Partnerships Work! Healthcare Partners Collaborate for Better Outcomes

1. Partnerships Work!Healthcare Partners Collaborate for Better Outcomes Teri Aldini, RN, BSN, MSA, Project Manager Susan Burns, BA, Director of Marketing Alina Pabin-Prusak, BSW, MUP, Long-Term Care Outreach Manager

2. Define Collaboration To work together, in a joint intellectual effort ♣ “Power in organizations is the capacity generated by relationships.” - Margaret Wheatly

3. Why Bother? • Collaboration “Knows no Bounds” • It can cross the entire healthcare continuum • Partners have different needs that can be met by others • The benefits are bigger than the effort • If you have a vision and a willingness, the dream can become a reality

4. Benefits of Successful Collaboration • Shared workload • Reduces the burden on resources (financial, staff) • Opportunity for building new relationships • Increases visibility of all organizations • Maximizes talent • Improves outcomes • Shared ownership • True community involvement

5. Where do We Start? • Establish a vision • Identify something that needs improvement in your community • Assess what is currently happening around the issue • Identify your potential partners • Who can help your vision become reality? • Who can benefit from this as well? • Start communicating your vision to them • How will you reach them? • Get them all in the same sandbox

6. Getting Everyone in the Sandbox • Gain commitment • Identify shared goals • Remind each other of them • Establish communications strategy • Use it wisely

7. Playing in the Sandbox • Create ground rules and enforce them • Play nice! • Handle conflicts in a constructive way • Disagree and still work together • Define roles in advance • Insist on the support of leadership • Practice joint decision-making

8. Building a Sandcastle • Together • Brainstorm activities and strategies • Creative ideas • Develop an action plan • Who, when, where, how • Develop an evaluation strategy • We’ve succeeded when… • What do I want to know? • What do I want others to know? • Go out and build the castle

9. Keep the Sand and the Builders • Maintain flexibility • Different styles and different ways to meet goals • Allow change • Leaders and feedback • Check progress • Reinforce your shared vision and common goals • Celebrate success • Use humor

10. Admire Your Castle

11. Concrete Examples • Flu Immunization Awareness Campaign • “Strike Out the Flu” • Michigan Heart Failure Discharge Documentation Collaborative

12. Strike Out the Flu • Public Awareness Campaign • Vision: If You Build It …They Will Come • MPRO and Visiting Nurse Association of Southeast Michigan • Summer 2004 • Raise community awareness on need for flu immunizations • Comerica Park (home of the Detroit Tigers) is the “perfect venue” • This has never been done in Detroit

13. Play Ball! • September 30, 2004 - Tigers lose 4 to 6 in the second game of a double header to the Tampa Bay Devil Rays. MPRO alerted by Tigers that we can have the ball park the following Friday for our requested press event – plenty of time…or so we thought • Event Day is set for October 8, 2005…but wait…the unthinkable happens

14. Even the Best Laid Plans Can Go Awry, and They Did! “Flu shot shortage looms Chiron, vaccine maker that was to provide half of U.S. supply, forced to shut down British plant.” - October 6, 2004: 6:41 p.m. EDT • Days before the “big-event” national flu vaccine shortage announced • MPRO re-crafts message and gets the commitment of partners to participate in revamped press conference • 48 hours to put it all together

15. Meet the “Dream Team”

16. The “Strike Out the Flu” Team • American Cancer Society • American Diabetes Association • American Heart Association • American Lung Association • Cystic Fibrosis Foundation • City of Detroit Health Department and Senior Citizens Department • MPRO • National Kidney Foundation • Visiting Nurse Association of Southeast Michigan

17. Common Goals • Unified awareness campaign created to inform the public on how to protect themselves from the flu • Focus experts on giving simple prevention tips, i.e. hand washing, anti-viral medications, and plenty of rest • Experts are gathered to provide reassurance and advice to their constituencies

18. Visuals are in Place • Slogan is picked • Message is targeted • Uniforms picked out • Scoreboard is lit • Team baseball hats created

19. Game Day Arrives and it’s a Home Run!

20. Michigan Heart Failure Discharge Documentation Collaborative • Collaborative for clinical improvement • 39 Michigan hospitals • Partners • Blue Cross Blue Shield of Michigan • American College of Cardiology – MI Chapter • Hospitals • MPRO

21. Why Did we Come Together? • Heart failure was top diagnosis • Opportunity for improvement • Quality of Care Measure tracked by Medicare and the Joint Commission (JCAHO)

22. Goals • To improve adherence to evidence-based heart failure care standards, improve patient outcomes, and decrease readmission rates • Assure that a fully executed discharge document that includes all six Medicare/JCAHO elements is embedded into the care of the heart failure patient

23. Roles in the Partnership Hospitals • Physician Champions • Project Leaders • Multidisciplinary teams GFHC • Funding MPRO MI-ACC BCBSM • Opinion leaders • Data • QI Expertise • Measurement • Physician leadership • Physician Network • QI Expertise

24. What are the Elements? • Heart Failure-1 Discharge Instructions • Activity level • Diet • Discharge medications • Follow-up appointment • Weight monitoring • What to do if symptoms worsen

25. Our Model for Improvement • Institute for Healthcare Improvement (IHI)Collaborative Model • Designed to help close the gap by creating a structure in which organizations can easily learn from each other and recognized experts • Short-term (6-15 months) • Seek improvement in a focused topic area

26. Our Model for Improvement (cont.) • Organizational commitment • Learning sessions • Organizations come together to learn about the chosen topic • Barriers and strategies • Storyboarding as a technique • Plan changes • Action periods • Team test changes in the clinical setting

27. Outcomes

28. Outcomes (cont.)

29. Comparison Between Participating and Non-participating Hospitals

30. Did the Collaborative Work? • The data has spoken! • National recognition • National American College of Cardiology presentation • American Heart Association abstracts • Partnership and collaboration continues • 38 more hospitals • Cardiovascular focus

31. Project Motto Go over, go under, go around, or go through, but never give up!

32. Lessons We’ve Learned • Partnering works! • Organizations may not always know the specifics, but patience and perseverance will reap rewards • Events open the door for further collaborations • Be adaptable and prepare for the unexpected

33. Now You Try It

34. Contact Information: Teri Aldini, RN, MSA, Project Manager, (248) 465-7340, or taldini@mpro.org Susan Burns, BA, Marking and Public Relations Director, (248) 465-7375, or sburns@mpro.org Alina Pabin-Prusak, BSW, MUP, Manager, Long-Term Care Outreach, (248) 465-7371, or apabin@mpro.org This material was prepared by MPRO, the Medicare Quality Improvement Organization for Michigan, under contract with the Centers for Medicare & Medicaid Services, an agency of the U.S. Department of Health and Human Services.