Leiza Johnson BSN RN NH Quality Improvement Specialist MountainPacific Quality Health Alaska state hospital amp nursing home association chief nurse executive meeting December 2017 Serve as the Medicare Quality Innovation NetworkQuality Improvement Organization QINQIO for Alaska ID: 768908
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Leiza Johnson, BSN, RNNH Quality Improvement SpecialistMountain-Pacific Quality Health Alaska state hospital & nursing home associationchief nurse executive meetingDecember 2017
Serve as the Medicare Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for AlaskaFive offices: Alaska, Hawaii, Montana, Wyoming and GuamContracted by the Centers for Medicare & Medicaid Services (CMS) to achieve the triple aim: 1) better care 2) better population health 3) lower costsWe have expert staff who facilitate various quality improvement projects across the state Mountain-pacific quality health
Role of the QIN-QIO Drive recognition of quality improvement Provide technical assistance Provide tools and resources Share best practices (learning & action networks) Partnering with statewide stakeholders to align efforts Enhance quality of health care delivery
OUR ALASKA TEAM IS… STRONG DYNAMIC DIVERSE EXPERIENCED
The Alaska team Sharon Scudder State Director, Alaska Leiza Johnson Nursing Home Task Lead Lori Chikoyak Antimicrobial Stewardship Miranda Burzinski Quality Reporting Preston Groogan Quality Reporting Kyla Newland Adverse Drug Events Coleman Cutchins Care Coodination Cathy Colwell Diabetes Self-Management
Current Initiatives from CMS and Mountain-Pacific Staff Quality Reporting (Hospitals & Outpatient – QPP, MIPS, eCQI) Improving Coordination of Care Improving Antimicrobial Stewardship Reducing Disparities with Diabetes Miranda Burzinski Coleman Cutchins Lori Chikoyak Cathy Colwell Reducing Adverse Drug Events (ADEs) Improving Cardiac Health Improving Adult Immunization Rates Improving Long-Term Care Coleman Cutchins & Kyla NewlandKyla Newland Coleman Cutchins Leiza Johnson
Screen patients in outpatient settings to prevent ADEs Track/ monitor ADEs Provide tools for ADE education Engage/ empower patients in their own care & medication management Reducing ADE s Three high-risk drug classes: Anticoagulants Opioids Diabetic agents
Establish collaborative of nursing homes to work with the QIN-QIO on quality improvement initiativesIn Alaska, this collaborative is called the “Alaska Nursing Homes Together,” or “ANHT,” group.CMS established goals for this work:Enrollment target: 35% of all Alaska nursing homesComposite score of <6 target: Rolling targets of 15%, 25%, 45% and 50% of nursing home partners achieving target by established dates (2016, 2017, 2018)Antipsychotic use reduction target: Reduction in rate (RIR) from baseline targets established of 3%, 9%, 15% and >15% each year (3% RIR by March 2016, etc.)Note: Alaska has failed this measure the past two quarters. Leiza Johnsonnursing home project
Project goals Exceeded Goal! Exceeded Goal!
antipsychotic reductionWe are NOT meeting contract goal(s) – Root Cause Analysis to evaluate failure.
Represents quality indicators selected to characterize nursing homes’ performanceIncludes 13 QMs, which are summed to get an overall composite scoreData is pulled from nursing home’s Minimum Data Set (MDS) submissionWhen setting QI targets, CMS recognized the best nursing homes had a composite score of <6, so this was established as the goal Defining thecomposite score
Sample composite report state of Alaksa
State of Alaska QMs
Quality Measure Alaska Sept. Alaska Aug. Montana Sept. Wyoming Sept. Hawaii Sept. Nation 11/9/17 Antipsychotic Use 11.15 10.33 14.49 12.64 6.80 15.9 Incontinence 41.41 37.63 44.36 41.94 46.82 47.6 Late Loss ADLs 16.26 15.03 14.97 15.62 13.33 18.3 Pain 28.42 28.08 13.17 13.29 6.56 5.9 State Average 9.03 8.65 8.90 8.40 5.94 N/A Current status Alaska vs. Mountain-Pacific’s other states vs. national rates Goal for all measures is <6. ANHTs have chosen Antipsychotic Use, Incontinence, Late Loss ADLs and Pain as QMs to focus on at the state level.
Questions?Leiza Johnson, BSN, RNMountain-Pacific Quality Healthejohnson@mpqhf.org
Thank you for your time! D eveloped by Mountain-Pacific Quality Health, the Medicare Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for Montana, Wyoming, Alaska, Hawaii and the U.S. Pacific Territories of Guam and American Samoa and the Commonwealth of the Northern Mariana Islands, 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. 11SOW-MPQHF-AK-C2-15-53