Using HIT to Improve Patient Safety and Quality - Summary of Changes

Transcription

1 Utilizing HIT to Improve Patient Safety and Quality Kelly Cinquegrani, RHIA Quality Data Analyst FirstLight Health System

2 Outline Introduction and background Meaningful Use Quest Project Utilizing HIT to improve patient safety/quality Standardization of protocols Structured data capture for quality reporting Clinical decision support Achievements Success decreasing Patient Falls Final Steps in becoming paperless

3 FirstLight Health System Located in Mora, Minnesota Primary Service Area includes Mora, Ogilvie, Hinckley and Pine City 25-Bed Critical Access Hospital, 3 Primary Care Clinics and one Eye Clinic 370 Employees 1 st Critical Access Hospital in the nation to reach Stage 6 on HIMSS EMRAM

4 SISU Membership Member since 2002 Based in Duluth Consortium of 17 hospitals located across Minnesota Shared IT resource Support Meditech Health Care Information System (Hospital EMR) Provides system s IT network Extension of member facilities staff Consider SISU to be our IT Department

5 Current Membership SISU, Duluth MN Members Community Memorial Hospital Cook County North Shore Hospital Cook Hospital Cuyuna Regional Medical Center Deer River HealthCare Center Ely-Bloomensen Community Hospital FirstLight Health System Hutchinson Area Health Care SMDC Medical Center Mercy Hospital Bigfork Valley Hospital Pine Medical Center Riverwood Healthcare Center Regina Medical Center Swift-County Benson Hospital St. Mary s Innovis Health United Hospital District Associate Members Grand Itasca Clinic and Hospital Chippewa County-Montevideo Hospital RiverView Health St. Michael s Hospital Minneapolis/St. Paul

6 Quest Project Goals HRSA Grant Focused on EHR Data Standardization and Direct Quality Reporting 1. Use data captured in the EHR to meet quality improvement efforts and external quality reporting requirements as the basis for increasing patient safety, improving quality of care, and reducing healthcare costs 2. Expand, validate and extend previous work done by the College of St. Scholastica on an HIT Best Practice Framework

7 Objective 1 Quest Project Objectives Standardize the collection of clinical data within each facility s respective EHR Accelerate the ease with which rural healthcare organizations capture, report, and analyze clinical quality data using the capabilities of the EHR systems Electronically report from each facility 3-5 commonly identified clinical quality measures as defined by CMS in section II(A)(3) of the Electronic Health Record Incentive Program Final Rule Provide aggregated data back to clinicians in each facility to inform healthcare delivery and quality improvement efforts Objective 2 Understand how multiple, independent rural healthcare organizations can work collaboratively to standardize the capture and reporting of required data elements Understand how rural healthcare organizations use aggregated data for quality improvement purposes within their particular settings Facilitate the dissemination of project findings to other healthcare facilities facing similar challenges

8 Project/HIT Challenges Demographics Rural (measure selection) Organizational Cultural resistance Staffing Finance Data utilization and analytic capabilities Technical Vendors Documentation/Workflows Builds Standardization Workflow Build Data

9 Project/HIT Challenges >50% of all data elements required for MU are derived from provider or nursing structured documentation Currently this data is housed in paper-based records and/or in narrative format w/in the EHR Example: Stroke Few stroke cases admitted- mostly transferred using paper processes.

10 Utilizing HIT to improve patient safety and quality Standardization of protocols Build system to support process Multi-Disciplinary Teams! Best practice not always the best practice

11 Utilizing HIT to improve patient safety and quality Contraindications for Clinical Quality MU Pharmacy took on larger role to take burden off of nursing/physicians

12 Utilizing HIT to improve patient safety and quality continued: Patient Flags Ex. Pts with MRSA or MDRO Flags put on status boards Med/Surg, ED, and OR Registration has pop-up to notify receiving department

13 Structured data capture for quality reporting Ease of report running from EMR system to: Demographic upload core measures Abstract patients for appropriate state measures Direct reporting of meaningful use clinical quality measures

14 Utilizing HIT to improve patient safety and quality Through the use of clinical decision support and electronic documentation, healthcare-associated infections, falls, and other negative healthcareassociated events can be more quickly identified, tracked, monitored, and eliminated.

15 Utilizing HIT to improve patient safety and quality example: Pneumonia Patient- Electronic order sets created to order appropriate Antibiotics Electronic documentation of Immunization Prior to new 2012 measure

16 Progress from Electronic Documentation of Immunizations 120% Pneumococcal Vaccination 100% 80% 60% 40% 20% 0% Q Q Q Q Q Q Q Q4 2011

17 Exception Analysis Pneumonia Patient continued: Antibiotic selection inappropriate Quality department & Pharmacy review

18 Overall Optimal Pneumonia Care 120% Overall Optimal Care- PN 100% 80% 60% 40% 20% 0% Q Q Q Q Q Q Q Q Q1 2012

19 100+ Days without a Fall! Number of Inpatient Falls # of Falls

20 Final Steps to Paperless 2011 Operating Room Electronic documentation Emergency Room Implementation Stage 1: Paper orders electronic ordering Stage 2: Paper T-sheet electronic documentation Dragon implemented

21 Questions? Kelly Cinquegrani, RHIA