HIIN Update - Michigan MICAH Quality Network meeting Andrew Syrek | - - PowerPoint PPT Presentation
HIIN Update - Michigan MICAH Quality Network meeting Andrew Syrek | Senior Healthcare Data Analyst February 21, 2020 ADE-Opioids ADE Opioids 9 8 8 7 7 6 5 5 4 3 3 2 2 2 1 1 1 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0
February 21, 2020
Andrew Syrek | Senior Healthcare Data Analyst
1 1 1 1 1 1 1 1 2 2 3 5 7 8 1 2 3 4 5 6 7 8 9
Jan 2019 ‐ Dec 2019
ADE‐Opioids
Data as of February 6, 2020
1 1 1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 3 3 3 3 4 8 1 2 3 4 5 6 7 8 9
Jan 2019 ‐ Dec 2019
Falls
Data as of February 6, 2020
Data as of September 31, 2019
Data as of September 31, 2019
29 1 6
PFE‐5 Implementation
Fully Implemented Not Implemented Partially Implemented
Data as of February 6, 2020
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ADE ‐ Anticoagulants ADE ‐ Hypoglycemics ADE – Opioids CAUTI – NHSN SIR: ICU Excluding NICU CLABSI Rate – ICU and other units
Falls with Injury: NQF 0202 Pressure Injury: AHRQ PSI‐03 Sepsis and Septic Shock Mortality SSI – Abdominal Hysterectomy NHSN SIR VTE – PE or DVT Rate: AHRQ PSI‐12 VAE ‐ PVAP Readmissions – Same Facility MRSA Rate
15.8% 15.8% 8.9% 17.7% 30.3% 23.1% ‐42.8% 6.6% 7.7% 4.1% 11.8% ‐0.6% 24.2% 0.4% 11.5% Data as of September 31, 2019
Developed partnership with MN HIIN
80 presentations given on GLPP HIIN programming & successes CAHs demonstrated improvement in 74% of measures CAHs have driven a 73.4% improvement in CLABSI Over 80% data reporting across all measures Launch of Reliability Culture Implementation Guide
51.9% of network is rural
27.8% improvement in overall HIIN Reliability Measure
77% of network has implemented a PFAC
Improvement demonstrated in 76% of all measures 32 Quality Fundamental Trainings
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2016‐4 2017‐1 2017‐2 2017‐3 2017‐4 2018‐1 2018‐2 2018‐3 IL 6.07 6.46 6.23 5.74 5.75 5.87 5.38 4.93 MI 6.17 6.03 5.89 5.85 6.01 5.89 5.50 5.48 WI 6.01 5.31 5.12 5.49 5.44 5.51 4.70 4.75
4.50 5.00 5.50 6.00 6.50 7.00
Rate Per 1000 Year‐ Quarter
HIIN Reliability Measure
HIIN Reliability Measure Definition: Numerator: The HIIN Reliability Measure includes the following measures: ADE ‐ Excessive Anticoagulation, ADE ‐ Hypoglycemia/Glucose Management, ADE ‐ Opioid‐related, CAUTI Rate – All, CDI Rate, CLABSI Rate – All, Falls with Injury, MRSA Rate, Pressure Ulcers PSI‐03, Sepsis PSI‐13, SSI Rate – COLO, SSI Rate – HYST, SSI Rate – KPRO, SSI Rate – HPRO, Total IVAC Plus, VTE PSI‐12 Denominator: Patient Days
35.8% of network are CAHs
Launched seven Playbooks on proven interventions
Successfully co‐lead ADE Affinity Group
Launched 2 cohorts of Alternative to Opioids (ALTO) Program Convening of System Leaders regularly for cross collaborative learning 100% active engagement from all participating hospitals 197 Hospitals completed a Health Equity Organizational Assessment 98.1% retention rate
participating HIIN hospitals
Transparent data dashboard utilized across HIIN
CAHs have driven 59.6% improvement in MRSA and 29.7% improvement in CDI
Advancement of rural efforts through partnerships with state based centers for rural health
94.8% of network has successfully implemented Shift Change Huddles
National Partnerships developed with AHRQ 46 simulations
7 topic areas The GLPP HIIN Reliability Measure quantifies all‐cause harm by aggregating the total number of harm events across 16 different measures (listed below), divided by patient days to depict the impact of HIIN work on reducing total patient harm.
Kristy Shafer-Swadley kswadley@mha.org
Andrew Syrek | Senior Healthcare Data Analyst
February 21, 2020
According to 2016 U.S. Census Bureau data, more than 23% of Michigan residents are now 60 or
seven years since the 1960s. At the same time, roughly 80% of older adults have at least one chronic disease, and 77% have at least two. As reported by Bridge Magazine, Michigan has the highest concentration of older residents in the
with the challenges of social and home support dynamics for older residents, make developing age‐friendly care settings and processes vital for the well‐being of Michigan’s aging patients.
Sources: US Census Bureau, Bridge Magazine, The Detroit News
The Issues and Gaps (1) Older adults:
treatment
evidenced care
medications
encourage mobility
decline
harms and death
Network of Age‐Friendly States and the World Health Organization Global Network of Age‐Friendly Cities and Communities. The action is intended to help the state prepare for dramatic and imminent demographic changes and ensure that Michigan communities can take steps to accommodate all ages. The state’s application was accepted by AARP and the World Health Organization and certification was awarded. Michigan becomes the 5th state to join the network. The others are Colorado, Florida, Massachusetts and New
Source: AARP
Widespread misunderstanding about the aging process, lack of information about how older people contribute to society, led to pervasive ageism Ageism is alive and well in our attitudes, behaviors, programs, and policies; and it affects employment, health care practices, psychological well‐being, family dynamics, and more… Research by the FrameWorks Institute found that the public believes aging is synonymous with decline and dependency, and that the aging process is a battle to be fought
Age-Friendly Health Systems is an initiative of The John A. Hartford Foundation and the Institute for Healthcare Improvement (IHI), in partnership with the American Hospital Association and the Catholic Health Association of the United States (CHA). These core partners have been working on the Age- Friendly Health Systems Initiative over the past few years.
90 care features identified in pre‐work Redundant concepts removed and 13 discrete features found by IHI team Expert Meeting led to the selection of the “vital few”: the 4Ms Me tho ds: Re vie we d 17 c are mo de ls with le ve l 1
dec.), ICU stays (80% dec.), while increasing hospice use (47.2%) and pt satisfaction (AHRQ 2013)
increased LOS of 6.3 days compared to controls (Wong 2011)
improve mobility (Klein 2015)
References at end of slides
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rie ndly He alth Syste ms and the 4Ms F rame wo rk are no t inte nde d to be a mo de l o r pro g ram that is laye re d o n to p o f the c are yo u pro vide to day. T
he 4Ms ar e a fr amewor k to o rg anize the e ffic ie nt de live ry o f e ffe c tive c are with o lde r
adults.
rie ndly He alth Syste ms are de sig ne d to c lo se the g ap be twe e n the e vide nc e -base d c are that we kno w wo rks and the r
eliable pr actice of that car e with ever y older adult in e ve ry inte rac tio n within e ve ry c are se tting .
t is hig hly like ly that so me o f the 4Ms are in plac e so me whe re with so me o lde r adults mo st o f the time in yo ur c are se tting . Be g in yo ur Ag e -F rie ndly He alth Syste m jo urne y by le arning ho w the 4Ms are alre ady in prac tic e to day. Consider
what activities you may be able to stop doing when the 4Ms ar e r eliably in pr actice.
he 4Ms ar e a set to be inte g rate d to g e the r into c are fo r e ve ry adult ag e s 65 and
se tting .
4MS as a SET Reliably Practices Every Patient (65+), Every Time
The 4Ms in an Age‐Friendly Health System Hospital
The 4Ms in an Age‐Friendly Health System Practice
The Issues and Gaps (2) Geriatrics models of care proven very effective Yet models reach only portion who could benefit Models difficult to disseminate and scale Models difficult to reproduce in community hospitals with less resources Few models work across care settings Various models co‐exist and confuse
https://aging.rush.edu/professional‐older‐adult‐family‐care/age‐friendly‐health‐system/4ms‐ framework/
EP4
Slide 39 EP4 I really like this video - I think it summarizes what i shared above in a good way- but its 6 minutes long so do iI cut out similar info shared in the presentation and share the video or cut the video out?
Ewa Panetta, 2/12/2020
October 2019, MHA Keystone Center launched the Age‐Friendly Health Systems Action Community to bring attention to the 65‐years‐and‐older population. Funded by the Michigan Health Endowment
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Jason Hecht, PharmD, BCPS, BCCCP 4M ‐ Medication Michelle Moccia DNP, ANP‐BC, CCRN, GS‐C 4M ‐ Mentation Pat Posa RN, BSN, MSA, FAAN: 4M ‐ Mobility Arlene Stoller MS, RN‐ BC, ACNS‐BC, GCNS, CDP 4M – What Matters
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Team Webinar Tools & Methods to Assess and Act
Putting the 4Ms into Practice Getting Started Call High‐level overview
setting to begin, set up your team. Team Webinar 1 Assessing and Acting on the 4Ms as a set
consistent with the 4Ms and set an aim. Team Webinar 2 4Ms Deep Dive: What Matters
consistent with the 4Ms
Team Webinar 3 4Ms Deep Dive: Medication Team Webinar 4 4Ms Deep Dive: Mentation Measuring the impact of 4Ms care Team Webinar 5 4Ms Deep Dive: Mobility
4Ms Team Webinar 6 Celebrate and discuss reliably acting
Celebrate and prepare for scale‐up
Hospital
Author Unknown
https://member.mha.org/events/upcoming-events