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Kentucky AHA/HRET Hospital Engagement Network. Charisse Coulombe, MS, MBA, CPHQ; Senior Director, HEN Hospital Engagement Network Health Research & Educational Trust American Hospital Association. Hospital Engagement Network. ACA considerable focus on quality
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Kentucky AHA/HRET Hospital Engagement Network Charisse Coulombe, MS, MBA, CPHQ; Senior Director, HEN Hospital Engagement Network Health Research & Educational Trust American Hospital Association
Hospital Engagement Network • ACA considerable focus on quality • Created the CMS Innovation Center • Public-private partnership • Set 40/20 goal • Tool: Hospital Engagement Networks • 26 contracts awarded • Contracted with 31 state and regional hospital associations • 1,600 + hospitals Hospital Leadership Clinicians & Front Line Staff (Teams) THE PATIENT
Partnership for Patients The 40/20 Goal • Keep patients from getting injured or sicker Reduce preventable hospital-acquired conditions by 40 percent 1.8 million fewer injuries to patients, with more than 60,000 lives saved over the next three years • Help patients heal without complication Reduce all hospital readmissions by 20 percent 1.6 million patients will recover from illness without suffering a preventable complication requiring re-hospitalization within 30 days of discharge
HEN Progress to Date EEDs/OB ADVERSE EVENTS • 449- Number of hospitals with hard stop policies • 42%- Average percent reduction (from baseline to months 9 through 12) in elective births < 39 weeks admitted to NICU for 286 hospitals • 38% - Average percent reduction (from baseline through month 12) in EED > =37 weeks and <39 weeks for 271 hospitals • $40.8 m - Estimated projected cost savings for avoided NICU admissions for 2012 CAUTIs • 15 percent reduction in CAUTIs since 2011 for 290 hospitals • 27 CAUTIs prevented each month • $325,000 estimated projected costs avoided by end of 2012 CLABSIs • 28% percent reduction of CLABSIs for 302 hospitals • 5 CLABSIs prevented each month • $4 m estimated projected costs for avoided CLABSIs by end of 2012
HEN Progress to Date ADEs • 32% - Average percent reduction (from baseline through month 12) in excessive anticoagulation in inpatients with warfarin treatment for 80 hospitals • $1.32 m Estimated projected cost savings for avoided ADEs in 2012 FALLS WITH OR WITHOUT INJURY • 4% - Average percent reduction (from baseline through month 12) in falls with or without injury for 550 hospitals • $19.0 mEstimated projected cost savings for avoided falls in 2012 PRESSURE ULCERS • 2% - Percent reduction (from baseline through month 12) inpercent of patients with at least one Stage II or greater pressure ulcer for 152 hospitals • $1.7 m Estimated cost savings for avoided pressure ulcers in 2012 (annualized) SSIs • <1.2% Average surgical site infection rate (within 30 days following procedure) for over 500 hospitals in months 1 through 12
HEN Progress to Date VTEs • 11% Average percent reduction (from month 1 to month 12) in potentially preventable VTE rate for 88 hospitals • $11.7 m - Estimated projected cost savings for avoided VTEs in 2012 (annualized) VAPs • <1.23 Averageventilator-associated pneumonia rate in the ICU (per 1,000 device days) for 390 hospitals in months 1 through 12 READMISSIONS • 16% Average percent reduction (from baseline to month 12) in 30 Day All- Cause Readmission rate for 420 hospitals • 24 - Average number of fewer readmissions per month, per hospital for 351 hospitals (from baseline to November 2012) • $80.9 m Estimated projected cost savings for avoided readmissions in November 2012
CMS Goals • 40% reduction in all harm topics • 20% reduction in readmission • Have 60% or more hospitals (in HEN/state) submitting data in all applicable topics and attaining reduction goals for potential renewal in 2014
CMS Commitments • At least 70 percent of AHA HEN birthing hospitals will implement hard-stop policies or have an EED rate less than 3 percent by April 1st of 2013; 80% as of 5/31/13: AHA/HRET HEN currently at 63% as of 2/18/13; KY currently at 47% as of 2/18/13 • 100 percent of AHA HEN hospitals will be submitting data on at least six HACs by January 31st of 2013: AHA/HRET HEN currently at 71% as of 2/25/13; KY currently at 88% as of 2/25/13 (68/77) • Make transparent the hospitals part of the HRET HEN on the HRET website: AHA/HRET HEN has posted the names of all of the HEN hospitals by state. • Make transparent all hospitals working on 10 HACs on the HRET HEN website: AHA/HRET HEN has posted the names of all of the CMS HEN hospitals by HEN that are working on the 10 HACs (or all that are applicable). There are currently 292 hospitals that fit this criterion. Kentucky has 1 hospital: Fleming County Hospital • Doubling the number of hospitals showing a 20 percent improvement in readmission; AHA/HRET currently at 124 hospitals as of 2/8/13;
Kentucky Summary Table * KY hospitals submitting 13 different OB measures
Results to Date • CMS understands that all of the hospitals are making rapid improvement in multiple areas • The results at both the HEN and Kentucky levels are showing improvement and areas that need focus • For areas of focus - Talk to your teams, see what other improvements can be tested and what will work for your hospital/culture to improve patient safety and quality of care • Participate on webinars, LISTSERVs, networking events • For areas showing improvement – ensure that your processes are hard wired and the culture has shifted to allow for this improvement to be sustained long after the HEN project is completed
Next Milestones for the HEN Project • Continue to focus on improvement strategies to help hospitals reduce harm and prevent readmissions • Work with hospitals to expand their improvement work across all (applicable) topics (2->5->All) • Work with hospitals to continue to input data into the CDS and evaluate improvement to date • Confer rights via CDC NHSN
Thank You! • AHA/HRET HEN is proud of the accomplishments that have occurred to date and continue to look forward to accelerating the improvement across all topics! • We are here to support KHA and you in any way possible • General Email: hen@aha.org • Data Specific Questions: hendatasupport@aha.org
