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PQCNC III. The journey continues…. Agenda. Update Review of 2006 Collaborative Report Review of the Blueprint Expectations of Families PQCNC Executive Board Initiative proposals Initiative selection Wrap Up. Update. Organizational Efforts Blueprint Family recruitment Site Visits

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pqcnc iii


The journey continues….

  • Update
  • Review of 2006 Collaborative Report
  • Review of the Blueprint
  • Expectations of Families
  • PQCNC Executive Board
  • Initiative proposals
  • Initiative selection
  • Wrap Up
  • Organizational Efforts
    • Blueprint
    • Family recruitment
    • Site Visits
    • PQCNC Vermont Oxford Enrollment
    • Presentations
  • Funding
  • Project Development
site visits
Site Visits
  • Meet local clinical and quality improvement leaders
  • Tour facilities
  • Meet hospital executive leadership
  • Identify concerns of local perinatal leaders
  • Present an overview of PQCNC
    • Mission, vision and structural organization
    • State the case for PQCNC’s value to all stakeholders
site visits1
Site Visits
  • Participants at Meetings to date
    • Nurses
    • OBs
    • Neos
    • NNPs
    • Family Support Specialists and Staff
    • Quality Directors
    • Directors of Women’s and Infant Services
    • VP’s
    • CFOs
    • CEOs
site visits2
Site Visits
  • Ideas for improvement
  • Success stories
  • Unsolicited presentations of local data
    • The good, the bad and the ugly
  • Pride and enthusiasm
  • A desire to share and improve
  • Goal to visit all PQCNC hospital centers by years end
site visits3
Site Visits
  • Discussion of MOA
    • VON membership required to be member
  • Overwhelming desire for all data to be transparent amongst centers
    • Clear understanding data not to be used in marketing etc
  • Concerns re public reporting
    • Data issues and risk adjustment
  • MOA being reviewed by UNC legal
  • Will distribute over next two weeks
von enrollment
VON Enrollment
  • 2005 report with 10 centers
  • 2006 report includes 11 centers
  • By end 2007 will be 14 centers in VON and included in the PQCNC report
  • 83% of tertiary centers in the 2006 report
  • At least 92% of tertiary centers will be in the 2007 report
von enrollment1
VON Enrollment
  • An increasing number of community NICUs are interested in VON
  • In the 2005 report 1 community NICU
  • In the 2007 report there will be at least three…14 to go….
  • Absolute commitment from PQCNC to generate core education module and support for data collectors
pqcnc comparisons online nightingale
PQCNC Comparisons Online: Nightingale
  • www.vtoxford.org
  • https://nightingale.vtoxford.org/login.aspx?ReturnUrl=%2freports.aspx
  • MartyMc123456
  • Investments for the Future Grant
    • Dean SOM UNC Chapel Hill
    • Three years, ends 2010
    • Funding $655,000 over three years
    • Support personnel, infrastructure, communication, consultation, travel
    • Defined timeline for organization, initiation of projects, spread of work from neonatal to perinatal care
Committed supporters in the State Legislature (Senators Purcell and Dalton)

Recurring funds through the Education Committee for 2 years

future funding sources
Future Funding Sources
  • Private Organizations
  • Payers and Purchasers
    • Private payers/insurers
    • Private purchasers
    • State and Federal Agencies
  • Others

We are solvent for the next 2 ½ years.

Let’s prove our value!

outreach education in perinatal care

Outreach Education in Perinatal Care

Dr. Joe Holliday

Head Women’s Health Branch

Division of Public Health NC

update presentations
  • NC MFM Think Tank (April 2007)
    • First organizational meeting for state MFMs
  • ABP Subspecialties Meeting (July 2007)
    • Pediatric subspecialists and MOC Part 4
  • Tennessee Initiative for Perinatal Quality Care (TIPQC) (Nov 2007)
pqcnc looking ahead
PQCNC…Looking Ahead
  • Outreach as Quality Outreach and Education
  • Organizing of Maternal Care Providers
    • Meetings later this month, larger meeting early 2008
    • Identify or develop a complete perinatal data set
      • Pilot development of patient generated electronic data set linked to medical record
      • VON expanding maternal indicators
      • Use current administrative data set: Mission Hospital and NPIC
    • Maternal provider representation on Executive Board
  • Interstate Collaboration
    • Data sharing between Ohio, California, Tennessee
    • Development of joint projects
why perinatal collaboratives current environment
Why Perinatal Collaboratives? Current Environment
  • Transparency
    • Increasing public reporting of selected clinical outcomes
      • Voluntary reporting by hospitals (CMS)
        • Hospital Compare (http://www.hospitalcompare.hhs.gov)
      • Mandated in nine states currently
      • Maryland is requiring reporting of perinatal outcomes
    • Majority of reporting relates to adult diseases
      • Cardiac Failure, Heart Attack, Pneumonia, Surgical
neonatal indicators
Neonatal Indicators
  • Maryland Health Care Commission



pqcnc looking ahead1
PQCNC…Looking Ahead
  • Perinatal Care Transformation
    • Call for indicators by National Quality Forum
      • Numerous groups giving input re tested indicators
      • Indicators likely to be based on administrative data sets
      • Current favorites are birth trauma/3 and 4th degree lacerations
    • Successful collaboratives will have the opportunity to be part of these discussions
2006 pqcnc collaborative report
2006 PQCNC Collaborative Report
  • Disc or hard copy
  • Compares PQCNC centers anonymously
  • 40 key indicators
  • 11 Centers
  • 2006 Report
    • 1672 VLBW infants
    • 76% of VLBWs in NC
  • Data from 2 tertiary centers not included this report
pqcnc blueprint1
PQCNC Blueprint
  • Intended to make the case for PQCNC
  • Designed to provide some structure
  • Allow the Executive Board to develop rules of order
  • Form an Executive Board which will guide future PQCNC direction
  • Blueprint currently being reviewed by reader volunteers
  • Final document for distribution by Dec 1
pqcnc blueprint2
PQCNC Blueprint
  • Why do we need a perinatal Collaborative?
  • The mission and objectives of PQCNC
  • Keys to our success
    • Data
    • Collaboration
    • Action
    • Analysis
    • Education
pqcnc blueprint3
PQCNC Blueprint
  • Describe the PQCNC organizational structure
  • State PQCNC responsibilities
  • Identify stakeholders and responsibilities
  • Make the value case for PQCNC
    • Value to families
    • Value to payers and purchasers
    • Value to providers
pqcnc structural organization



Administrative Core

Executive Committee

Data Comm


(incl. website)

Data Management

Advisory Board

Projects &





Project Committee

Education Committee





PQCNC Structural Organization

Other data sets

executive board
Executive Board
  • Key driver for PQCNC activities and function
  • A position which requires some heavy lifting
    • Optimize travel
    • Limit time away from home
  • Initial meeting in January
    • Communication beforehand
    • Establish working relationships
    • No proxies
  • Many other leaders at local and state level will be needed to advance the PQCNC mission
executive board1
Executive Board
  • Initial board selection
    • Manageable size
    • Demonstrated commitment
    • Balance regions, geography, hospital type, personnel by medical and provider specialty
  • Board service period, rules of operation and order and priorities are the Board’s decisions
executive board2
Brenda Boberg

Mike Cotten

Jim Cummings

Kate Menard

Mildred Carraway

John Wimmer

Mike O’Shea

Ross Vaughan

Dave Fischer

Jincie Nichols

Joe Holliday

Barb Buechler

Ginny Raviotta

Merry-K Moos

Nick Lynn

Keith Gallaher

Patti Forest

Sheri Carrol

Rob Silver

Jay Kothaida

Tom Ivester

Heidi Brown

Sam Cykert

Rob Silver

Executive Board
next steps
Next Steps
  • Initial steps towards project development
    • Champions develop action plan in conjunction with Executive Board
    • Administrative Core offers assistance (IT, consultative services, education, data collection etc)
    • Execution has already begun, target implementation February 2008
    • Horizon for completion…Dec 2008
  • Board discussions re organization and priorities over the next two months
  • Subcommittees need to be established by the Board
  • Board meeting end January
next steps1
Next Steps
  • Strengthen alignment with maternal providers
    • Present, ? Present at next state OB/MFM meeting
    • Guidance of maternal care Board Members
    • Begin discussion of potential perinatal projects
next steps2
Next Steps
  • Complete site visits
  • Increase VON enrollement
  • As projects evolve so will communication methods (interactive website)
    • PQCNC members updated on project progress
    • Update on ongoing PQCNC activities
  • Board will determine schedule, agenda, and location for next meeting