HQID got Cleveland Regional doctors engaged to improve patient care

Situation:

Are economic incentives to hospitals – also known as pay-for-performance or value-based purchasing – an effective way to improve the quality of inpatient care?

Solution:

In 2003, The Centers for Medicare & Medicaid Services (CMS) and the Premier healthcare alliance teamed up to launch the Hospital Quality Incentive Demonstration™ (HQID) – the first national project of its kind designed to answer that question. More than 250 hospitals from across the nation joined the project initially. A long-time Premier Healthcare Informatics products user, Aurora Health Care chose to participate in HQID.

Results1

As politicians and policymakers search for models of healthcare payment and reform, fourth-year results reveal the HQID project is helping patients live longer and receive recommended treatments more frequently.

1From an article by Susan D. DeVore, President and CEO, Premier healthcare alliance, “Results from the First 4 Years of Pay for Performance” in the January 2010 edition of HFM Magazine.

“From the beginning of the HQID project, our physicians were engaged and concerned about improving care for our patients. Hospital case managers conducted reviews of patient charts and would ask physicians about care measures that mirrored the national benchmarks. It did not take long for improvements to take hold, creating improved outcomes for our patients and a culture of quality.

“Unfortunately, the county that we serve has some of the highest levels of heart disease in North Carolina. So during our first year of participation in the HQID project, Cleveland Regional Medical Center (CRMC) focused on the process measures in the clinical area of congestive heart failure (CHF). Our goal was to uncover the reasons why patients with CHF were readmitted to the hospital so frequently, and then create processes to ensure that would not continue.

“What we found was that many patients had difficulty understanding care instructions, they lacked an adequate support system at home, or their financial situation prevented them from taking proper care of themselves. As a result, they were frequently readmitted, and some were labeled as ‘non-compliant’ as it appeared they were not attempting to manage their condition.

“Our staff reached outside the box of traditional healthcare, working to develop consistent education with home healthcare companies and nursing homes. In addition, community care managers assisted CHF patients with self management skills and identified needed resources for those patients who had previously been termed ‘non-compliant.’ Often, it was as simple as helping them understand our healthcare language – for example, alerting them to how much salt was in the soup they were eating daily. We learned that the words we choose, salt over sodium, helped patients better understand their dietary needs and how to keep themselves healthy.

“As a result, our adherence to the quality measures across all the clinical areas improved, many significantly – in particular, targeted discharge instructions for CHF patients improving almost 60 percent.1”

Elizabeth Popwell
FACHE Chief Ancillary Executive and Safety Officer Cleveland Regional Medical Center, Shelby, NC

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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