Cathryn C Trimby RRT RCP CathyTrimbymsjorg Quality and Data Manager Six SigmaLean Certified Mission Health System Asheville NC 28801 6 Member Hospital System Western North Carolina Tertiary Referral Center ID: 780227
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Slide1
Mission Health System COPD Readmission Data
Cathryn C. Trimby, RRT, RCPCathy.Trimby@msj.orgQuality and Data ManagerSix Sigma/Lean CertifiedMission Health SystemAsheville, NC 28801
Slide26 Member Hospital SystemWestern North Carolina Tertiary Referral Center
708 Acute Beds and 62 BH BedsLevel II Trauma CenterOffer services to approximately 1M people in 18 countiesRegional Transport Provider3rd Busiest ED in North Carolina
Slide3COPD Readmission Rate Definition
The number of Patients with a Principal Diagnosis of COPD that are readmitted for any cause to an acute care facility within 30 Days of a prior COPD index admission.Total number of Patients with a Principle Diagnoses for COPD for the time periodExclusion List- Transfers
Admit Status- Elective
Patients who leave Against Medical Advice
Slide4COPD: Care Process Model (CPM)
Slide5COPD Readmission Risk FactorsComparison
Discharge period: July 1, 2014-June 30, 2017Risk FactorsMissionStateNational
AMI
29%
30%
30%
CABG
24%
23%
25%
HF
48%
50%
49%
PN
56%
51%
50%
Stroke
4%6%6%Vascular orCirculatory Disease44%41%44%Renal Failure38%36%35%
Mission Patient Complexity
Mission
State
National
Eligible Discharges
964
30,694
852,039
Mean Age
74.8
75.7
76.7
Slide6COPD In Western North Carolina
Slide7MMH COPD Readmission Rate FY16 to FY18
Time PeriodOverall 30-Day Readmission RateFY 1715.75
Slide8Population Demographics
Gender Race66.7% Medicaid
Age
Slide9Discharge Disposition Analysis
Discharge DispositionDC Disposition mapped to Readmission
Slide10Readmission Demographics% Readmitted within 30 days
LOS effects on readmissionsReadmission post DC in Days % Readmissions 16 20 0 25 50 0 100 30
Slide11Charles Blankenship, Manager Mission Health EMS
Stace Horine, MD, Medical DirectorRandy Fugate Coordinator/NavigatorMobile Integrated HealthMission Community CaraMedics Program
Slide12What is the Community CaraMedic Program?
A program that uses certified community paramedics to operate in expanded roles within their scope of practice under the direction of a physician to provide in-home care to patients who are “at risk” due to a recent hospital discharge, chronic medical condition, or other significant factor. Filling gaps when other services are not available.
Slide13A well-structured, well-supported and high functioning department
Medical Director - Medical administrator responsible for the oversight of community paramedic medical care and clinical servicesCoordinator / Navigator - Provides administrative services and dispenses procedures and policies; monitors work activities, projects and progressCare Manager
– Responsible for enhancing the quality of care coordination, patient management throughout the continuum of care, and to assure cost-effectiveness of
care
Community
CaraMedic
- Supports existing health services; provides integrated health services in partnership with other health professionals; extends access to health services in underserved and general populations, including primary care, public health, disease management, prevention and wellness, mental health, and dental health; and performs other duties as required
.
Slide14Engaged and Planned FY18 UtilizationThe Mission Community CaraMedics program is engaged
7 certified CaraMedics, 487 consults1
Slide15MHP achieved $910K savings on high risk Medicare Population with the assistance of Mission CaraMedics
Significant annualized savingsSavings estimate based on annualized utilization savings and Mission Hospital FY 2016 average Medicare charges, payments and ALOS.
Slide16Length of Stay:
Mortality:Readmissions
Slide17End Results: 30-Day Risk-Standardized Readmission Measures
Better than the National/State Rates(1/18 Nationally and 1/2 State)Joint Commission Certified DSC Program Surveyed twice with No citations
Slide18Successful PracticesPulmonary Navigators/ Chronic Disease Specialists
Achieving and sustaining The Joint Commission Certification Standardized Care: Care Process Model“Coding Correctly” PI TeamSystem-wide Pay for Performance Mortality ReviewTransitions of Care TeamPCP FocusCommunity CaraMedic Program
Slide19Questions?
Slide20