Hospital attributes $2.8M savings to QualityAdvisor™ practitioner profile

Challenge:

Since The Joint Commission realigned its focus on professional practice evaluation in 2007, the pressure has been on hospitals to develop fair and effective ways to evaluate physician performance. At the same time, hospitals have been under increasing pressure to ensure that they are providing clinically appropriate care at the lowest possible cost – a situation that has become even more crucial as the result of healthcare reform legislation. Hospitals don’t yet know the specifics of what reform will require, but they do know one thing: reimbursements will not increase.

Solution:

Knapp Medical Center began using QualityAdvisor™ in June 2008 to improve the hospital’s clinical performance and to support its professional practice evaluation efforts. When Premier’s QualityAdvisor product was launched, Knapp made presentations to physicians to explain its database of more than 600 facilities, the ability to benchmark against other “like” hospitals, risk adjustment for clinical and financial measures, and physician measures to be collected.

Knapp prefers Premier’s comprehensive practitioner profile, especially with its integration of core measures, and uses the profiles for both focused and ongoing professional practice evaluation required by The Joint Commission. “We use the reports for quality reviews for OPPE and FPPE. If we were to have a physician go on 100 percent review, we could easily pull a report from QualityAdvisor,” said Ginger Robles, RN, director of Quality Management.

“We recently had a situation where a specific physician’s outcomes were questioned,” she noted. “We pulled a report from QualityAdvisor which showed that was definitely not the case. QualityAdvisor verifies outcomes and provides reports quickly and reliably. If we didn’t have it, we could use our electronic medical record to identify cases, but then we’d have to do a manual audit which would take valuable time and resources. QualityAdvisor is just so much easier. Instead of hours and days, we had the answer in minutes.”

Practitioner profiles are reviewed regularly by department chiefs and presented to physicians at quarterly department meetings. Robles and her team are available to answer physician questions. These reports also go in the credentialing files and to the chief of service who deals with members of the department if there is a problem.

Contracted hospitalists, who admit 60 percent of adults, get monthly profiles. Executive leadership team members meet with the hospitalists and their director to review financials and physician profiles from QualityAdvisor. They “are very, very proactive in wanting to comply with core measures,” Robles said. “They really study their individual reports. We tell them when they are performing well on measures and where they are below expectations on measures.”

Result:

Knapp had a successful Joint Commission survey in February
2009. Said Robles, “It was a good survey. The surveyors liked
the reports we used from QualityAdvisor.”

• Knapp attributes some $2.8 million in savings to its OPPE
  program and using the QualityAdvisor practitioner profile.
• From calendar year 2008 to calendar year 2009, Knapp’s
  reductions in average length of stay (ALOS) resulted in
  eliminating 1,304 days of care. They also saved 98 days
  through eliminating readmissions, saved 27 lives and avoided
  complications in 28 cases.
• Core measures have improved. “One reason is the physician-
  specific information we have available through
  QualityAdvisor. The other is we’ve been out there, working
  with them, sharing information and data, educating them,
  helping them improve care. It has helped to be able to say
  about the practitioner profile: ‘This is your report.’”
• Knapp also has a strong case management program. The
  Patient Safety team encompasses accreditation, medication
  safety, review policies and weekly safety rounds. It’s a very
  active group, involving nurses and clinical managers
  throughout the hospital. All of those measures together have
  resulted in the improvements.
• Knapp uses QualityAdvisor information in other ways. It is in
  one of 14 communities around the nation that CMS has
  chosen for its Care Transitions Project, seeking to eliminate
  unnecessary hospital readmissions. The goal is to improve healthcare processes so that patients, caregivers and the entire team of providers have what they need to keep patients from returning to the hospital for ongoing care needs.
• “The physicians have been very receptive overall. We’ve had to spend some time educating them about what the charts mean and we’ve done presentations and we’ve sat down one-on-one when they have questions,” Robles said.

"I wouldn’t want to return to our old way of doing things before QualityAdvisor. Now it is more exciting because we can see core measures and outcomes by individual physician rather than just hospital-wide results. This makes a bigger impact with our physicians.”

Ginger Robles, RN
Director of Quality Management
Knapp Medical Center, Weslaco, TX

“Doctors are competitive so they don’t like their peers to do better than they do. The practitioner profiles also allow us to easily pinpoint who’s not doing well so we can work with them. Overall, there has been continuing improvement since the program began.”

Ginger Robles, RN
Director of Quality Management
Knapp Medical Center, Weslaco, TX

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Copyright 2012 Premier Inc., 13034 Ballantyne Corporate Place, Charlotte, NC 28277. 877.777.1552Terms & Conditions