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The VIP Network

The VIP Network. In 2008, the Value in Inpatient Pediatrics (VIP) Network emerged with the vision to build an inclusive pediatric inpatient collaboration for clinicians in order to provide hospitalized children the most efficient, safe, and evidence based healthcare.

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The VIP Network

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  1. The VIP Network In 2008, the Value in Inpatient Pediatrics (VIP) Network emerged with the vision to build an inclusive pediatric inpatient collaboration for clinicians in order to provide hospitalized children the most efficient, safe, and evidence based healthcare. A guiding principle of the network is that the 70% of children hospitalized at non-children’s hospitals deserve the same access to  

  2. In 2011, leadership at the American Academy of Pediatrics (AAP) and the Quality Improvement Innovation Networks (QuIIN) approved the integration of the VIP Network into the QuIIN Program. This will the VIP network access to critical resources needed for long term success and allow hospitalist to collaborate in QI activities with primary care physicians, who are members of the Practice Improvement Network (PIN) under the QuIIN umbrella.

  3. The Five Domains of Value: • Access • Technical Quality • Functional Status • Service Satisfaction • Cost/price • Value (V) == A + TQ +FS + SS • C

  4. Quality Improvement Before After better worse Quality better Quality worse

  5. Clinical Conditions Patient Safety Health Care Systems

  6. Clinical ConditionsVIP Collaborative #1 Benchmarking Bronchiolitis • This VIP QI Collaborative led by Drs. Ralston, Garber, Shen and Narang allowed 17 hospitals to share secrets over 4 years to improve the management of Bronchiolitis • The National Institutes of Health (NIH) invests over $31.2 billion annually in medical research (NIH, 2011) much of it devoted to treatment studies which are vitally important. • Unfortunately, the Institute of Medicine (IOM, 2001) reports it takes an average of 17 years for clinical research findings to be used regularly in clinical practice

  7. Benchmarking Bronchiolitis

  8. Patient SafetyVIP Collaborative #2 : Improving Patient Identification • This VIP QI collaborative led by Drs. Phillips, Muething and Hain allowed 6 hospitals to share secrets to reduce pediatric patient ID band error rates. • Alarmingly, it is estimated that up to 98,0001 people die in hospitals each year from preventable medical errors, making this the eighth leading cause of death in the US, ahead of motor vehicle accidents, breast cancer and AIDS. • Safe patient care begins with ensuring a healthcare provider is delivering care to the right person.

  9. Improving Patient Identification • The collaborative audited 11,377 patients from 6 Hospitals for ID band errors between September 2009 and September 2010. • The ID band failure rate decreased from 17% to 4.1% (77% relative reduction).

  10. Health Care SystemsCollaborative #3: Improving Hospitalist- PCP Discharge Communication • This VIP Collaborative has 2 phases led by Drs. Shen, Shelbourne, Coughlin and Cooperberg and has alllowed 10 hospitals to share secrets to improve hospitalist-PCP discharge communication • With the advent of health care reform and the gradual implementation of Pediatric ACO's and bundled payments in our health care marketplace,  the VIP Network is committed to supporting QI collaboratives focused on empowering hospitalists to connect the silos of our fragmented system and align ourselves with our consumers: (1) Hospitals; (2) 3rd Party Payers ; (3) PCP;s  and (4) Patients.

  11. Improving Hospitalist-PCP Discharge Communication • Phase 1: • This QI collaborative engaged 10 hospitals From September, 2010 to April 2010, and improved the Percent of discharges with documented communication with PCP within 2 calendar days of discharge increased from an average of 68% to 95%. • Phase 2: • This QI Collaborative created an “Essential D/C Content Bundle” based on a PCP Survey • By September, 2012, this QI Collaborative’s AIM is that 90% of charts will have documentation of communication of “essential D/C content bundle “with PCP within 2 days

  12. Benchmarking Bronchiolitis

  13. Improving Patient IdentificationApproved for MOC IV Credit

  14. Improving PCP- Hospitalist CommunicationApproved for MOC IV Credit

  15. Next Steps • Transition to new VIP Website (within AAP-QuIIN) • Formal Membership Application • Integration into QuIINListserve • Use new AAP Quality Improvement Data Aggregatory (QIDA)

  16. Next Steps • Bronchiolitis • Benchmarking Bronchiolitis • Complete MOC application; publish results • continue for original members to submit data and use database (eventually using QIDA) • Phase 2: • Use standard QI methodology to test impact of “bronchiolitis protocol” to decrease misuse and overuse of bronchodilator • Expert Panel to convene as 1st step for Phase 2

  17. Next Steps • Discharge Communication • Complete MOC application; submit for publication • Complete Phase 2 and will pilot QIDA • Understanding how to Improve Pediatric Readmissions is a natural outcome measure for this group and connects PIN and VIP members.. • Next Step is charter an Expert Panel to discuss devising a “decreasing readmission bundle” to set foundation for a QI Collaborative

  18. Next Steps • New Projects • Capacity is 2 ACTIVE “new active projects” at a time • Use “New Project Application” template to submit to VIP Steering Committee • Goal is follow AAP IRB guidelines and MOC requirements • Encourage “pilot” projects led by individual motivated leaders that may transition into fully supported into VIP active projects that needs more support (IRB, MOC Credit) • QI Education • Develop education tools for use of all VIP members

  19. VIP Members by State132 members in 35 states MA-5 NH-2 3 2 2 1 2 8 4 8 1 5 7 5 5 1 2 10 RI-2 1 6 NJ-5 7 1 1 5 1 4 1 MD-3 1 13 2 3 HI-2 June 2012

  20. the subtleties of medical decision-making can be identified and learned. The lessons are hidden. But if we open the book on physicians’ results, the lessons will be exposed. And if we are genuinely curious about how the best achieve their results, he believes they will spread” AtulGawande, MD

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