HIIN Update - Michigan MICAH Quality Network meeting Andrew Syrek | - PowerPoint PPT Presentation

HIIN Update - Michigan MICAH Quality Network meeting Andrew Syrek | Senior Healthcare Data Analyst February 21, 2020

ADE-Opioids ADE ‐ Opioids 9 8 8 7 7 6 5 5 4 3 3 2 2 2 1 1 1 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Jan 2019 ‐ Dec 2019 Data as of February 6, 2020

Falls with Injury Falls 9 8 8 7 6 5 4 4 3 3 3 3 3 2 2 2 2 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Jan 2019 ‐ Dec 2019 Data as of February 6, 2020

Post-Operative Sepsis (PSI-13) Data as of September 31, 2019

Sepsis Mortality Rate Data as of September 31, 2019

CAH – PFE 5 Implementation PFE ‐ 5 Implementation Fully Implemented Not Implemented 6 1 Partially Implemented 29 Data as of February 6, 2020

GLPP HIIN Update

GLPP HIIN Improvement Data ADE ‐ Anticoagulants 15.8% ‐ 42.8% Pressure Injury: AHRQ PSI ‐ 03 15.8% ADE ‐ Hypoglycemics Sepsis and Septic Shock Mortality 8.9% 6.6% ADE – Opioids SSI – Abdominal Hysterectomy NHSN SIR 17.7% 7.7% CAUTI – NHSN SIR: ICU Excluding NICU VTE – PE or DVT Rate: AHRQ PSI ‐ 12 30.3% 4.1% CLABSI Rate – ICU and other units VAE ‐ PVAP 23.1% 11.8% C. Difficile Readmissions – Same Facility ‐ 0.6% 24.2% Falls with Injury: NQF 0202 MRSA Rate 11.5% 0.4% Data as of September 31, 2019 8

GLPP HIIN Successes The GLPP HIIN Reliability Measure quantifies all ‐ cause harm by aggregating 80 Over 80% presentations the total number of harm events across 16 different measures (listed below), 32 Quality data reporting given on GLPP divided by patient days to depict the impact of HIIN work on reducing total Fundamental across all HIIN Trainings patient harm. Advancement of 98.1% programming measures rural efforts offered 197 Hospitals retention rate & successes through HIIN Reliability Measure completed a Health of partnerships with Equity 7.00 94.8% of state based participating Organizational centers for rural 100% active network has HIIN hospitals Successfully Assessment health engagement from successfully co ‐ lead ADE 6.50 implemented all participating Affinity Group Shift Change hospitals National Launch of 46 simulations Huddles Partnerships Reliability Culture Rate Per 1000 6.00 offered across Implementation developed Guide 7 topic areas with AHRQ 51.9% of Launched seven 35.8% of 5.50 network is Playbooks on network rural proven CAHs have are CAHs CAHs have interventions driven 59.6% Transparent driven a 5.00 improvement in data dashboard 73.4% MRSA and 29.7% utilized across improvement CAHs improvement in Improvement HIIN Developed 4.50 demonstrated in CLABSI CDI 2016 ‐ 4 2017 ‐ 1 2017 ‐ 2 2017 ‐ 3 2017 ‐ 4 2018 ‐ 1 2018 ‐ 2 2018 ‐ 3 demonstrated improvement partnership in 76% of all IL 6.07 6.46 6.23 5.74 5.75 5.87 5.38 4.93 in 74% of with MN 27.8% measures 77% of Convening of MI 6.17 6.03 5.89 5.85 6.01 5.89 5.50 5.48 measures HIIN improvement System Leaders network has WI 6.01 5.31 5.12 5.49 5.44 5.51 4.70 4.75 in overall HIIN regularly for cross Year ‐ Quarter implemented Reliability Launched 2 collaborative a PFAC Measure HIIN Reliability Measure Definition: cohorts of learning Numerator: The HIIN Reliability Measure includes the following measures: ADE ‐ Excessive Alternative to Anticoagulation, ADE ‐ Hypoglycemia/Glucose Management, ADE ‐ Opioid ‐ related, CAUTI Rate – All, CDI Rate, CLABSI Rate – All, Falls with Injury, MRSA Rate, Pressure Ulcers PSI ‐ 03, Sepsis PSI ‐ 13, SSI Rate – COLO, Opioids (ALTO) SSI Rate – HYST, SSI Rate – KPRO, SSI Rate – HPRO, Total IVAC Plus, VTE PSI ‐ 12 Program Denominator: Patient Days 9

Reminder of March 9 Data deadline

BCBSM 2019-20 PG5 P4P Program

Kristy Shafer-Swadley kswadley@mha.org

Critical Access Hospital Dashboard Andrew Syrek | Senior Healthcare Data Analyst

CAH Dashboard Measures • IP Claims-based measures • Readmissions to same or any facility • Severe Sepsis/Septic Shock • CMS measures • Average time patients spent in the ED • ED volume • Left without being seen • OP Measures • OP procedure volumes (CT, MRI, X-Ray) • Colonoscopy screenings • Mammogram screenings • What else would you like to see?

MHA Keystone Center Age-Friendly Health Systems Action Community Ewa Panetta, Manager February 21, 2020

In the next 20 minutes…. Why Age ‐ Friendly Health Systems What is an Age ‐ Friendly Health System How we support health systems to become Age ‐ Friendly  MHA Keystone Center Action Community Ways to get engaged

Why Age-Friendly Health Systems?

Why Age-Friendly Health Systems? According to 2016 U.S. Census Bureau data, more than 23% of Michigan residents are now 60 or older — and life expectancy has increased by seven years since the 1960s. At the same time, roughly 80% of older adults have at least one chronic disease, and 77% have at least two . As reported by Bridge Magazine, Michigan has the highest concentration of older residents in the country . These changes in age and health, along with the challenges of social and home support dynamics for older residents, make developing age ‐ friendly care settings and processes vital for the well ‐ being of Michigan’s aging patients. Sources: US Census Bureau, Bridge Magazine, The Detroit News

Why Age-Friendly Health Systems? The Issues and Gaps (1) Older adults: • Routinely receive unwanted care and treatment • Routinely do not receive necessary and evidenced care • Are needlessly harmed by inappropriate medications • Have functional decline when we don’t encourage mobility • Experience avoidable delirium and cognitive decline • Disproportionately experience needless harms and death

Why Age-Friendly Health Systems? Gov. Whitmer commits to making Michigan an Age- Friendly State Gov. Gretchen Whitmer announced Oct. 7 that Michigan has joined the AARP Network of Age ‐ Friendly States and the World Health Organization Global Network of Age ‐ Friendly Cities and Communities. The action is intended to help the state prepare for dramatic and imminent demographic changes and ensure that Michigan communities can take steps to accommodate all ages. The state’s application was accepted by AARP and the World Health Organization and certification was awarded. Michigan becomes the 5th state to join the network. The others are Colorado, Florida, Massachusetts and New York. Virgin Islands, a U.S. territory, is also in the network. Source: AARP

Age-Friendly = Zero Tolerance for Ageism Widespread misunderstanding about the aging process, lack of information about how older people contribute to society, led to pervasive ageism Ageism is alive and well in our attitudes, behaviors, programs, and policies; and it affects employment, health care practices, psychological well ‐ being, family dynamics, and more… Research by the FrameWorks Institute found that the public believes aging is synonymous with decline and dependency, and that the aging process is a battle to be fought

Age-Friendly Health Systems Age-Friendly Health Systems is an initiative of The John A. Hartford Foundation and the Institute for Healthcare Improvement (IHI), in partnership with the American Hospital Association and the Catholic Health Association of the United States (CHA). These core partners have been working on the Age- Friendly Health Systems Initiative over the past few years.

4Ms: Core of an Age-Friendly Health System

Evidence-based Practice Changes Me tho ds: Re vie we d 17 c are mo de ls with le ve l 1 o r 2a e vide nc e o f impac t fo r mo de l fe ature s Redundant concepts Expert Meeting led to 90 care features removed and 13 discrete the selection of the “vital identified in pre ‐ work features found by IHI few”: the 4Ms team

4Ms: Evidence-base 28 • What Matters: • Asking what matters and developing an integrated systems to address it lowers inpatient utilization (54% dec.), ICU stays (80% dec.), while increasing hospice use (47.2%) and pt satisfaction (AHRQ 2013) • Medications: • Older adults suffering an adverse drug event have higher rates of morbidity, hospital admission and costs (Field 2005) • 1500 hospitals in HEN 2.0 reduced 15,611 adverse drug events saving $78m across 34 states (HRET 2017) • Mentation: • Depression in ambulatory care doubles cost of care across the board (Unutzer 2009) • 16:1 ROI on delirium detection and treatment programs (Rubin 2013) • Mobility: • Older adults who sustain a serious fall-related injury required an additional $13,316 in hospital operating cost and had an increased LOS of 6.3 days compared to controls (Wong 2011) • 30+% reduction in direct, indirect, and total hospital costs among patients who receive care to References at end of slides improve mobility (Klein 2015)