interventions are tracked as “near misses” via an online event reporting system for quality improvement analysis.

  
Iowa Healthcare CollaborativeAdverse Drug Events (ADE), Catheter-Associated Urinary Tract Infections (CAUTI), Injuries from Falls and Immobility, Maternity Care/Adverse Obstetric Events, ReadmissionsEvent/Conference/Workshop/Webinar
The goal of the LC is to provide a learning session followed by action periods to promote the PfP work and assist hospitals in their patient safety efforts.
Learning Communities were held on Aug 28 and Aug 30, 2012 Handouts/presentations can be found at the following links: http://www.ihconline.org/aspx/general/page.aspx?pid=77 http://www.ihconline.org/aspx/general/page.aspx?pid=78
Learning community attendance was over 120 participants each day
1. FLEX funding for CAH and RR hospitals to attend
2. Coupled the LC with IHC Annual Conference
Telligen; Iowa Department of Public Health; Iowa Hospital Association
None
Hospitals/Hospital Engagement Networks (HENs), Providers/Professionals, Public/Consumers, Purchasers/Payers, States/Communitieshttp://ihconline.orgClosed
Meg Nugent
Director, Clinical Strategies
nugentm@ihconline.org
Public Community Health Agency; Hospitals/Hospital Engagement Networks (HENs); Health ProfessionalPatient SafetyQuality ImprovementNo presence informationSevera Chavez1/30/2013 12:46 PMIowa8/21/2012 4:45 PMNo presence informationMeg Nugent
Educational events Aug 28 and 30, 2012 - Breakthrough Series Model. Learning communities will address readmissions, health literacy, CAUTI, Falls, and ADE.
  
ESRD ForumAdverse Drug Events (ADE), Central Line Associated Blood Stream Infections (CLABSI), Injuries from Falls and ImmobilityEvent/Conference/Workshop/Webinar, Partnership/Collaboration, Quality Initiative, Toolkit/Resource
engage all 18 Networks and then all dialysis facilities nationally focused on the P4P goals
engagement is occuring.  Exploring funding to develop measures for all activities
lack of funding to support activities; other priorities already established.
with hospitals and the CDC
Providers/Professionals
louis diamond---louis.diamond1@gmail.com 301 468 1166 and ED of the Forum De DeLuc forumcoord@centurytel.net 715 354 3735
Quality Measurement Research Improvement (QMRI); ProvidersPatient SafetyQuality ImprovementNo presence informationSevera Chavez1/30/2013 12:45 PM(National)11/14/2012 4:30 PMNo presence informationLouis Diamond
all 18 ERSD Network organizations encouraged to sign up as members of the P4P; activities focused on reduction in HAI undertaken; a Safety Safty and reduction in harm program, called the "5 Diamond Program" roled out to all the NWs.
Attachment
  
North Carolina Center for Hospital Quality and Patient SafetyMaternity Care/Adverse Obstetric EventsPartnership/Collaboration, Quality Initiative
1. 100 percent of NC hospitals providing maternity services pledge to implement a "hard stop" policy on labor and delivery to prevent EEDs.
2. All pledged hospitals voluntarily submit EED rate (TJC PC-01) to the NC Quality Center.
3. NC EED rate is <1 percent
1. 100 percent of NC hospitals (84 hospitals) providing maternity services have pledge to implement a "hard stop policy."
2. 63 percent of pledged hospitals have submitted data to the NC Quality Center.
3. EED rate for 3rd quarter 2012 is 3.5%
1. 100% or 84 hospitals have committed to preventing EEDs
2. Intermediate rate for 64% of these hospitals is 3.5% (3rd Quarter 2012 data)
1. Senior leadership buy-in at the NCHA Board of Trustees level.
2. Provide tools and education to hospitals staff as to the goal, why to do it and how to implement a hard stop policy.
3. Engagement of partners throughout the state at many levels of the health care delivery system so we are all on the same page, with a consistent message
FOX50/MIX101.5 WRAL FM
NC Hospital Association
NC Quality Center (Center for Hospitals Quality and Patient Safety)
NC/VA Hospital Engagement Network (NoCVA)
Perinatal Quality Collaborative of NC
NC March of Dimes
Community Care of North Carolina – Pregnancy Medical Home
State of NC, Division of Medical Assistance (Medicaid) – Pregnancy Medical Home
State of NC, Department of Public Health – Pregnancy Care Management
Carolinas Healthcare System Hospital Engagement Network
North Carolina State team for HRSA
Collaborative Improvement and Innovation Network (COIN) to reduce infant mortality
BCBS NC
Hospitals/Hospital Engagement Networks (HENs), Media, Providers/Professionals, Public/Consumers, Purchasers/Payers, States/CommunitiesNC 39 Weeks InitiativeIn progress
Dr. Carol Koeble
919.677.4211
ckoeble@ncha.org
Hospitals/Hospital Engagement Networks (HENs); Health Professional; Patient Family and Consumer; Providers; Public Community Health Agency; Purchaser; Health PlanPatient SafetyQuality Improvement, Workforce DevelopmentNo presence informationSevera Chavez1/30/2013 12:45 PMNorth Carolina11/28/2012 12:49 PMNo presence informationCarol Koeble
A statewide initiative to prevent early term deliveries between 37 weeks and 39 weeks gestation (EEDs) without a medical or Obstetrical indication
  
Center to Advance Palliative CareReadmissionsToolkit/Resource
To enable providers to comply with the Palliative Care Access Act in a finacially sustainable way while substantially improving care for those with serious illness.
We are currently seeking funding for this project.
Healthcare Association of New York State,  Hospice and Palliative Care Association of New York State, Empire State Association of Assisted Living, Home Care Association of New York State, LeadingAge New York, New York State Health Facilities Association, New York State Association of Health Care Providers, Medicare Rights Center, American Cancer Society, National Palliative Care Research Center
Providers/Professionals, Purchasers/Payers, States/CommunitiesIn progressProviders; Patient Family and Consumer; Health ProfessionalPatient SafetyInfrastructure/HIT, Quality Improvement, Workforce DevelopmentNo presence informationSevera Chavez1/30/2013 12:45 PMNew York11/14/2012 3:40 PMNo presence informationEmily Warner

This project aims to develop the tools, technical assistance and training necessary to support provider implementation of New York State’s Palliative Care Access Act (PCAA).  The 2011 NYS PCAA calls for hospitals, nursing homes, assisted living facilities, and home care agencies to screen their residents or patients for pain and palliative care needs, and to assure their access to such services.  To facilitate access to palliative care, we will engage hospital, nursing home, assisted living,  home care providers, and hospice providers in New York State in a comprehensive process over three years, which will include needs assessment, development of training, technical assistance, tools and application of strategies for scaling and diffusing these resources across the state. 

To provide a sustainable mechanism for future palliative care collaborations and ongoing technical assistance and support, we will establish and support two cross-setting provider resource teams to serve as resources for other provider partnerships.  Methods will include research, outreach, education and training, and technical assistance customized to the provider type, location, and self-identified needs for support

Readmission Action Team Member
  
Center to Advance Palliative CareReadmissionsPayment Model

The goal of this project is to accelerate collaboration between payers and providers to increase the availability of palliative care services that meet the needs of high-risk patients across settings.

We are currently seeking funding for this initiative.
National Business Group on Health

Payers with innovative palliative care programs.

Providers/Professionals, Purchasers/PayersIn progressPatient Family and Consumer; ProvidersAffordable CarePaymentNo presence informationSevera Chavez1/30/2013 12:45 PM(National)11/14/2012 1:12 PMNo presence informationEmily Warner

CAPC is working on a new initiative to encourage increased payer activity supporting palliative care programs.  This initiative will result in web-based tools that 1) identify payer practices that support expansion of effective palliative care services and access for patients; 2) feature innovations that are aligned with future payment reform directions, and 3) include practical approaches to assess what will work in local communities and how to convene payers and providers to develop, implement, and monitor new approaches. The tools and recommendations will be disseminated through CAPC, the National Business Group on Health, and other sponsoring organizations, as well as through an audio conference.

Readmission Action Team Member
  
Center to Advance Palliative CareReadmissionsToolkit/Resource
The goal of this project is to help providers adopt effective and sustainable community models of palliative care.
A webinar on outpatient palliative care services is scheduled for 12/12/12 at 1:30 EST.  You can register here: http://www.capc.org/capc-resources/audio-conf/12-12-2012
Providers/ProfessionalsCAPC IPAL-OPIn progressProviders; Patient Family and ConsumerPatient Safety, Effective Communication and Care CoordinationInfrastructure/HIT, Quality Improvement, Workforce DevelopmentNo presence informationSevera Chavez1/30/2013 12:45 PM(National)11/14/2012 12:58 PMNo presence informationEmily Warner

Outpatient palliative care services are growing to meet the increasing demand of improving care for seriously ill patients outside of the hospital.  New models of integrating palliative care into clinics and home-based programs are emerging that represent exciting opportunities to move palliative care upstream. As health care professionals and their institutions work to adopt these new models of care, questions emerge on best practices and sustainability.  

IPAL-OP is designed to help, offering a central repository for learning how to start an outpatient palliative care clinic or home-based program. IPAL-OP has amassed a collection of resources, tools and references from health care systems at the forefront of developing innovative outpatient palliative care services.

 

Readmission Action Team Member