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Partnership for Patients Safety I s Personal: Partnering with Patients and Families A Dialogue with Leaders from the NPSF Lucian Leape Institute, the Institute of Medicine and the Patient Centered Outcomes Research Institute. Tuesday, May 27, 2014 3:00-4:15 pm (ET). Martin Hatlie NCD.
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Partnership for PatientsSafety Is Personal: Partnering with Patients and FamiliesA Dialogue with Leaders from the NPSF Lucian Leape Institute, the Institute of Medicine and the Patient Centered Outcomes Research Institute Tuesday, May 27, 2014 3:00-4:15 pm (ET)
Martin Hatlie NCD Welcome
Partnership for Patients Campaign 196 Days and Counting! Our Patients are Counting on You!
Objectives • To learn about the recommendations of the NPSF Lucian Leape Institute for hospital leaders, clinicians and staff, consumers and policy makers in advancing PFE. • To understand what PCORI and IOM are doing to support research, disseminate evidence and engage PFACs • To spur action on emerging opportunities for patient advocates, hospitals and HENs to operationalize PFE as an SAB strategy
Questions to Run on • What more can HENs, hospitals and patient advocates do to achieve the recommendations of the NPSF Lucian Leape Institute’s Safety Is Personal report? • How can PFACs use the resources & opportunities created by IOM, PCORI and others to best use the forward energy of patient advocates to improve outcomes? • Safety IS personal, so what more can I do to engage patient advocates in improving Safety Across the Board as quickly as possible?
Partnership for Patients2 Bold Aims: 40/20 by 12/31/14 http://partnershipforpatients.cms.gov
Who is on the call today? • Hospital administrator • Hospital staff • HEN (Director or Staff) • QIO • Federal Agency Partner • Patient / Patient Advocate • Other
Maximizing PFE to Improve Outcomes Dennis Wagner and Paul McGann, MDCMSPfP Co-Directors
Partnership for Patients Signature Attributes of the Campaign Goal line in Sight 196 days Harvesting results so far Relentless focus on more results LEAPT Partnering to sustain action Reducing cycle time Expediting use of PFE structures to achieve SAB and reduce disparity • Thrilling goals • Urgency • Relentless focus on results • Inclusion & health equity • Safety Across the Board (SAB) • PFE • Important in itself • Embedded in the Campaign • An SAB strategy
Fall Prevention Center Mission • Alameda Health System has a Fall Prevention Center (FPC) whose mission is to identify older adults who are at risk for falls • Alameda provides screenings, medication reviews, fall prevention education, Geriatrician consults and interventions as needed that help decrease their fall risk and therefore reduce the number of preventable falls • Since its inception (Sept. 2011) the FPC has been successful in keeping 93% of its patients out of the Emergency Department due to an additional fall
RARE: Reducing Avoidable Readmissions Effectively in Minnesota • Goal: Engage hospitals and care providers in Minnesota across the continuum of care to prevent 6,000 avoidable hospital readmissions within 30 days of hospital discharge • Dates: 7/1/2011 - 12/31/2013 • Participants: 82 hospitals, 100 community partners • Triple Aim: • 6,000 avoidable hospital readmissions • 24,000 nights sleep in patients’ own beds • Tens of millions of dollars saved
RARE (continued) Areas of Focus: Results 7,030 readmissions avoided (as of Q3 2013) Exceeded original goal of 6,000 readmissions Helped patients spend 24,844 more nights sleeping comfortably in their own beds Reduced inpatient costs by an estimated $55 million 2013 winner of the John M. Eisenberg Patient Safety and Quality Award for Innovation in Patient Safety and Quality • Patient and family engagement: Ensuring processes are in place to: • Engage patients/family • Elevate the status of family caregivers as essential members of the team • Prepare the patient and family to manage care at home. • Interventions may include: • Teach back • Collaborative conversations and communication • Simulations with the patient and family member • Comprehensive discharge planning • Medication management • Transition care support • Transition communications
MHA’s “RARE” Campaign Reducing Avoidable Readmissions Effectively • Minnesota hospitals have collectively prevented 7,975 Readmissions and helped patients spend 31,900 nights at home instead of in the hospital • In the last quarter of 2013, Minnesota hospitals reached a collective reduction in Readmissions of 19 percent Source: Data from RARE website http://www.rarereadmissions.org/
Patient and Family Advisory CouncilA hospital-wide champion for Safety Across the Board
Does your hospital have a Patient and Family Advisory Council?41% of 1,438 responding hospitals have a PFAC; 28% are hospital-wide. (AHA/HRET 2013 survey of all hospitals)
HENs Report As of May, 2014 there are 1,483 hospitals with PFACs or Patients on Safety Committee
Time for a Boost: HENs report formation of PFAC or Patient on Safety Committee has leveled out.
How are the HENs doing in spreading PFACs among member hospitals?
Percent of HEN Network Hospitals with PFACsor Patients on Safety Committees, as of May 2014
Percent of AHA/HRET Network Hospitals with PFACs/Pt on Pt Safety Committee in Place – May 2014
Shout out!HENs and HRET/SHAs who have over 75% of their hospitals with PFACs/Pts on Patient Safety Committees in place.
Linda K. Kenney, President and FounderMITSS - Medically Induced Trauma Support Services Roundtable Participant NPSF Lucian Leape Institute, Safety is Personal Patient Perspective
NPSF Lucian Leape Institute Faculty Lucian L. Leape, MD Chair, NPSF Lucian Leape Institute Adjunct Professor of Health Policy Harvard School of Public Health Susan Edgman-Levitan, PA Member, NPSF Lucian Leape Institute Executive Director, John D. Stoeckle Center for Primary Care Innovation, Massachusetts General Hospital Tejal K. Gandhi, MD, MPH, CPPS President, National Patient Safety Foundation and NPSF Lucian LeapeInstitute 26
The National Patient Safety Foundation’s Lucian Leape Institute • Mission • Strategic Focus • Transforming Concepts 27
Members of the NPSF Lucian Leape Institute Lucian L. Leape, MD, Chair Adjunct Professor of Health Policy Harvard School of Public Health Tejal K. Gandhi, MD, MPH, CPPS President, NPSF Lucian Leape Institute President, NPSF Carolyn M. Clancy, MD Assistant Deputy Undersecretary for Health, Quality, Safety and ValueVeterans Health Administration Janet M. Corrigan, PhD, MBA Distinguished Fellow The Dartmouth Institute for Health Policy and Clinical Practice Susan Edgman-Levitan, PA Executive Director John D. Stoeckle Center for Primary Care Innovation Massachusetts General Hospital Gary S. Kaplan, MD, FACMPE Chairman and CEO Virginia Mason Medical Center Julianne M. Morath, RN, MS President & CEO Hospital Quality Institute of California Dennis S. O’Leary, MD President Emeritus The Joint Commission Paul O'Neill Former Chairman and CEO, Alcoa 72nd Secretary of the U.S. Treasury Robert M. Wachter, MD Associate Chair Department of Medicine University of California San Francisco 28
NPSF LLI Transforming Concepts • Medical education reform • Integration of care within and across delivery systems • Restoration of joy and meaning in work and ensuring the safety of the health care workforce • Active consumer engagement in health care • Transparency as a practiced value in everything we do in health care Leape L, Berwick D, Clancy C, et al., for the Lucian Leape Institute at the National Patient Safety Foundation. 2009. Transforming healthcare: a safety imperative. Qual Saf Health Care 18(6):424-428. doi:10.1136/qshc.2009.036954. 29
Safety Is Personal: Partnering with Patients and Families for the Safest Care From the NPSF Lucian Leape Institute Roundtable on Consumer Engagement Download at http://www.npsf.org/lli/safety-is-personal 30
NPSF LLI Patient Engagement Recommendations • Leaders of health care systems: • Establish patient and family engagement as a core value for the organization • Involve patients and families as equal partners in the design and improvement of care across the organization and or practice. Educate and train all clinicians and staff to be effective partners with patients and families • Partner with patient advocacy groups and other community resources to increase public awareness and engagement 32
NPSF LLI Patient Engagement Recommendations • Health care clinicians and staff: • Provide information and tools to support patients and families to engage effectively in their own care • Engage patients as equal partners in safety improvement and care design activities • Provide clear information, apologies and support to patients and families when things go wrong 33
NPSF LLI Patient Engagement Recommendations • Health care policy makers: • Involve patients in all policy-making committees and programs • Develop, implement and report safety measures that foster transparency, accountability, and improvement • Require that patients be involved in setting and implementing the research agenda 34
NPSF LLI Patient Engagement Recommendations • Patients, families and the public: • Ask questions about the risks and benefits of recommendations until you understand the answers • Don’t go alone to the hospital or doctor visits • Always know why and how you take your medications, and their names • Be really clear about the plan of action • Say back in your own words what you think you hear from clinicians 35
NPSF LLI Patient Engagement Recommendations • Patients, families and the public (cont’d): • Arrange to get any recommended lab tests done before a visit • Determine who is in charge of your care 36
Characteristics of Excellent Patient/Family Partners • The ability to share personal experiences in ways that others will listen and learn from them. • The ability to see the “big” picture. • Interested in more than one issue. • Interested in improving health care or research. • The ability to ask tough questions constructively. • The ability to connect with people. • A sense of humor. • Representative of the relevant patients/families/conditions. 37
Chinese Proverb Those who say it cannot be done should not interrupt the person doing it. - Chinese proverb 38
Organizations in Action Susan E. Sheridan, MBA MIM, Director of Patient Engagement, Patient Centered Outcomes Research Institute J. Michael McGinnis, MD MA, MPPSenior Scholar and Executive Director,Roundtable on Value & Science-Driven Health Care Institute of Medicine
Networking, Learning and Evidence: Strengthening the Foundation for Progress Institute of Medicine of the National Academy of Science http://www.iom.edu/
From Partnership in Care to Partnership in Research Sue SheridanPatient Engagement
Mission PCORI helps people make informed health care decisions, and improves health care delivery and outcomes, by producing and promoting high integrity, evidence-based information that comes from researchguided by patients, caregivers and the broader health care community.
PCORI Emphasizes Engagementfor Getting to Practical, Useful Research
Funded Projects to Date Total number of research projects awarded: 279 Total funds awarded: $464.2 million Number of states where we are funding research: 38 states (plus the District of Columbia and Quebec, Canada) 15
Improving Healthcare Systems Projects that address critical decisions that face healthcare systems, the patients and caregivers who rely on them, and the clinicians who work within them. 41 Awards $76.5 Million 19
Insights and Responses Bernard Roberson Administrative Director of Patient Family Centered Care, Georgia Regents Medical Center Lisa Morrise, MA Consumer Co-Chair, Patient and Family Affinity Group Knitasha Washington, DHA, FACHE NCD