Working to Improve Healthcare Quality Holly Standhardt February 21, 2020 Empowering patients, families and caregivers to achieve health care quality improvement
Objectives • Introduce Superior Health Quality Alliance (Superior Health) • Provide an overview of the Centers for Medicare & Medicaid Services (CMS) National Quality Strategy Aims • Describe national and regional efforts • Discuss opportunities for joining Superior Health
What is Superior Health Quality Alliance (Superior Health)? • Formed in 2019 with eight health care organizations across six states • Working to achieve broad national CMS Quality Strategy Aims • Our goal is to collaboratively improve the quality of health and health care for the consumers, patients, clinicians, organizations and communities we serve
What We Believe Mission • Improve the quality of health and health care through innovation, effectiveness and efficiency in designing and implementing CMS Network of Quality Improvement and Innovation Contractors (NQIIC) initiatives that are person-centered and integrated across the continuum of care and services Vision • Better health, better care, lower costs and better health care worker experience Values • Integrity | Innovation | Quality | Diversity
Our Team of Quality Improvement Experts Three Quality Improvement Organizations • MetaStar – WI • MPRO - MI • Stratis Health - MN Four Hospital Associations • Illinois Health and Hospital Association • Michigan Health and Hospital Association • Minnesota Hospital Association • Wisconsin Hospital Association End Stage Renal Disease Network https://www.superiorhealthqa.org/about-us • Midwest Kidney Network
Quality Improvement Across the Continuum of Care CURRENT STATE: Future: Future: Nursing home and community Additional work currently Additional work focused coalitions including clinics, found under the Hospital on ambulatory hospitals, and all care settings Improvement Innovation settings Network (HIIN) (Awarded) • Superior Health anticipates additional projects from CMS which will expand and focus on other settings • This work is expected to align with the current aims listed throughout this presentation • Why is this important? It will allow for a synergistic approach to quality improvement across all healthcare settings and promote a stronger collaboration with stakeholders • More to come…
What We Want To Achieve Regionally • Ensure there is regional reach covering nearly 900 Nursing Homes, 35 Community Coalitions, and create a regional quality improvement network • Engage health care organizations throughout the care continuum over the next five years • National CMS goals include: • Five bold Aims • Three high-priority settings and areas
Community Coalitions CMS’s High Priority Areas Nursing Homes
CMS’s Five Bold Aims • Improve behavioral health outcomes and decrease opioid misuse • Increase patient safety • Increase chronic disease self-management • Increase quality of care transitions • Improve nursing home quality
Aim 1: Improve Behavioral Health Outcomes and Decrease Opioid Misuse • Decreasing opioid- related overdose events • Increasing opioid safety • Spreading of opioid prescribing best practices
Aim 2: Increase Patient Safety • Reducing adverse drug events (ADEs) across all settings including all community settings and nursing homes • Reducing C. difficile in all settings including a reduction in hospitalizations for nursing home onset
Aim 3: Increase Chronic Disease Self-Management • Preventing one million cardiovascular events by 2024 • Reducing smoking prevalence among Medicare beneficiaries • Preventing diabetes and promoting self-care • Slowing the progression of chronic kidney disease
Aim 4: Increase Quality of Care Transitions • Improving community- based transitions of care to reduce hospital admissions and readmissions • Reduce community-based ADEs • Reduce the rate of emergency department (ED) visits and admissions by super utilizers
Aim 5: Improve Nursing Home Quality • Improving total quality score as part of Nursing Home Compare • Reducing adverse drug events (ADEs) • Reducing avoidable ED visits and hospital readmissions • Preventing healthcare- related infections
Area 1: Long Term Care – Nursing Home Quality Improvement Collaborative
Long Term Care - Nursing Home Reach Superior Health will engage nearly 900 nursing homes across MI, MN and WI; including those in most need of technical assistance and quality improvement support
Suggested Aims for Nursing Home Participation Nursing Homes Aim 1: Improve BH Outcomes and Aim 5: Improve Nursing Home Aim 2: Increase Patient Safety Decrease Opioid Misuse Quality Note: Nursing Homes will automatically be enrolled in a local Community Coalition
NH Quality Improvement Collaborative - Goals • Improve the total quality score used to calculate CMS Nursing Home Compare Star Ratings • Reduce adverse drug events for opioids, anticoagulants, diabetic agents and antipsychotics • Prevention and reduction of health care associated infections (HAI) such as C. difficile and Urinary Tract Infections (UTI) • Reduce resident harm for pressure injuries and falls • Reduce unnecessary ED visits and readmissions for nursing home residents
Working Together • Submit requested data for quality improvement purposes • Design and implement improvement plans based on identified opportunities • Participate in learning events • Connect with community collaborative networks in your area • Share best practices and lessons learned
Community Coalitions Area 2:
Community Coalition Reach Superior Health will engage a minimum of 35 community coalitions serving 65% of all Medicare beneficiaries across Michigan, Minnesota and Wisconsin
Suggested Aims for Community Coalition Participation Community Coalitions Aim 1: Improve BH Aim 3: Increase Aim 4: Increase Outcomes and Aim 2: Increase Aim 5: Improve Chronic Disease Quality of Care Decrease Opioid Patient Safety NH Quality* Self-Management Transitions Misuse *For NHs participating in a Community Coalition
Community Coalition Structure Aim 1: Improve BH Clinics Outcomes and Behavioral Decrease Opioid Hospitals Health Misuse Aim 4: Increase Quality of Care Nursing Emergency Transitions Departments Homes Aim 2: Increase Superior Patient Safety Health Home Pharmacies Aim 5: Improve Health NH Quality* Aim 3: Increase Chronic Disease Public EMS Self-Management Health Agencies Community Dialysis *For NHs participating in a Community Coalition Based Centers Orgs
Community Coalitions - Goals • Improve the health and health care for all within the community • Collaborate and share best practices • Improve patient and resident satisfaction • Accelerate progress toward shared goals
Working Together • Submit requested data for quality improvement purposes • Design and implement improvement plans based on identified opportunities • Participate in learning events • Connect with community collaborative networks in your area • Share best practices and lessons learned
Joining Superior Health
Why Participate? • Reduce the burden of regulatory reporting requirements • Improve performance on quality reporting • Access to data driven, quality improvement support • Participate in high quality educational offerings • Opportunity to network with peers • Improve population health and health equity • At no cost to your organization!
Who Should Join? Superior Health is looking for health care organizations that are motivated to change health care outcomes for beneficiaries and individuals considered high-risk and part of the vulnerable population. This includes: • healthcare organizations and systems • behavioral health organizations • clinicians • home health agencies • hospitals • community-based organizations • nursing homes and skilled nursing facilities • dialysis centers • pharmacies • emergency departments
Participation Requirements Conduct Assess Set vision and Share and regularly Enrollment and and establish submit scheduled upkeep of Sustain! analyze improvement requested check-ins information QI needs plan data with QI coach
Enrolling with Superior Health Complete the online enrollment participation form https://www.surveygizmo.com/s3/5362166/Join-Superior-Health-Quality-Alliance OR Complete the PDF enrollment participation form http://bit.ly/enroll-superior-health and send to info@superiorhealthqa.org
Contact Information Superior Health Quality Alliance • Phone: (833) 821-7472 • Email: info@superiorhealthqa.org • Online: https://www.superiorhealthqa.org/contact/
Questions? Holly Standhardt, Senior Quality Consultant
This material was prepared by Superior Health Quality Alliance under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The materials do not necessarily reflect CMS policy. 12SOW-MI/MN/WI-CC-20-08 012720 Empowering patients, families and caregivers to achieve health care quality improvement
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