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Move to Improve Program Process and Results

Gina Mazza RN, BSN Partner, Fazzi Associates Jim Culhane . MSW, MBA Director of Homecare and Personal Services VNA of Manchester and S NH. Move to Improve Program Process and Results. February 2013. Objective.

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Move to Improve Program Process and Results

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  1. Gina Mazza RN, BSN Partner, Fazzi Associates Jim Culhane. MSW, MBA Director of Homecare and Personal Services VNA of Manchester and S NH Move to Improve Program Process and Results February 2013

  2. Objective • To identify best practice strategies for reducing avoidable hospitalizations of the home care patient. 2

  3. Move To Improve Project Statistics • 76 Agencies • Size of agencies by Average Daily Census: • Mean: 230 • Median: 157 • # agencies less than 100: 19 • # between 100 and 300: 39 • # agencies greater that 300: 20 3

  4. Move To Improve Project Statistics • For comparative analysis, agencies were divided into three categories: 4

  5. The Program… • Initiated collection of baseline OASIS data • Agency practice survey • Focus Group • Developed Tracker and Hospitalization Management Dashboard • Training 5

  6. Revised Structure • Audit tool revised • Dashboard revised • Monthly Accountability/Planning Meeting

  7. SafeSide™ Structure

  8. Fazzi’s SafeSide Outcomes Model The Outcome Oriented Change Model Process Improvements Data Monitoring and Tracking Project Leader Planning and Improvement Meeting Practice Refinements Real-Time Audits Education and Competency New Strategies

  9. Leadership of Program 9

  10. Frequency of Monitoring Hospitalization Rates 10

  11. Results of Agencies Performing Audits 11

  12. Overall Results 12

  13. Recommendations • Audit charts of hospitalized patients • Critical to identifying core issues related to hospitalization • Create teachable moments • Set clear and measureable goals and share with team • Set stretch goals and publicize and celebrate wins 13

  14. Recommendations 3. Accountability • Have a leader that has authority, accountability and respect of clinicians. 4. Develop a plan for change and operationalize • Plan, Do, Check, Act • Don’t let daily fires distract from the focus. 14

  15. SafeSide Hospitalization Study 2012: Key Findings 1. This patient was identified as high risk for ACH. 2. Interventions were implemented for the ACH risks identified. 15

  16. Final Thoughts • Act with purpose • Make decisions based on data • Set clear goals • Have clear outcomes 16

  17. Gina L. Mazza RN, BSN413- 584-5300 17

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