Quality - Power Huddle writeups

quality & Care redesign power huddles

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Key insights from Vizient Connections Summit sessions

Journey to Improving on a National Quality Scorecard

University of Maryland, Baltimore, Maryland; Mangla Gulati, MD, Chief Quality and Safety Officer, Medstar Washington Hospital Center, Washington, DC (formerly at University of Maryland Medical Center); Kristin Seidel, PhD, RN, Clinical Data Scientist, UM Medical Center; Jennifer Murphy, RN CCDS, CDI Site Manager; Jason Custer, MD, Director of Patient Safety, Vice Chair of Quality and Safety, and Department of Pediatrics Division Head of Pediatric Critical Care Medicine; Megan Tripoli, RN, Senior Manager, Clinical Decision Support

We focused our strategic planning efforts on mortality and safety with a five-year Vizient road map so as to reflect on and improve the great care that we knew we are committed to providing our patients. Mangla Gulati

Key Takeaways

Action Items

Leverage existing teams, provide continuous training, goal-set for sustainable improvements and remember the journey doesn't happen overnight.

Quality improvements require embracing and understanding methodologies, including the right people on your team and tailoring clinical documentation improve-ment reviews along the way.

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LOS Reduction Through Service Line-Focused MS-DRG Intervention

Inova Health System, Falls Church, Virginia; Anne Brittain, PhD RT(R)(M)(QM), CPHQ, LSSGB, Director, Quality Improvement and Outcomes; Rishi Garg, MD, Chief Medical Officer, Inova Fairfax Medical Campus

With historically high patient volumes everywhere, Length of Stay (LOS) reduction resonates regardless of the size or locale of a facility, and this also is true of the use of Medicare Severity Diagnosis Related Groups (MS-DRG) data. Anne Brittain

Key Takeaways

Action Items

Supplier Implications

Use iterative data year-over-year and engage service lines to improve patient outcomes.

As activities shift to the outpatient arena, there could be supplier impact both on the inpatient and outpatient settings.

Shifting away from tradition by integrating service lines into hospital operations and using MS-DRG data can positively impact hospital performance.

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There’s No Place Like Home: Serving Acute Care Patients Where They Belong

NYU Langone Health, Mineola, New York; Eve Dorfman, DNP, RN, NEA-BC, Vice President, Operations; Jeanmarie Moorehead, EdD, RN, NEA-BC, Senior Director, Home Health Care and Home Hospital; Faith Lynch, DNP, RN, CNN, Senior Director, Dialysis Operations; Jenna Blind, DNP, RN, CPHQ, Director of Education, Professional Development and Quality Improvement, Home Health Care and Home Hospital

Home Hospital delivers care that is congruent with principles and practices of traditional inpatient hospital care — held to the same, if not higher, standards as traditional inpatients for patient satisfaction, clinical outcomes, and meeting quality and regulatory requirements. Jenna Blind

Supplier Implications

Key Takeaways

Action Items

It's never too late to start planning for a Home Hospital program implementation, but approach your executive champions ASAP.

Suppliers can benefit from learning how a Home Hospital program model leverages technology and supplies.

Executive buy-in, change management and understanding CMS requirements are crucial to creating a Home Hospital program.

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Stat: Stanford’s Telemedicine Low-Acuity Track for Emergency Department Visits

Stanford Health Care, Stanford, California; Meagan F. Moyer, MPH, RD, Manager, Digital Health Operations; Sam Shen, MD, MBA, Associate Chief Quality Officer; Patrice Callagy, RN, MPH, MSN, CEN, Executive Director, Emergency Services

Staffing shortages, clinician burnout and aging populations are already straining our organizations and will only continue to do so over time. We created and continue to iterate our emergency medicine virtual care program based on problem-first principles. Meagan F. Moyer

Supplier Implications

Key Takeaways

Action Items

Leverage technology hardware, software and clinical workflows, while partnering with frontline staff and seeking executive leadership support.

Suppliers should be open to their providers needing their product to be flexible and able to adapt to their clinical needs.

Scale physician resources across multiple sites, integrate a virtual ER and create multidisciplinary teams to improve outcomes including length of stay.

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Hypertension RPM: A Patient Portal and Population Health Hypertension Intervention

University of Chicago Medicine, Chicago, Illinois; Sean Bernstein, MD, Clinical Informatics Fellow; Sachin D. Shah, MD, Chief Medical Information Officer; Tameka Wilson, DNP, RN, AMB-BC, NE-BC, Assistant Director, Ambulatory Nursing

We piloted a remote patient monitoring program for patients with uncontrolled hypertension using digital activation to improve hypertension control and reduce health disparities. Tameka Wilson

Key Takeaways

Action Items

Empower your workgroup team to assess how well your organization is providing access to care and make a plan to address hypertension.

Improving hypertension with a digital and population health-based solution requires teamwork across disciplines and engaging patients as part of their healthcare plan.

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Top Takeaways

• Addressing uncontrolled hypertension and making a large impact takes a true team including a variety of disciplines (providers, nurses, medical assistants, IT and pharmacists).
• The Remote Patient Monitoring program (RPM) improved the control of hypertension and reduced disparities within the community.
• Patients were able to fully engage in their healthcare plan while developing a rapport with the clinical staff.

"Our technology-centered program depends on hardware and software to operate successfully. Our vendors that produce and supply this technology are key players in our success. Our IT team members needed the flexibility within our EHR to create novel backend changes that met the clinical workflow needs of our team," Moyer said. "Suppliers should be aware and open to their buyers needing their product to be flexible and able to adapt to clinical needs. Technology needs to adapt to users, not the other way around."

Action Items

• Assess and analyze the need for your organization in regard to community and health disparities.
• Create a workgroup that includes all disciplines (pharmacy, nurses, providers, equity team, executive leadership and patient representative) in healthcare to discuss a plan to address uncontrolled hypertension.

Action Items

• It is never too soon to start planning for a Home Hospital program implementation.
• Begin to approach your potential executive champions as soon as possible.

"There is potentially an impact for suppliers as activities shift to the outpatient arena," Rishi Garg said. "Both on the inpatient and outpatient side."

"The logistics that are required to bring care to an acute care patient in their home is complex," Blind said. "Hospital at Home programs leverage the newest technologies and ancillary support to facilitate the provision of care. Suppliers can benefit from learning how our program model leverages technology and supplies."

Action Items

• Implement iterative use of year-over-year data to continuously improve based on patient diagnosis.
• Engage service line teams in hospital operations.

Top Takeaways

• MS-DRG data can be used to drive change.
• Integrating service lines into hospital operations creates opportunities for both the service line and the hospital.
• Shifting away from tradition can positively impact hospital performance.

Action Items

• Leverage technology hardware, software and clinical workflows to extend physicians to serve multiple care sites. Think about existing technology-driven clinical programs and if they can be built upon for new use cases.

• Partner with front-line staff to design the solution to the problem you are solving, and be open to new ideas and the process of continuous improvement.
• Seek executive leadership’s support and openness to approving changes to long-standing and accepted processes.

Action Items

• Leverage existing structures and processes.
• Harness passion for improvement.

• Communicate consistently about performance.

• Gather monthly feedback and course correct along the way.

• Educate and reinforce measurement.

• Create new and evolving partnerships.

• Persevere and focus for sustainable, long-term improvements.

Top Takeaways

• Executive buy-in is critical to the successful implementation of a Home Hospital program.
• Do not underestimate the importance of change management when implementing a Home Hospital program and be sure to involve representatives from any and all stakeholders.
• Understand the requirements under CMS to implement a Hospital at Home program.

Top Takeaways

• Emergency Departments are experiencing increasing in patient volumes and a subsequent strain on existing resources. We chose to virtualize our fast track program for low acuity patients to scale physician resources across multiple sites.
• Our program shows that telemedicine can be used in the ED setting to reduce patient length of stay while not compromising patient satisfaction or ED return rate.
• Successful innovation requires a multi-disciplinary approach from design to implementation.

Top Takeaways

• Define True North with approval from the Quality Board.
• Reorganize existing quality board and get them “on board.”
• Implement focused education for stakeholders.

• Frequently communicate about journey and reiterate the strategic plan with stakeholders.

• Celebrate incremental improvements.

• Ensure sustainability of gains by setting goals for ongoing opportunities.