Changes in healthcare and the role of the respiratory therapist
This presentation is the property of its rightful owner.
Sponsored Links
1 / 54

Changes in Healthcare and the Role of the Respiratory Therapist PowerPoint PPT Presentation


  • 158 Views
  • Uploaded on
  • Presentation posted in: General

Changes in Healthcare and the Role of the Respiratory Therapist. John Wilson BSRT, RRT-ACCS. Disclosure. Speaker Bureau – Monaghan Medical. Goals. Have a basic understanding of Value Based Purchasing Have a basic understanding of HCAPS

Download Presentation

Changes in Healthcare and the Role of the Respiratory Therapist

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Changes in healthcare and the role of the respiratory therapist

Changes in Healthcare and the Role of the Respiratory Therapist

John Wilson BSRT, RRT-ACCS


Disclosure

Disclosure

Speaker Bureau – Monaghan Medical


Goals

Goals

  • Have a basic understanding of Value Based Purchasing

  • Have a basic understanding of HCAPS

  • Have knowledge of CMS’s Readmission Reduction Program

  • Have some specific ideas about how respiratory therapists can play a role in reducing COPD readmissions

  • Leave with hope and encouragement that Respiratory Therapists can be leaders in Healthcare Reform and continue to grow and thrive as a profession


Affordable care act

Affordable Care Act

Attempts to reform the healthcare system by:

  • Providing more Americans with affordable quality health insurance

  • Curbing the growth in healthcare spending

Condensed version – 974 pages long


Topics addressed in detail

Affordable Care Act

Topics addressed in detail

  • Quality, affordable health care for all Americans

  • The role of public programs

  • Improving the quality and efficiency of health care

  • Preventing chronic disease and improving public health

  • Health care workforce

  • Transparency and program integrity

  • Improving access to innovative medical therapies

  • Community living assistance services and supports

  • Revenue provisions

  • Reauthorization of the Indian Health Care Improvement Act


Hospital value based purchasing

Hospital Value-Based Purchasing

Section 3001(a) of the Affordable Care Act


Hospital value based purchasing1

Hospital Value-Based Purchasing

Intent:

Link Medicare’s payment system to improve healthcare quality

  • including the quality of care provided in the inpatient hospital setting


What has changed

What has Changed?

Past

  • Diagnosis Related Groups (DRG)

  • Paid for treating

Future

  • Pay for Performance

  • Population Management


Hospital value based purchasing2

Hospital Value-Based Purchasing

Purpose

  • Promote better clinical outcomes for hospital patients

  • Improve their experience of care during hospital stays


How will they achieve this

How will they achieve this?

  • Eliminate or reduce occurrence of adverse events (healthcare errors resulting in patient harm)

  • Adopting evidence-based care standards and protocols that result in the best outcomes for the most patients

  • Re-engineering hospital processes that improve patients’ experience of care


Measures hospital value based purchasing

Measures:Hospital Value-Based Purchasing

Hospital’s performance will be based on their performance in several areas


Measures hospital value based purchasing1

Measures:Hospital Value-Based Purchasing

Fiscal Year (FY) 2013

  • 12 Clinical Process of Care measures

  • 8 Patient Experience of Care dimensions - HCAHPS survey


Clinical process of care measures

Clinical Process of Care measures

AMI

Heart Failure

Pneumonia

Surgical Care Improvement


Measures hospital value based purchasing2

Measures:Hospital Value-Based Purchasing

Fiscal Year (FY) 2014

  • 13 Clinical Process of Care measures

  • 8 Patient Experience of Care dimensions (HCAHPS)

  • 3 30-Day Outcome Mortality measures:

    • Acute Myocardial Infarction (AMI)

    • Heart Failure (HF)

    • Pneumonia (PN)


Measures hospital value based purchasing3

Measures:Hospital Value-Based Purchasing

Fiscal Year (FY) 2014


Measures hospital value based purchasing4

Measures: Hospital Value-Based Purchasing

Fiscal Year (FY) 2015

  • 12 Clinical Process of Care measures

  • 8 Patient Experience of Care dimensions (HCAHPS)

  • 3 - 30-Day Outcome Mortality measures:

    • Acute Myocardial Infarction (AMI)

    • Heart Failure (HF)

    • Pneumonia (PN)

  • 1 Agency for Healthcare Research and Quality (AHRQ) Composite measure:

    • Patient Safety Indicator (PSI-90)]

  • 1 Healthcare Associated Infection:

    • Central Line-Associated Blood Stream Infection (CLABSI)

  • 1 Efficiency measure:

    • Medicare Spending Per Beneficiary (MSPB)


Hospital value based purchasing3

Hospital Value-Based Purchasing

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)


Changes in healthcare and the role of the respiratory therapist

How

Can we

Always

Have

Patient

Satisfaction


Hcahps intent

HCAHPS - Intent

To provide a standardized survey instrument and data collection methodology for measuring patients' perspectives on hospital care

Are we comparing Apples-to-Apples?


Hcahps goals

HCAHPS - Goals

  • To produce comparable data on the patient's perspective on care

  • Designed to create incentives for hospitals to improve their quality of care

  • Increase the transparency of the quality of hospital care provided


Hcahps measures

HCAHPS - Measures


Hcahps public reporting

HCAHPS – Public Reporting


Hcahps public reporting1

HCAHPS – Public Reporting


Hcahps public reporting2

HCAHPS – Public Reporting

There is much more and –

The public is out there shopping


Readmissions reduction program

Readmissions Reduction Program

subpart I of 42 CFR part 412 (§412.150 through §412.154)


Readmissions reduction program1

Readmissions Reduction Program

  • Requires CMS to reduce payments to hospitals with excess readmissions

  • Effective for discharges beginning on October 1, 2012

  • Provides incentives for hospitals to reduce the number of hospital readmissions


Changes in healthcare and the role of the respiratory therapist

Readmissions Reduction Program

  • 2,211 American hospitals received reimbursement penalties for high readmission rates

    • Together they forfeited about $280 million in Medicare funds in 2012

  • According to Medicare, 2 out of 3 hospitals evaluated failed to meet its new standards for preventing 30 day readmissions.


Changes in healthcare and the role of the respiratory therapist

Proposed

Replacements of the hip or knee


Readmissions reduction program2

Readmissions Reduction Program

  • I in 5 Medicare beneficiaries are readmitted within 30 days - Which equates to 2.3 million patients

  • National cost of over $17 Billion

  • Half of patients readmitted had no physician contact

  • 70% of surgical readmits were for chronic medical conditions.

  • Potentially 40% of all Readmissions are preventable

  • New England Journal of Medicine

  • Stephen F. Jencks, MD, MPH, Mark Williams, MD and Eric A Coleman, MD MPH.


Readmission factors

Readmission Factors

  • 69% were non compliant with meds

  • 51% lacked knowledge: How to use Therapy Devices

  • 45% inadequate knowledge of medications

  • 42% unable to self manage care

  • 37% had no follow up visit with Physician

  • 31% develop infection post discharge

AARC webcast August 28-12 “Hospital to Home-efforts at Reducing Hospital Readmissions”. Greg Spratt BS, RRT; Kimberly Wiles BS, RRT; Becky Anderson RRT.


Respiratory therapist in this new era of healthcare

Respiratory Therapist in this new era of healthcare

How will we Add Value?

August - 2013


You don t need to recreate the wheel

You don’t need to recreate the wheel

Look at what others are doing

Network with your peers


Other resources connect online

Other Resources – Connect Online


Other resources connect online1

Other Resources – Connect Online


Other resources attend meetings

Other Resources - Attend Meetings


Other resources attend meetings1

Other Resources - Attend Meetings


Copd readmissions what can we do

COPD Readmissions – What can WE do?


Chronic care model

Chronic Care Model


Chronic care model1

Chronic Care Model


In the hospital treating the exacerbation

In the Hospital – Treating the Exacerbation


Readmission factors1

Readmission Factors

  • 69% were non compliant with meds

  • 51% lacked knowledge: How to use Therapy Devices

  • 45% inadequate knowledge of medications

  • 42% unable to self manage care

  • 37% had no follow up visit with Physician

  • 31% develop infection post discharge

AARC webcast August 28-12 “Hospital to Home-efforts at Reducing Hospital Readmissions”. Greg Spratt BS, RRT; Kimberly Wiles BS, RRT; Becky Anderson RRT.


Readmission factors2

Readmission Factors

  • 45% inadequate knowledge of medications


Readmission factors3

Readmission Factors

  • 51% lacked knowledge: How to use Therapy Devices


New products

New Products


Readmission factors4

Readmission Factors

  • 51% lacked knowledge: How to use Therapy Devices


Readmission factors5

Readmission Factors

  • 42% unable to self manage care


Readmission factors self management

Readmission Factors – Self Management


Readmission factors self management1

Readmission Factors – Self Management


Readmission factors6

Readmission Factors

  • 37% had no follow up visit with Physician

    WHY only 37%?????

    Physicians are inconsistent

  • 21.7% of patients with follow-up with their PCP or pulmonologist had an ED visit with-in 30 days of discharge

  • 26.3% of patients with no post-discharge follow-up had an ED visit with-in 30 days of discharge

Sharma, Kuo, Freeman, Zhang, & Goodwin (2010)


Readmission factors7

Readmission Factors

  • 21.7% of patients with follow-up with their PCP or pulmonologist had an ED visit with-in 30 days of discharge

  • 26.3% of patients with no post-discharge follow-up had an ED visit with-in 30 days of discharge

Sharma, Kuo, Freeman, Zhang, & Goodwin (2010)


Readmission factors8

Readmission Factors

  • 31% develop infection post discharge

    • Teaching patients early recognition of symptoms is critical

    • Action plan in place?


Summary

Summary

  • Healthcare is transforming as we speak

  • Our reimbursement structure is changing

  • We have an awesome opportunity as respiratory therapists but we must embrace the change and get out of our cofort zone

  • Our future is bright if we grow as professionals and practice as engaged members of the healthcare arena


Changes in healthcare and the role of the respiratory therapist

HAPPY RESPIRATORY CARE WEEK


Thank you

Thank You!

I appreciate the opportunity to be here with you all today.

John Wilson BSRT, RRT-ACCS, RCP

Respiratory Supervisor

Novant Health Rowan Medical Center

Salisbury, NC [email protected]


  • Login