Archive for March, 2007

How to Structure a Healthcare Performance Improvement Process That Results in Incentive Payments

March 26th, 2007 by Melanie Matthews

Already on a quest to accelerate clinical excellence, Memorial Medical Center in Springfield, Ill. was the first hospital to sign on with the CMS/Premier Hospital Quality Improvement Demonstration in 2003. Jim Benté, Memorial’s vice president of quality and organizational development, said the initiative was a natural extension of Memorial’s focus on safety, quality and clinical excellence. A top performer in the demonstration project, Memorial initiates employees in its culture of quality from the day they’re hired, explains Benté. To emphasize this commitment, department and individual goals in this initiative are prominently displayed throughout the hospital.

Technology that allows Cleveland Regional Medical Center (CRMC) to conduct concurrent chart reviews also generates reports that guide nurses and physicians in improving the patient experience, explained Liz Popwell, Cleveland County Healthcare Systems’ vice president of systems management. A holistic approach to outpatient care — including proper discharge instructions, disease-specific survival kits, and outpatient care analysis — has resulted in a 37 percent drop in hospital readmissions. The challenge to maintaining CRMC’s top rating in the Premier Hospital Quality Incentive Demonstration Project, she said, is ensuring that new staff members are adequately trained in core measures and processes.

Robots — dispensing meds in the pharmacy, assisting in the operating room, and even facilitating remote doctors’ rounds — is just one example of the technology supporting quality initiatives at Hackensack University Medical Center (HUMC), explained Regina Berman, administrative director for performance improvement. As the top earner in the CMS/Premier Pay for Performance project for two years running, HUMC has seen a “reverse migration” of patients who used to head to New York for medical care, said Ms. Berman. Its bariatric surgery program draws patients from around the nation, and its cancer center 100 attracts new patients each week. Just 10 miles from the Big Apple, HUMC has been cited by Business Week magazine for its technology initiatives and by New York magazine as one of the top 10 hospitals where physicians would go for their own care. She attributes the success of HUMC to involvement and commitment of front-line staff.

Benté, Berman, and Popwell gave us the inside details on how these hospitals have structured their internal processes to support an environment of performance improvement that has led to quality incentive payments from CMS under the Hospital Quality Improvement program during an April 18, 2007 audio conference, How to Structure a Healthcare Performance Improvement Process That Results in Incentive Payments.

Click here to listen to comments from Berman, Benté and Popwell online.

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Managing Transitions to Care for the Frail Elderly

March 26th, 2007 by Melanie Matthews

The hands-on approach of Enhanced Care Initiatives’ “Easy Care” program for the frail elderly is built on human interaction, communication and reinforcement. Nurses act as health advocates, pulling together all aspects of a patient’s care and supporting the patient by working for them in the healthcare system. However, technology has its place: a tablet PC is a communication hub for nurses, a web-based patient data collection tool is an information repository, and in-home monitoring tracks meds intake. Dr John Charde, Enhanced Care Initiatives’ vice president of strategic development, described how Enhanced Care Initiatives varied programs “touch” the frail elderly.

Fall risk assessment is built into XLHealth’s health risk assessments for the elderly, explained Laurie Russell, its senior director of health solutions. Members’ caregivers and pharmacists also play key roles in XLHealth’s fall prevention efforts. More than a year into CMS’ Medicare Health Support Program, Russell detailed how her organization’s “Ask Your Doctor” report empowers members with the language to address medical conditions during a doctor visit.

Charde and Russell explored how to create effective care management approaches for the frail elderly during an April 26, 2007 audio conference, Managing Transitions to Care for the Frail Elderly.

Click here to listen to comments from Dr. Charde and Russell online.

Schools: An Information Gateway to Help Prevent Childhood Obesity

March 9th, 2007 by Melanie Matthews

Bowing to pressure from parents, the state of Arkansas — the first of six states to mandate that schools send home body mass index (BMI) scores to parents, is now considering whether to repeal its law. Parents fear that the BMI reports can hurt a child’s self-esteem.

If not BMI “report cards,” what role can schools play in reducing the incidence of childhood obesity? Partnerships between schools, payors and healthcare providers can fill a critical need for the dissemination of information on this topic.

The school my children attend launched a contest this week with the support of the school nurse to encourage the children (parents) to pack healthy snacks and lunches for the children. This two-week contest gives children the opportunity to win prizes [let’s hope it’s not candy] and to hear their name announced over the loudspeaker if their lunch or snack includes an item from a healthy list sent home before the launch of the contest.

My kids are so excited about this opportunity. They compare the list of “approved” items every morning to make sure their lunch box contents makes the grade.

Yes, it’s a simple step, but in the case of my household, it’s been very successful. I only wish they would extend the contest for the entire year as it appears my children are more motivated by what the school tells them to eat than by what I tell them. Moreover, each day this week, my kids have reported back to me on the number of kids packing healthy snacks. It is impressive.

If you pair this type of contest with some community-based programs to educate parents sponsored by a local hospital or health plan, it might just be a better way to help reduce the incidence of childhood obesity than the BMI report card that some parents find objectionable.

Take for instance, St. Louis (Mo.) Children’s Hospital, one of the programs highlighted in Childhood Obesity: Truths, Trends & Program Design . The hospital takes a head-to-toe approach to spreading the word on wellness in schools and in the community.

“Fit N’ Fun Adventure,” a 20-day program available for the classroom, progresses students through a game board’s worth of physical activities—hopping on one foot, running up stairs, etc. The activities are monitored in school and registered at home, where a parent or caregiver must sign off on each exercise before a child may advance to the next one. The physical exercises are reinforced with nutrition-based information and activities. Participants who successfully complete the program are rewarded at a completion ceremony.