NoCVA HENPreventing Avoidable

Readmissions Collaborative - Virginia

Abraham Segres, MHAVice President, Quality and Patient SafetyVirginia Hospital & Healthcare Association

June 11, 2012

NoCVA HEN

• This activity is part of the North Carolina Virginia Hospital Engagement Network(NoCVA HEN)

• The NoCVA HEN is led by the NC Quality Center in partnership with the Virginia Hospital & Healthcare Association

• The NoCVA HEN exists to support the goals of the CMS national effort - The Partnership for Patients

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Partnership for Patients Goals

• By the end of 2013, preventable hospital acquired conditions would be reduced by 40%, compared to 2010

• By the end of 2013, 30-day hospital readmissions would be reduced by 20%, compared to 2010

• This Collaborative is designed to impact the goal of reducing avoidable readmissions

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• Describe the NoCVA Virginia Preventing Avoidable Readmissions Collaborative goals, methods and measures

• Understand the IHI’s STAAR model for Improving Care Transitions and Reducing Avoidable Rehospitalizations

• Identify specific strategies to reduce avoidable rehospitalizations

• Understand the expectations of collaborative participants

Objectives

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• Introductions & Project Overview• Individual Hospital Readmission• Improving Care Transitions and Reducing

Avoidable Rehospitalizations• Lunch• Readmission Measures• Introduction to the IHI Readmission Diagnostic Tool• Next Steps – Action Planning

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Agenda

The Problem of Readmissions

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• Frequent and costly• Many are avoidable• Many represent

complications• Poor care transitions

impact patient well-being and contribute to readmissions

• Value based purchasing: penalty for readmissions

Collaborative Mission

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To improve transitions in care and reduce avoidable hospital readmissions.

Collaborative Goals

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• Reduce readmissions rates by 20%

• Increase medication reconciliation at discharge to 95%

• Additional hospital specific goals based on hospital assessment of readmission patterns

Participating Virginia Hospitals

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• Augusta Medical Center• Bedford Memorial Hospital• Carilion Franklin Memorial

Hospital• Carilion Roanoke Medical

Center• Carilion Tazewell Community

Hospital• Centra Lynchburg General

Hospital• Chesapeake Regional Medical

Center• Culpeper Regional Hospital

• Fauquier Hospital• Prince William Health System• Rappahannock General

Hospital• Southern Virginia Regional

Medical Center• Southside Community

Hospital – Centra• Southside Regional Medical

Center• Virginia Hospital Center

• Priority: Top priority for 33%; Top 3 for 67%; Top 4 for 80%

• Team Status: 57% has a structured quality team in place

• Performance Status: 19% better than goal; 14% at goal; 48% worse than goal; 19% not a goal/don’t know

• Transition of Care Models: 52% homegrown; 37% none; 5% BOOST, 5% Impact,

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NOAT Survey Results: Readmissions in VA Hospitals

The Model

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• Institute for Healthcare Improvement (IHI): o STARR – State Action

on Reducing Avoidable Readmissions

o How-to-Guide: Creating an Ideal Transition Home to Reduce Avoidable Rehospitalizations

Methods

• Develop multidisciplinary project team

• Assess recent readmissions

• Conduct observations of patient admission, education, and discharge

• Review assessment and observation information

• Develop targets for improvement

• Identify and connect with local community organizations, services and practices

• Develop & implement action plans for improvement targets

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Methods

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• Monthly webinars• Group coaching calls• In-person learning

sessions• Apply specific

improvement tools such as Lean’s value stream mapping

Website for Resources

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NoCVA HEN:

Readmissions Virginia

Timeline

Pre-work May – June, 2012

Learning Session 1 June 11, 2012 – Richmond, VA

Action Period 1 June – December, 2012

Content Webinars June, July, August, September & December

Coaching Calls June, September & December

Monthly Data Collection - Submitted Quarterly

May-December 2012

Learning Session 2 January 30, 2013 – Richmond, VA

Action Period 2 February – June, 201315

Questions?

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Individual Hospital Readmission Experience

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• Familiarize yourself with your hospital’s current readmission data.

• Familiarize yourself with work your hospital has done or is doing to address readmissions.

• Identify one recent patient readmission story that revealed opportunities for process improvement.

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Current State