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Denni McColm, CIO Renee Whitman-Teeter, Director of Performance Improvement Citizens Memorial Healthcare. Quality – What is it?. Patient outcomes, did they get well? Short term? Long term? Patient perceptions? How often we followed evidence based protocols? Survival rates?

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Denni McColm, CIO

Renee Whitman-Teeter, Director of Performance Improvement

Citizens Memorial Healthcare


Quality what is it
Quality – What is it?

  • Patient outcomes, did they get well?

    • Short term?

    • Long term?

  • Patient perceptions?

  • How often we followed evidence based protocols?

  • Survival rates?

  • Readmissions rates?

  • Is it safe, error-free care?






How are they using that quality data
How are they using that quality data?

  • Publicizing it on the Internet

  • Paying us for it


  • Deployment of Rapid Response Teams…at the first sign of patient decline

  • Delivery of Reliable, Evidence-Based Care for Acute Myocardial Infarction…to prevent deaths from heart attack

  • Prevention of Adverse Drug Events (ADEs)…by implementing medication reconciliation

  • Prevention of Central Line Infections…by implementing a series of interdependent, scientifically grounded steps called the “Central Line Bundle”

  • Prevention of Surgical Site Infections…by reliably delivering the correct perioperative antibiotics at the proper time

  • Prevention of Ventilator-Associated Pneumonia…by implementing a series of interdependent, scientifically grounded steps called the “Ventilator Bundle”


Cmh strategic initiatives
CMH Strategic Initiatives

  • Core/Regulatory Measures

  • Pain

  • Turnaround Times


Using it to improve quality
Using IT to Improve Quality

  • EMR

  • CPOE

  • eMAR

  • Reduce errors of transcription/illegibility

  • Give physicians more information with which to make care decisions

  • Alert drug/drug interactions and allergies

  • Improve the timeliness of results


  • Order prompting in the ED

  • Order prompting in PCS

  • Required fields

  • Documentation templates for physicians

  • OE Rules

  • Evidenced based order sets

  • Clinical alerts


Changing our thinking

FROM ONE AT A TIME CHART REVIEWS AFTER THE FACT

TO:

NPR Reports

Required Fields

Reporting Daily, end of shift

BUILDING IN QUALITY & MONITOR IT CONCURRENTLY

Changing our thinking . . .


But,

  • Where should we focus our effort?

  • Where are we doing the worst?

  • We could write an NPR for every one of those measures (Core, ORYX, 100K Lives . . . . . . . . . .)

  • How many people would it take to write an NPR report for every quality measure out there?

  • Just to determine where to focus . . . And then,

  • How would we adjust for severity and compare to benchmarks?


  • The Institute for Health Metrics (IHM) is:

    • A non-profit that helps us leverage our electronic systems for quality improvement

    • Extracting data from MEDITECH for use in:

      • Quality of Care Reporting & Benchmarking

      • Physician Performance Analysis & Reporting

    • A MEDITECH Strategic Ally


Recognizing that we need
Recognizing that we need . . .

  • Quality management tools to help us:

    • Identify

    • Analyze

    • Target

    • Track

  • Tools that are:

    • Automated

    • Timely

    • Use sophisticated analytics

    • Give us a graphical presentation

    • Case/provider drill downs and

    • Trend analysis


Aies tm pqms tm
AIESTM & PQMSTM


Extract data directly from meditech

IHM:

Clean

Normalize

Map

Report

Hospital HCIS

Web Based Monthly Reports

IHM

VPN

Extract Data Directly from Meditech











Benefits
Benefits

  • Automates Data Extraction and Analysis

    • Eliminates manual data collection, analysis and reporting

    • Gives us an unbelievable number of measures

      • Extracted

      • Severity adjusted

      • Benchmarked

  • Presents and Analyzes Data in a Usable and Actionable Format

    • Focuses Efforts on the True Causes & Drivers of Performance

    • Supports timely Interventions and Improvement Strategies

    • Helps Clinical Staff Focus on Improving the Quality of Care


Upcoming releases
Upcoming Releases

  • Concurrent Case Management System (CCMS)

    • Identification and scoring for high risk patients

    • Daily reports for Core Measure case tracking

    • Daily reports for concurrent quality improvement efforts

  • Financial Analysis System

  • Nursing Quality Management System


Thanks
Thanks!

Questions:

Denni McColm, [email protected]

Renee Whitman-Teeter, [email protected]

Jeff Borkowski, [email protected]


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