Wednesday, October 14, 2015
National Healthcare Quality Improvement Week
National Healthcare Quality Week is October 18-24, 2015.
Any of us who are involved with healthcare should take a moment to celebrate some of the measurable achievements in healthcare quality on improved patient care outcomes.
Each of us make a difference - Administrators, Nurses, Therapists, Social Workers, Nursing Assistants and all who contribute to a patient's healthcare experience.
I have been a health care professional and leader for the past 30 years. In my 30 years of practice as a Nursing Home Administrator, Registered Nurse, Public Health Professional, Home Health Provider and now as an Acute Care Compliance Officer, I have never seem a time more dynamic than the past five years. "Syzergy" is a term in astrology that means alignment of planets/celestial bodies. I believe that we are in a time of healthcare syzergy, one where there is alignment of political, financial and consumer forces working to change the landscape of healthcare and demanding improvements in both the value and quality of U.S. healthcare.
Health Care Quality Improvement , like leadership, is part science and part art . I believe that the Affordable Care Act (ACA) and other policy initiatives have had a significant impact on quality of care. The increased focus on public reporting, transparency, and quality measures have sparked interest in quality outcomes and provided the catalyst for remarkable quality improvement gains in several long-term care clinical quality measures over the past several years.
On March 2, 2015 CMS released the 2015 Impact Assessment of Quality Measures Report.
Dr. Patrick Conway, CMS Deputy Administrator for Innovation and Quality and Chief Medical Officer, stated "the 2015 Impact Report demonstrates that the nation has made clear progress in improving the healthcare delivery system to achieve the three aims of better care, smarter spending, and healthier people."
The key findings include:
· Quality measurement results demonstrate significant improvement. 95 percent of 119 publicly reported performance rates across seven quality reporting programs showed improvement during the study period (2006–2012). In addition, approximately 35 percent of the 119 measures were classified as high performing, meaning that performance rates exceeding 90 percent were achieved in each of the most recent three years for which data were available.
· Race and ethnicity disparities present in 2006 were less evident in 2012. Measure rates for Hispanics, Blacks and Asians showed the most improvement, and American Indian/Native Alaskans and Native Hawaiian/Pacific Islanders the least improvement. Transparency and monitoring of measures rates by race and ethnicity for all publicly reported measures and ensuring that disparities across programs, setting and demographic groups are eliminated, remain top priorities consistent with our CMS Quality Strategy.
· Provider performance on CMS measures related to heart and surgical care saved lives and averted infections. From 2006 to 2012, 7,000 to 10,000 lives were saved through improved performance on inpatient hospital heart failure process measures, and 4,000 to 7,000 infections were averted through improved performance on inpatient hospital surgical process measures. (A number of the measures are also included in the previously released patient safety results demonstrating from 2010 to 2013 a 17 percent reduction in patient harm, representing 1.3 million adverse events and infections avoided, approximately 50,000 lives saved, and an estimated $12 billion in cost savings.)
· CMS quality measures impact patients beyond the Medicare population. Over 40 percent of the measures used in CMS quality reporting programs include individuals whose healthcare is supported by Medicaid, and over 30 percent include individuals whose healthcare is supported by other payer sources. This demonstrates the public-private collaboration that CMS facilitates and hopes to expand.
· CMS quality measures support the aims of the National Quality Strategy (NQS) and CMS Quality Strategy. CMS quality measures reach a large majority of the top 20 high-impact Medicare conditions experienced by beneficiaries, with more measures directed at the six measure domains related to the NQS priorities, and better balance among those domains. Much of our data resulted from process measures; however, there is an increase in measures related to patient outcomes, patient experience of care, and cost and efficiency. CMS is moving increasingly toward these outcome measures across programs.
The 2015 report can be found at:
I am personally very heartened by these findings and feel them in my everyday work. This past week I attended a system collaborative meeting where the top leaders in my acute care system came together to discuss "Just Culture," national safety initiatives, strategies for involving staff in changing practices around near miss events and staff satisfaction survey results that will impact the future of quality and safety work in our organization. This work is amazing to me and the outcomes are improving with a lot of hard work by many dedicated people.
In closing I would like to share a quote from my healthcare quality hero, Dr. Avedis Donabedian. In an interview with Health Affairs one month before his death he said:
"Systems awareness and systems design are important for health professionals, but they are not enough. They are enabling mechanisms only. It is the ethical dimensions of individuals that are essential to a system’s success. Ultimately, the secret of quality is love. You have to love your patient, you have to love your profession, you have to love your God. If you have love, you can then work backward to monitor and improve the system."
Tammy Rolfe, Adjunct Professor, St. Josephs College
Posted by Twila Weiszbrod at 11:42 AM