Adult Enterprise Leadership Update February 10 2015 Mitch Edgeworth and Robin Steaban Todays Agenda The Triple Aim Goal Alignment Our Journey Our agenda is consistent with the national movements in healthcare ID: 767640
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Adult Enterprise LeadershipUpdate February 10, 2015 Mitch Edgeworth and Robin Steaban
Today’s Agenda The Triple Aim Goal Alignment Our Journey
Our agenda is consistent with the national movements in healthcare… The IHI Triple Aim
2016… 2015 2014 2013 2012 …2011 Today Future Value-driven, Coordinated Care Volume-driven, Fragmented Care Payment System Changes Fee-for-Service Episode or Comprehensive Care Payment Delivery System Changes Care Coordination Provider Feedback & Accountability Measurement around Quality & Efficiency The national agenda is moving rapidly… Clinical Integration 5 CMS Community Care Transition Program CMS Bundled Payment Pilot Hospital-Acquired Conditions Penalties HITECH/ Meaningful Use Penalties DRG Readmissions Penalties HITECH/Meaningful Use Incentives Value-Based Purchasing Incentives Fragmented e vent driven care TennCare Bundles Commercial Bundles CMS Bundled Payment
Fee-for-service will soon be in our past www.insidenorth.com
30 Days Admission Discharge Pre-op SNF/HH/Home/PCP Admissions/Discharge planning Surgery/ Diagnostic Post-op Treatment Discharge Simple Stable Routine Fragile Unstable Complex Catastrophic What does “Care Across the Continuum” mean? Personalizing Care Across the Continuum Matching Resources to Patient Care Needs “Everything the Patient Needs ad Nothing They Don’t”
How are we responding to these new challenges? Creation of PCC structure Better measurement in cost and quality Redesigning the entire episode of care Development of VHAN Investment in information technology
Group feedback There are many efforts underway to accomplish the triple aim. What are ideas in your area where we can: Prepare for population heath Improve the experience of care Reduce costs per capita
Goal alignment is critical
Pillar Goals Focus Our Efforts
Goal Attainment Requires Action at Every Level of the Organization Standard Work Measurement /Reporting Role Clarity / Accountability
Goal Attainment - Action at Every Level Measurement /Reporting Standard Work Reduce Hospital Acquired Injuries Reduce PCC Falls with injury rate Reduce falls with injury on a unit Increase time to last fall A ccuracy and access to date Ensure access to best practices Standardize approach to falls reduction at unit level Educate staff on best practice standard Leader Rounding Measure performance at an individual level Coach for success Targeted toileting Hourly Rounding Bedside report Falls prevention bundle Role Clarity / Accountability
Our Journey
Tremendous work is underway thanks to many people in this room Case management redesign Discharge phone calls Time to fill vacancies Nurse triage B/P acquisition accuracy The Vanderbilt Clinic Model (aka Standard Clinic Operating Model) iRound Nurse call replacement Documentation of start and stop times of medication infusions for outpatientsClinical documentation excellenceStandard check-in / check-outContinuous monitoring EVS workflow improvementNew food production and menusEstimated date of dischargeLab ready labelsNew units - 7 South and TVC ObservationStandard Inpatient Operating ModelRapid cycle redesign
Other Important Challenges Are Before Us VU/VUMC Split Replacement of all clinical IT systems Replacement of Medication Cabinets Hiring and onboarding
Preparing ourselves through constant training is vital as we pursue the Triple Aim… Preparation for quality and TJC Lean training - HPP Communication training – Kimberly Pace Staff engagement tactics – Advisory Board
Summary IHI Triple Aim - Connecting the Dots - Episode of Care Care coordination Case- management redesign Discharge phone calls VHAN HCAHPS Access Discharge phone callsNurse triage Falls preventionPressure ulcer preventionCLABSICAUTIReadmissionsMortalityLOS Episode of Care/Bundle work
Questions & Answers
Thank You
Future of Outcomes Monitoring