Telligen Update Christine LaRocca, MD April 26, 2019 This material was prepared by Telligen, the Medicare Quality Innovation Network Quality Improvement Organization, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. This material is for informational purposes only and does not constitute medical advice; it is not intended to be a substitute for 1 professional medical advice, diagnosis or treatment. 11SOW-QIN--C2-01/18/19-3167
Objectives • Who is Telligen and What Do We Do? • Telligen Updates: Infection Prevention and Antibiotic Stewardship Quality Assurance & Performance Improvement National Nursing Home Quality Care Collaborative (NNHQCC) Composite Score Honor Roll National Partnership to Improve Dementia Care Antipsychotic Reduction in Colorado Nursing Homes Website Resources and New Tools 2
Who is Telligen? What is the QIN-QIO Program? • Telligen: The Medicare Quality Innovation Network-Quality Improvement Organization (QIN- QIO) for Colorado, Iowa, and Illinois • QIN-QIO Program Purpose: To improve the efficiency, effectiveness, economy, and quality of services delivered to Medicare beneficiaries 3
Who is Telligen? What is the QIN-QIO Program? QIN-QIOs • have performance-based contracts with the Centers for Medicare & Medicaid Services (CMS) • help achieve national quality goals through focused efforts at the community level • provide technical assistance and convene learning and action networks at no cost to support healthcare quality improvement at the community level This Photo by Unknown Author is licensed under CC BY-ND 4
What We Do: Current QIN-QIO Strategic Initiatives 5
We Collaborate with Partners Our Partners Include: • CMDA The Colorado Society for Post-acute and Long- term Care Medicine • Colorado Department of Public Health and Environment (CDPHE) • Colorado Health Care Association & Center for Assisted Living (CHCA) • Colorado Hospital Association (CHA) • End Stage Renal Disease (ESRD) Network 15 This Photo by Unknown Author is licensed under CC BY 6
Infection Prevention and Antibiotic Stewardship Nursing Home Cohort: Reporting and Reducing Clostridioides difficile Infections (CDI) • Celebration! 26 Colorado nursing homes successfully submitted 10 months of baseline CDI data into the National Healthcare Safety Network (NHSN) module for 2017, and successfully submitted 12 months of CDI data for 2018 • Thank you to the NHSN Nursing Home Trailblazers! • List of homes posted on Telligen’s website: National Healthcare Safety Network Trailblazer Honor Roll https://www.telligenqinqio.com/resource/our-work/nursing-home-care/nursing-home-care- resources/national-healthcare-safety-network-trailblazer-honor-roll/ 7
TAG BUSTERS An infection prevention and Antimicrobial stewardship Collaborative
Infection Prevention and Antibiotic Stewardship “Tag Busters” Nursing Home Infection Prevention and Antibiotic Stewardship 2019 Collaborative • 28 facilities joined this virtual collaborative: 25 nursing homes, one inpatient hospice and two critical access hospitals • Goal: Address infection prevention focus areas frequently tagged during survey and more! • Hand hygiene • Personal protective equipment (PPE) • Environmental decontamination • Antibiotic stewardship • Sepsis recognition This Photo by Unknown Author is licensed under CC BY-SA-NC 10
Quality Assurance & Performance Improvement (QAPI) QAPI is key to creating sustainable change and improvement • QAPI push -Sprint is a six-week virtual learning experience • 263 individuals, representing 122 Colorado nursing homes, participated since 2016 • QAPI relay is a collection of 30 minute webinars focused on MDS coding for specific long-stay quality measures • Recorded webinars available online. Each session averages 100-150 participants • QAPI Express is a one-day intensive offered to nursing home organizations and in coordination with CHCA • Nearly 100 Colorado nursing homes participated in 2018 11
National Nursing Home Quality Care Collaborative (NNHQCC) Composite Score Honor Roll Telligen created the NNHQCC • Composite Score Honor Roll with a social media toolkit for homes to share their success! • Media kit was popular with 1,632 page views by Dec. 2018 • Nearly half (48.8%) of Colorado nursing homes recruited reached the goal composite score of < 6.0 during the collaborative 12
This Photo by Unknown Author is licensed under CC BY-SA-NC 13
Distribution of Composite Scores for Colorado Nursing Homes: 2016 vs 2018 2016 Q2 2018 Q3 14
National Partnership to Improve Dementia Care • CMS launched Partnership in 2012 • Goal to reduce antipsychotic medication (APM) use by 30% nationally by end of 2016 (quality measure excludes Schizophrenia, Tourette’s syndrome and Huntington’s disease) • Exceeded goal! Decreased from 23.9-15.7% nationally • Late Adopters • Reduce APM use by 15% (from baseline) by Dec 2019 • Colorado Dementia Partnership • Between 2012-2017, CO dropped from 19.4 to 14.7% (a 24% change) • BUT…We’re now trending upwards • Let’s Take Action! • Check out Telligen’s APM Use in Dementia Care Toolkit • https://www.telligenqinqio.com/our-work/nursing-home-care/ 15
Telligen Website Resources www.telligenqinqio.com • Nursing home resources • Toolkits • Suspected UTI Action Tool • Antibiotic Time-Out Tool and much more! • Telligen Portal • Opioid resources • Sepsis identification This Photo by Unknown Author is licensed under CC BY-SA-NC 17
Suspected Urinary Tract Infection (UTI) Action Tool • This tool was co-created by CHA, CDPHE, CHCA, Dr. Greg Gahm, and Telligen in November 2018 • It is designed to guide nursing staff in the initial evaluation and next steps for possible urinary tract infection (UTI) in residents without a urinary catheter • Check it out! • https://www.telligenqinqio.com/resource/our-work/antibiotic- stewardship-in-long-term-care/antibiotic-stewardship-in-long-term- care-resources/suspected-urinary-tract-infection-uti-action-tool/ 18
Antibiotic Time-Out Tool • An important practice to help optimize and monitor antibiotic use as part of a successful Antibiotic Stewardship program. • This tool was co-created by CHA, CDPHE, CHCA, and Telligen. Finalized in February 2019. • Tool includes a checklist and instructions for taking a Time-Out to reassess every antibiotic within 48-72 hours after antibiotic start. https://www.telligenqinqio.com/resource/our-work/antibiotic-stewardship-in-long-term- care/antibiotic-stewardship-in-long-term-care-resources/antibiotic-time-out-checklist/ 19
Sign Up for the Weekly Digest! • Emailed every Monday • Latest events, news and resources from Telligen and our partners • Visit www.TelligenQINQIO.com to sign up! 20
Connect with Us • www.TelligenQINQIO.com • Learn more about the Telligen QIN Nursing Home team • View nearly 170 helpful nursing home resources • You follow us, we’ll follow you: • Facebook • Twitter • LinkedIn 21
QUESTIONS? Christine LaRocca, MD Medical Director, Telligen christine.larocca@area-D.hcqis.org clarocca@telligen.com Elizabeth Schulte Mullins, MSW, NHA Program Specialist elizabeth.schulte@area-D.hcqis.org This Photo by Unknown Author is licensed under CC Phone: 720-554-1395 BY-SA 22
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