Building Synergy Among National Health System Initiatives and a Regional Health Improvement Collaborative: A Case Study of the Cleveland Veterans Affairs Medical Center Brook Watts, MD, MS Chief Quality Officer Louis Stokes Cleveland VA Medical Center and Associate Professor Case Western Reserve School of Medicine 12/13/2016 Louis Stokes Cleveland VA Medical Center
Area of Service A Cleveland VA Medical Center or Outpatient Clinic is located within 30 minutes or 30 miles of every Veteran in Northeast Ohio. Louis Stokes Cleveland VA Medical Center
Facility Statistics FY14 FY15 Number of Unique 110,134 112,000 Veterans Served Number of Unique Women 5,772 5,857 Veterans Served Number of Appointments 1,898,942 1,965,061 Number of Employees 4,666 4,766 12/13/2016 Louis Stokes Cleveland VA Medical Center
The Cleveland Story • VA clinical outcomes are generally benchmarked extensively – but internally. Long term VA priority. • Why eye exams for diabetic patients? – Number one cause of preventable blindness in Americans – 25% of Veterans receiving VA care have diabetes (compared to 8% of the general US population) • Age of population • 70% of Veterans receiving VA care are overweight/obese 12/13/2016 Louis Stokes Cleveland VA Medical Center
The Cleveland Story 12/13/2016 Louis Stokes Cleveland VA Medical Center
The Cleveland Story • Louis Stokes Cleveland VA Medical Center is the first to be included in a Regional Heath Collaborative • Initially just the main campus primary care clinic, receiving Gold Stars each year This year all community outpatient clinic outcomes for inclusion in • reporting • All 14 Northeast Ohio VA Healthcare System primary care clinics received a Gold Star 12/13/2016 Louis Stokes Cleveland VA Medical Center
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How? • “We’ve been working on this for years.” • Automatic electronic reminders in the health record – Reinforced with patients by staff at check-in • Use of teleretinal imagers – 30% (8,022) patients screened in this way • Co-location of optometry staff 12/13/2016 Louis Stokes Cleveland VA Medical Center
Approach to Care • Emphasis on health promotion and disease prevention – “closed healthcare system” • Key Focus areas for primary care: • High blood pressure, tobacco and alcohol use, diet and nutrition, fitness and physical activity • Mental Health Louis Stokes Cleveland VA Medical Center
Approach to Care • VA’s electronic health record - oldie but goodie • Benchmarking techniques, e.g. the “Primary Care Olympics”, encourage transparency • Full implementation of the Patient-centered Medical Home Model, with support from pharmacy and social work • Telehealth 12/13/2016 Louis Stokes Cleveland VA Medical Center
Approach to Care • Connected Health - Clinical Video Telehealth - Home Telehealth - Tele-mental Health - Mobile Health - My Health e Vet - Secure Messaging - SCAN-ECHO - Mobile Apps - VA Point of Service Kiosks Louis Stokes Cleveland VA Medical Center
Approach to Care • Leadership • Consistent facility and clinical leadership • Culture • Commitment to transparency • Commitment to innovation • Commitment to steal (and share) new ideas shamelessly • Benefits of external benchmarking to clinical staff Louis Stokes Cleveland VA Medical Center
Gold Star Staff 12/13/2016 Louis Stokes Cleveland VA Medical Center
Thank You to our COMMUNITY! Louis Stokes Cleveland VA Medical Center
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