44th Annual Conference & Exhibition July 9-11, 2015 Houston TX. Respiratory Care : A New Profession is Evolving

Size: px
Start display at page:

Download "44th Annual Conference & Exhibition July 9-11, 2015 Houston TX. Respiratory Care 2015-2020: A New Profession is Evolving"

Transcription

1 44th Annual Conference & Exhibition July 9-11, 2015 Houston TX Respiratory Care : A New Profession is Evolving Patrick J. Dunne, MEd, RRT, FAARC HealthCare Productions, Inc. Fullerton, CA

2 Disclosure Professional relationship with Monaghan Medical Corporation Mylan Pharmaceutical Career-long member/supporter of AARC State affiliates Texas Society

3 Objectives Review the government changes in health care replacing the traditional FFS delivery of care model; List those instances where government change will directly influence the delivery of respiratory care; Describe the key features of the emerging chronic care model and how RTs can become actively involved, and Identify a high-value contribution that RTs can make to improve patient safety.

4 Situational Analysis Summer 2015 Health care reform s operative buzz words Disruptive change, Transformational change, Game changer, Disruptive innovation, Radical redesign, Fundamental shift, etc. Bottom line - - It s system wide All providers eventually affected Patient Protection and Affordable Care Act of years & still going strong In spite of set-backs with exchanges, subsidies, etc. Millions of Americans realizing positive benefits 2 more years of continued implementation Elections of 2016 Some may campaign on complete repeal Given evidence Repeal no longer a realistic option

5 Government Change in Health Care Sleepless in the C Suites MAJOR ONGOING ORGANIZATIONAL CHALLENGES Transition to EHR Hospital Compare website Physician Compare website Experience of Care impact Inconsistent hospital rankings Newer Joint Commission expectations Transition to ICD-10 coding

6 Angst in the C Suites Revenue Stream Challenges Value-based Purchasing Effective FY 2012 FY 2015: Up to 1.5% bonus (or) penalty 30% of all payment by 2016; 50% by 2018 Hospital Readmission Reduction Program (up to 3% penalty) Effective FY 2012 FY 2015: $429 million from 2,610 hospitals Hospital-acquired Conditions Reduction Program (1% penalty) FY 2015: $330 million from 724 hospitals nationwide Post-op pulmonary conditions (PPCs) a major concern

7 Government Change in Health Care The New Environment of Care TRADITIONAL EMPHASIS Acute care In-patient Treat symptoms Billable procedures Individual patient Volume metrics NEWER EMPHASIS Chronic care Out-patient Manage disease Outcomes of care Patient populations Value metrics It s no longer about how many or what kind of procedures are done... It s all about HOW care is delivered!!

8 Challenges to Respiratory Care Services Traditional Role Changing Consultants abound Contingency-based fee Others can do basic RT treatments True value not always obvious Making crisis moments look routine Traditional productivity metrics no longer relevant Linkage to billable procedures very limiting Transition to relative value units (RVUs) Capture clinical productivity in all areas for all activities Full integration into EHR

9 Challenges for Respiratory Care A Defining Moment in our History Adapt or become irrelevant Maintaining status quo risky Conventional wisdom sometimes iffy Seize/embrace new opportunities Align with main concerns of the C-Suites Be perceived as part of the solution Talk the talk & walk the walk of health care reform It s really payment reform!!! Maintain/strengthen existing clinical competencies Change context in which we practice Referral vs. an order Care vs. treatments Service vs. a department

10 The AARC Response Strategic Plan Embodies key recommendations of 2015 and Beyond initiative Formally approved October 2014 Eight major objectives Each objective fully described Implementation strategies identified Facilitate orderly, well-planned transition Involve all key stakeholders Minimal disruption to existing workforce

11

12 The AARC Response Strategic Plan Objective 1. Refine and expand scope of practice Promote advanced practice for RTs, inclusive of scientific evidence demonstrating the value/role of RT in all practice settings; Advocate clinical practice to be outcome-based, value-driven and delivered using evidence-based protocols Expansion to encompass: Advanced practice credentialing, Chronic disease management, Health/wellness educator, Telehealth, and others.... Services that emphasize quality, access, and cost savings unique to RT;

13 The AARC Response Strategic Plan Objective 2. Advance knowledge base/educational preparation of RTs Support existing & future articulation agreements between associate and bachelor degree programs; Expedite development of bachelor/graduate degree programs with goal of BS as entry level; Work with state affiliates/licensing boards to establish RRT credential as entry-level for licensure.

14 The AARC Response Strategic Plan What about here and now? How about the 140,000-plus RTs nationwide?

15 Challenges for Respiratory Care A Defining Moment in our History Advocate for better chronic care Develop a chronic care footprint MacColl Institute Participate in care transition Become patient safety advocate Improve/formalize all patient handoffs Adopt patient safety checklists Monitor Patient Safety Roundtable (AARC Connect) Address post-operative pulmonary complications

16 Impact of of Chronic Conditions Chronic conditions overly expensive Account for ⅔ of total expenditures ($1.8 of $2.8 trillion) Most characterized by frequent exacerbations Excessive hospital utilization Symptom treatment versus disease management Current sense: Traditional chronic care is ineffective Multiple providers = fragmented care = uncoordinated care Information not shared (set-backs, complications, changes) Evidenced based care the exception, not the rule

17 Chronic Disease Management A Global Problem

18 Chronic Disease Management Coordinated approach to chronic medical care Improve health outcomes, quality of life Reduce disease progression, complications Manage health care utilization Traditional payment model broken New payment models per 2010 PPACA Act Hospital readmission reduction program Value based purchasing Accountable care organizations Patient centered medical homes The evidence: Community-based programs work

19 The Chronic Care Model MacColl Institute

20 Patient Safety: The Early Days Published 1999 by US Institute of Medicine Based on Harvard Medical Practice Study (N Engl J Med; 1991) Estimated 44,000 to 98,000 preventable deaths each year Error rate highest in Intensive/critical care units, Surgical suites, Emergency departments

21 Patient Safety: Today Journal of Patient Safety Vol 9; No 3: September 2013 Literature search ,000 to 400,000 preventable deaths per year Non-lethal harm 10-to-20 fold higher Near misses/non-reported incidents unknown

22 AARC Resources

23 AARC Patient Safety Checklists In-Hospital Oxygen Transport

24 AARC Checklists Transfer from Intensive care

25 Post-operative Pulmonary Complications (PPCs) Major patient safety implications Relatively recent area of investigation Prevalence following general surgery/anesthesia Overall range: 2% to 40% 2% (low risk pt. & low risk procedure) 40% (high risk pt. & high risk procedure) 10-fold higher mortality in abdominal pts. Risk intensifies closer to diaphragm

26 PPCs (cont.) Increases LOS 12 days vs. 3 days Increases 30-day readmissions Major contributor to surgical morbidity, mortality & costs A marker for high mortality in hospitalized elderly pts.?

27 Surg Clinics N Amer. Volume 95; April 2015

28 Surg Clinics N Am. Volume 95: April 2015 PPCs are more of a financial burden than cardiovascular or infectious complications after surgery, costing the US $3.4 billion annually

29 Major PPC Conditions Atelectasis Respiratory infection (fever) Bronchospasm Aspiration pneumonia Pleural effusion Pneumothorax Respiratory failure

30 Predictive Factors for PPCs Smetana GW. Ann Intern Med Patient Related Age ( 65 yrs.) Low SpO 2 ( 90%) Recent respiratory infection (2-3 weeks) Anemia Procedure Related Surgical site/procedure (Cardio-thoracic, abdominal) Length of surgery ( 2.5 hrs.) Emergency vs. elective

31 Additional Risk Factors for PPCs Branson R. Respir Care; November 2013 COPD CHF OSA (esp. undiagnosed/untreated) Other chronic conditions (i.e. diabetes) Cigarette smoker Functional dependence Impaired sensorium Drug/alcohol dependence

32 Pulmonary Effects of General Anesthesia Including Endotracheal Intubation Mechanical disruption to delicate muco-ciliary escalator Contributes to retained secretions Bronchoconstriction due to release of circulating mediators Lungs normal response to inhaled noxious gases Decrease of surfactant production Undermines stability of alveoli Inhibition of alveolar macrophages Dust cells unable to scavenge

33 Excess Airway Mucus linked to PPCs Increased Production Current smokers History of COPD Congestive heart failure Viral/bacterial infection Excess Decreased cough mucus Poor pain control Poor ciliary function Impaired diaphragm function Airway occlusion/atelectasis Resp. muscle weakness Decreased Elimination Increased risk of Postoperative Pulmonary Complications

34 Role for OPEP Therapy in PPCs? Recent Studies Postoperative OPEP in thoracic & upper abdominal surgery patients 1 Decreased risk of fever (statistically and clinically relevant) 2.6 day shorter hospital stays Well tolerated and accepted by patients with no adverse events PEP in postoperative coronary artery bypass graft (CABG) patients 2 Reduced rates of pulmonary complications (pneumonia) Improved pulmonary function Better 6 minute walk distances 1. Zhang X, Wang Q, et al. Journal of Physiotherapy Haeffener MP, Ferreira GM, et al. American Heart Journal; Nov 2008

35 Summary The Dawning of a New Era RT Departments MUST re-design traditional operations to compete in new environment of care realities: Align current practice with newer expectations Hospital s responsibility no longer ends at discharge Poorly treated chronic patients a huge financial liability Explore alternative post-discharge follow-up options Improving chronic care outcomes a new priority Make evidence-based care the rule, not the exception Advocate for protocol/algorithm directed practice Undertake value-analysis to eliminate low-value activities Explore high-value opportunities

36 44th Annual Conference & Exhibition July 9-11, 2015 Houston TX Respiratory Care : A New Profession is Evolving Patrick J. Dunne, MEd, RRT, FAARC HealthCare Productions, Inc. Fullerton, CA

Preoperative Pulmonary Evaluation: Truth and Fiction. What are this patientʼs risks? Goals for Today

Preoperative Pulmonary Evaluation: Truth and Fiction. What are this patientʼs risks? Goals for Today Preoperative Pulmonary Evaluation: Truth and Fiction Nichole G. Zehnder, MD Instructor in Internal Medicine Division of Hospital Medicine University of Colorado at Denver Hospital Medicine Group What are

More information

November 8, 2012 BEST PRACTICES IN RESPIRATORY CARE PRODUCTIVITY AND STAFFING

November 8, 2012 BEST PRACTICES IN RESPIRATORY CARE PRODUCTIVITY AND STAFFING AARC White Paper November 8, 2012 BEST PRACTICES IN RESPIRATORY CARE PRODUCTIVITY AND STAFFING This paper provides guidance and considerations in the application of the AARC Position Statement: Best Practices

More information

Proving Respiratory Therapy value in the Affordable Care Pay Structure

Proving Respiratory Therapy value in the Affordable Care Pay Structure Proving Respiratory Therapy value in the Affordable Care Pay Structure The Curve 2 2 No Margin No Mission (FFS) Outcomes 3 * 2001 study in five states found that medical debt contributed to 46.2% of all

More information

The New Complex Patient. of Diabetes Clinical Programming

The New Complex Patient. of Diabetes Clinical Programming The New Complex Patient as Seen Through the Lens of Diabetes Clinical Programming 1 Valerie Garrett, M.D. Medical Director, Diabetes Center at Mission Health System Nov 6, 2014 Diabetes Health Burden High

More information

Respiratory Care. A Life and Breath Career for You!

Respiratory Care. A Life and Breath Career for You! Respiratory Care A Life and Breath Career for You! Respiratory Care Makes a Difference At 9:32 am, Lori Moreno brought a newborn baby struggling to breathe back to life What have you accomplished today?

More information

Results of Surgery in a New Lung Institute in South Texas Focused on the Treatment of Lung Cancer

Results of Surgery in a New Lung Institute in South Texas Focused on the Treatment of Lung Cancer Results of Surgery in a New Lung Institute in South Texas Focused on the Treatment of Lung Cancer Lung cancer accounts for 13% of all cancer diagnoses and is the leading cause of cancer death in both males

More information

Rehabilitation and Lung Cancer Resection. Roberto Benzo MD MS Mindful Breathing Laboratory Division of Pulmonary & CCM Mayo Clinic

Rehabilitation and Lung Cancer Resection. Roberto Benzo MD MS Mindful Breathing Laboratory Division of Pulmonary & CCM Mayo Clinic Rehabilitation and Lung Cancer Resection Roberto Benzo MD MS Mindful Breathing Laboratory Division of Pulmonary & CCM Mayo Clinic Disclosure Funded by the National Cancer Institute NIH for Preoperative

More information

Presented by Kathleen S. Wyka, AAS, CRT, THE AFFORDABLE CA ACT AND ITS IMPACT ON THE RESPIRATORY C PROFESSION

Presented by Kathleen S. Wyka, AAS, CRT, THE AFFORDABLE CA ACT AND ITS IMPACT ON THE RESPIRATORY C PROFESSION Presented by Kathleen S. Wyka, AAS, CRT, THE AFFORDABLE CA ACT AND ITS IMPACT ON THE RESPIRATORY C PROFESSION At the end of this session, you will be able to: Identify ways RT skills can be utilized for

More information

THE AFFORDABLE CARE ACT ITS EFFECTS ON RESPIRATORY CARE & SLEEP DEPARTMENTS

THE AFFORDABLE CARE ACT ITS EFFECTS ON RESPIRATORY CARE & SLEEP DEPARTMENTS THE AFFORDABLE CARE ACT ITS EFFECTS ON RESPIRATORY CARE & SLEEP DEPARTMENTS SHANE KEENE, DHSC, RRT- NPS, CPFT, RPSGT, RST DEPARTMENT HEAD, ANALYTICAL AND DIAGNOSTIC SCIENCES UNIVERSITY OF CINCINNATI Mr.

More information

RT AS PROJECT MANAGER:

RT AS PROJECT MANAGER: RT AS PROJECT MANAGER: IMPROVING CARE TRANSITIONS DECREASES UNPLANNED READMISSIONS TAMMY JARNAGIN, BHS, RRT DIRECTOR CARDIOPULMONARY SERVICES, NEURODIAGNOSTICS, HOME MEDICAL EQUIPMENT Objectives Recognize

More information

Quality measures in healthcare

Quality measures in healthcare Quality measures in healthcare Henri Leleu Performance of healthcare systems (WHO 2000) Health Disability-adjusted life expectancy Responsiveness Respect of persons Client orientation Fairness France #1

More information

A STRATIFIED APPROACH TO PATIENT SAFETY THROUGH HEALTH INFORMATION TECHNOLOGY

A STRATIFIED APPROACH TO PATIENT SAFETY THROUGH HEALTH INFORMATION TECHNOLOGY A STRATIFIED APPROACH TO PATIENT SAFETY THROUGH HEALTH INFORMATION TECHNOLOGY Table of Contents I. Introduction... 2 II. Background... 2 III. Patient Safety... 3 IV. A Comprehensive Approach to Reducing

More information

Home Health Care Today: Higher Acuity Level of Patients Highly skilled Professionals Costeffective Uses of Technology Innovative Care Techniques

Home Health Care Today: Higher Acuity Level of Patients Highly skilled Professionals Costeffective Uses of Technology Innovative Care Techniques Comprehensive EHR Infrastructure Across the Health Care System The goal of the Administration and the Department of Health and Human Services to achieve an infrastructure for interoperable electronic health

More information

Preventing Readmissions

Preventing Readmissions Emerging Topics in Healthcare Reform Preventing Readmissions Janssen Pharmaceuticals, Inc. Preventing Readmissions The Patient Protection and Affordable Care Act (ACA) contains several provisions intended

More information

University of Kansas. Respiratory Care Education

University of Kansas. Respiratory Care Education University of Kansas Respiratory Care Education What is Respiratory Care? Respiratory Care is the health profession that specializes in the promotion of optimum cardiopulmonary function and health Respiratory

More information

Value Based Care and Healthcare Reform

Value Based Care and Healthcare Reform Value Based Care and Healthcare Reform Dimensions in Cardiac Care November, 2014 Jacqueline Matthews, RN, MS Senior Director, Quality Reporting & Reform Quality and Patient Safety Institute Cleveland Clinic

More information

What is an ACO? What forms of organizations may become an ACO? IAMSS 30 th Annual Education Conference Pearls of Wisdom

What is an ACO? What forms of organizations may become an ACO? IAMSS 30 th Annual Education Conference Pearls of Wisdom IAMSS 30 th Annual Education Conference Pearls of Wisdom The Impact of Accountable Care Organizations (ACOs) and Health Care Reform on Credentialing, Privileging and Peer Review April 28-29, 2011 Michael

More information

Medicare Respiratory Therapist Access Act - 2013

Medicare Respiratory Therapist Access Act - 2013 Medicare Respiratory Therapist Access Act - 2013 These Frequently Asked Questions (FAQs) are designed to provide insight into developing a legislative initiative, to discuss why AARC is taking a different

More information

Patient Optimization Improves Outcomes, Lowers Cost of Care >

Patient Optimization Improves Outcomes, Lowers Cost of Care > Patient Optimization Improves Outcomes, Lowers Cost of Care > Consistent preoperative processes ensure better care for orthopedic patients The demand for primary total joint arthroplasty is projected to

More information

Benefit Design and ACOs: How Will Private Employers and Health Plans Proceed?

Benefit Design and ACOs: How Will Private Employers and Health Plans Proceed? Benefit Design and ACOs: How Will Private Employers and Health Plans Proceed? Accountable Care Organizations: Implications for Consumers October 14, 2010 Washington, DC Sam Nussbaum, M.D. Executive Vice

More information

Description of the OECD Health Care Quality Indicators as well as indicator-specific information

Description of the OECD Health Care Quality Indicators as well as indicator-specific information Appendix 1. Description of the OECD Health Care Quality Indicators as well as indicator-specific information The numbers after the indicator name refer to the report(s) by OECD and/or THL where the data

More information

The Role of Telemedicine in Home Monitoring and Long Term Care June 7, 2012. Penny S. Milanovich President UPMC Visiting Nurses Association

The Role of Telemedicine in Home Monitoring and Long Term Care June 7, 2012. Penny S. Milanovich President UPMC Visiting Nurses Association The Role of Telemedicine in Home Monitoring and Long Term Care June 7, 2012 Penny S. Milanovich President UPMC Visiting Nurses Association Cost of Chronic Conditions An average of 40-50% of healthcare

More information

30 DAY COPD READMISSIONS AND PULMONARY REHAB

30 DAY COPD READMISSIONS AND PULMONARY REHAB 30 DAY COPD READMISSIONS AND PULMONARY REHAB Trina M. Limberg, Bs, RRT, FAARC, MAACVPR Director, Preventative Pulmonary and Rehabilitation Services UC San Diego Health System OVERVIEW The Impact of COPD

More information

J of Evolution of Med and Dent Sci/ eissn- 2278-4802, pissn- 2278-4748/ Vol. 3/ Issue 65/Nov 27, 2014 Page 13575

J of Evolution of Med and Dent Sci/ eissn- 2278-4802, pissn- 2278-4748/ Vol. 3/ Issue 65/Nov 27, 2014 Page 13575 EFFECT OF BREATHING EXERCISES ON BIOPHYSIOLOGICAL PARAMETERS AND QUALITY OF LIFE OF PATIENTS WITH COPD AT A TERTIARY CARE CENTRE Sudin Koshy 1, Rugma Pillai S 2 HOW TO CITE THIS ARTICLE: Sudin Koshy, Rugma

More information

The Why and How of a CDI Program. Deb Neville, RHIA, CCS-P, Elsevier/MC Strategies Donna Bonno, CPC- CPC-I, QuadraMed September 12, 2012

The Why and How of a CDI Program. Deb Neville, RHIA, CCS-P, Elsevier/MC Strategies Donna Bonno, CPC- CPC-I, QuadraMed September 12, 2012 The Why and How of a CDI Program Deb Neville, RHIA, CCS-P, Elsevier/MC Strategies Donna Bonno, CPC- CPC-I, QuadraMed September 12, 2012 Objectives Understand the reasons behind a Clinical Documentation

More information

FY 16 MHAC Methodology Redesign HSCRC Performance Measurement Work Group February 20, 2014

FY 16 MHAC Methodology Redesign HSCRC Performance Measurement Work Group February 20, 2014 FY 16 MHAC Methodology Redesign HSCRC Performance Measurement Work Group February 20, 2014 1 Presentation Contents Background: Reason to change, guiding principles, timing Measurement Methodology Payment

More information

Documenting & Coding. Chronic Obstructive Pulmonary Disease (COPD) Presented by: David S. Brigner, MLA, CPC

Documenting & Coding. Chronic Obstructive Pulmonary Disease (COPD) Presented by: David S. Brigner, MLA, CPC Documenting & Coding Chronic Obstructive Pulmonary Disease (COPD) Presented by: David S. Brigner, MLA, CPC Sr. Provider Training & Development Consultant Professional Profile David Brigner currently performs

More information

Chapter Seven Value-based Purchasing

Chapter Seven Value-based Purchasing Chapter Seven Value-based Purchasing Value-based purchasing (VBP) is a pay-for-performance program that affects a significant and growing percentage of Medicare reimbursement for medical providers. It

More information

Hospital to Physician Office to Home: A Respiratory Led Program Across the Continuum of Care

Hospital to Physician Office to Home: A Respiratory Led Program Across the Continuum of Care Hospital to Physician Office to Home: A Respiratory Led Program Across the Continuum of Care Charley P. Starnes, RRT, RCP Clinical Respiratory Specialist- COPD Education Important Milestones July 2011-

More information

Harnessing the Power of Data Analytics to Transform Care for Vulnerable Populations

Harnessing the Power of Data Analytics to Transform Care for Vulnerable Populations Harnessing the Power of Data Analytics to Transform Care for Vulnerable Populations Fred Cerise, MD, MPH President and CEO, Parkland Health and Hospital System Ruben Amarasingham, MD, MBA, President and

More information

A VISION TO TRANSFORM U.S. HEALTH CARE. The programs to make it a reality.

A VISION TO TRANSFORM U.S. HEALTH CARE. The programs to make it a reality. A VISION TO TRANSFORM U.S. HEALTH CARE. The programs to make it a reality. HCI 3 IMPROVING HEALTH CARE QUALITY AND VALUE with evidence-based incentive programs and a fair and powerful model for payment

More information

Overview and Legal Context

Overview and Legal Context Impact of ACOs on Physician/Provider Membership Decisions 0 Overview and Legal Context Michael R. Callahan Katten Muchin Rosenman LLP Vice Chair, Medical Staff Credentialing and Peer Review Practice Group

More information

Global Lab for Innovation

Global Lab for Innovation Global Lab for Innovation Innovation Profile IT for Cost-Effective Decision Making Cedars-Sinai Health System Clinical decision support and the Choosing Wisely guidelines are built into an Electronic Medical

More information

The Global Alliance against Chronic Respiratory Diseases

The Global Alliance against Chronic Respiratory Diseases The Global Alliance against Chronic Respiratory Diseases Pulmonary hypertension Dr Marc Humbert What is the burden of pulmonary hypertension? The true burden of pulmonary hypertension is currently unknown

More information

Provider Manual. Section 18.0 - Case Management and Disease Management

Provider Manual. Section 18.0 - Case Management and Disease Management Section 18.0 - Case Management and Disease Management 18.1.1 Introduction 18.2.1 Scope 18.3.1 Objectives 18.4.1 Procedures Case Management 18.4.1-A. Referrals 18.4.1-B. Case Management Mercy Maricopa Acute

More information

Value-Based Purchasing

Value-Based Purchasing Emerging Topics in Healthcare Reform Value-Based Purchasing Janssen Pharmaceuticals, Inc. Value-Based Purchasing The Patient Protection and Affordable Care Act (ACA) established the Hospital Value-Based

More information

Raising Sleep Apnea Awareness:

Raising Sleep Apnea Awareness: Raising Sleep Apnea Awareness: Among People with Diabetes in North Carolina, 2012 People with diabetes have more sleep problems than people without diabetes in the same age, sex, and race/ethnicity group.

More information

Frank R. Salvatore Jr., RRT, MBA, FAARC Administrator Ancillary Services Greater Hudson Valley Health System Middletown, NY AARC President 2015-2016

Frank R. Salvatore Jr., RRT, MBA, FAARC Administrator Ancillary Services Greater Hudson Valley Health System Middletown, NY AARC President 2015-2016 Frank R. Salvatore Jr., RRT, MBA, FAARC Administrator Ancillary Services Greater Hudson Valley Health System Middletown, NY AARC President 205-206 Dallas, TX Objectives Review the AARC Mission and Vision

More information

See page 331 of HEDIS 2013 Tech Specs Vol 2. HEDIS specs apply to plans. RARE applies to hospitals. Plan All-Cause Readmissions (PCR) *++

See page 331 of HEDIS 2013 Tech Specs Vol 2. HEDIS specs apply to plans. RARE applies to hospitals. Plan All-Cause Readmissions (PCR) *++ Hospitalizations Inpatient Utilization General Hospital/Acute Care (IPU) * This measure summarizes utilization of acute inpatient care and services in the following categories: Total inpatient. Medicine.

More information

Getting to value in high-value health care

Getting to value in high-value health care + Getting to value in high-value health care Ashish K. Jha, MD, MPH December 4 th, 2015 @ashishkjha + We have a value problem 1 + Value= Quality Costs + Quality is suboptimal 1 in 4 seniors injured during

More information

IDENTIFYING CLINICAL RESEARCH QUESTIONS THAT FIT PRACTICE PRIORITIES. Module I: Identifying Good Questions

IDENTIFYING CLINICAL RESEARCH QUESTIONS THAT FIT PRACTICE PRIORITIES. Module I: Identifying Good Questions 1 IDENTIFYING CLINICAL RESEARCH QUESTIONS THAT FIT PRACTICE PRIORITIES Module I: Identifying Good Questions Objective Describe how to find good clinical questions for research. 2 ntifying good clinical

More information

Best Practices in Managing Patients With Chronic Obstructive Pulmonary Disease (COPD)

Best Practices in Managing Patients With Chronic Obstructive Pulmonary Disease (COPD) Best Practices in Managing Patients With Chronic Obstructive Pulmonary Disease (COPD) DuPage Medical Group Case Study Organization Profile Established in 1999, DuPage Medical Group (DMG) is a multispecialty

More information

KIH Cardiac Rehabilitation Program

KIH Cardiac Rehabilitation Program KIH Cardiac Rehabilitation Program For any further information Contact: +92-51-2870361-3, 2271154 Feedback@kih.com.pk What is Cardiac Rehabilitation Cardiac rehabilitation describes all measures used to

More information

3/11/15. COPD Disease Management Tackling the Transition. Objectives. Describe the multidisciplinary approach to inpatient care for COPD patients

3/11/15. COPD Disease Management Tackling the Transition. Objectives. Describe the multidisciplinary approach to inpatient care for COPD patients Faculty Disclosures COPD Disease Management Tackling the Transition Dr. Cappelluti has no actual or potential conflicts of interest associated with this presentation. Jane Reardon has no actual or potential

More information

Improving Hospital Performance

Improving Hospital Performance Improving Hospital Performance Background AHA View Putting patients first ensuring their care is centered on the individual, rooted in best practices and utilizes the latest evidence-based medicine is

More information

Pulmonary Rehabilitation. Use it or lose it??? By John R. Goodman BS RRT

Pulmonary Rehabilitation. Use it or lose it??? By John R. Goodman BS RRT Pulmonary Rehabilitation Use it or lose it??? By John R. Goodman BS RRT Of all the forms of Rehabilitation that are available in medicine, pulmonary rehabilitation is a relative newcomer. For example Cardiac

More information

The Value of the Respiratory Therapist Delivering Respiratory Care

The Value of the Respiratory Therapist Delivering Respiratory Care The Value of the Respiratory Therapist Delivering Respiratory Care Tom Lamphere BS, RRT-ACCS, RPFT, FAARC Executive Director, Pennsylvania Society for Respiratory Care Instructor, Resp. Care Program Gwynedd

More information

Population Health and

Population Health and Population Health and Potentially Preventable Events 3M solutions for population health, patient safety and cost-effective care Challenge: Shifting the financial risk The healthcare industry seems to change

More information

Lowering Costs and Improving Outcomes. Patient Engagement Issues. Nancy Davenport-Ennis President & CEO. September 8 th, 2009

Lowering Costs and Improving Outcomes. Patient Engagement Issues. Nancy Davenport-Ennis President & CEO. September 8 th, 2009 The Healthcare Imperative: Lowering Costs and Improving Outcomes Patient Engagement Issues Nancy Davenport-Ennis President & CEO National Patient Advocate Foundation September 8 th, 2009 Institute of Medicine

More information

Modern care management

Modern care management The care management challenge Health plans and care providers spend billions of dollars annually on care management with the expectation of better utilization management and cost control. That expectation

More information

Rehabilitation s Role in Decreasing Returns to Acute Care

Rehabilitation s Role in Decreasing Returns to Acute Care Rehabilitation s Role in Decreasing Returns to Acute Care Glenda Mack, PT, MSPT, MBA, CLT, CWS Division Vice President Clinical Operations, RehabCare Objectives Participants will verbalize three primary

More information

Success and Survival in Pulmonary Rehab

Success and Survival in Pulmonary Rehab Success and Survival in Pulmonary Rehab 35 Years and Still Growing Valerie McLeod, RRT Manager, Pulmonary Rehabilitation McLaren Flint, MI Disclosure Information I have no disclosures. While some brands

More information

A Project to Reengineer Discharges Reduces 30-Day Hospital Readmission Rates. April 11, 2014

A Project to Reengineer Discharges Reduces 30-Day Hospital Readmission Rates. April 11, 2014 A Project to Reengineer Discharges Reduces 30-Day Hospital Readmission Rates April 11, 2014 About the QIO Program Leading rapid, large-scale change in health quality: Goals are bolder. The patient is at

More information

A MANAGER S GUIDE: HOW BETTER NURSE TO PATIENT RATIOS CAN IMPROVE THE HEALTH OF YOUR PATIENTS & LOWER STAFFING COSTS.

A MANAGER S GUIDE: HOW BETTER NURSE TO PATIENT RATIOS CAN IMPROVE THE HEALTH OF YOUR PATIENTS & LOWER STAFFING COSTS. A MANAGER S GUIDE: HOW BETTER NURSE TO PATIENT RATIOS CAN IMPROVE THE HEALTH OF YOUR PATIENTS & LOWER STAFFING COSTS. RN-TO-PATIENT RATIOS & PATIENT SAFETY RN-to-Patient ratio is another key component

More information

Guiding Protocolized Patient Care through Branching Logic. By Cindy Sparkman, BS, RRT-NPS and Mickey Roach, BS, RRT

Guiding Protocolized Patient Care through Branching Logic. By Cindy Sparkman, BS, RRT-NPS and Mickey Roach, BS, RRT Guiding Protocolized Patient Care through Branching Logic By Cindy Sparkman, BS, RRT-NPS and Mickey Roach, BS, RRT University of Utah 2 University of Utah FY2012 Hospitals and Clinics; 4 Hospitals 10 Community

More information

Main Section of the proposal: 1. Overall Aim & Objectives:

Main Section of the proposal: 1. Overall Aim & Objectives: Main Section of the proposal: 1. Overall Aim & Objectives: Over the past two decades Providence Health & Services has developed a comprehensive tobacco cessation program within our health system. The foundation

More information

Best Practices in Managing Patients With Chronic Obstructive Pulmonary Disease (COPD)

Best Practices in Managing Patients With Chronic Obstructive Pulmonary Disease (COPD) Best Practices in Managing Patients With Chronic Obstructive Pulmonary Disease (COPD) Harvard Vanguard Medical Associates Case Study Organization Profile Founded in the 1960s, Harvard Vanguard Medical

More information

The Target of an Organization

The Target of an Organization Respiratory Care 2015: What Does The Future Hold? Timothy R. Myers MBA, RRT-NPS Director, Women s & Children s Respiratory Care & Procedural Services and Pediatric Heart Center Rainbow Babies & Children

More information

Cardiopulmonary Physical Therapy. Haneul Lee, DSc, PT

Cardiopulmonary Physical Therapy. Haneul Lee, DSc, PT Cardiopulmonary Physical Therapy Haneul Lee, DSc, PT Airway ClearanceTechniques Breathing Exercise SpecialConsiderations for MechanicallyVentilated Exercise Injury Prevention and Equipment provision Patient

More information

Rural Pulmonary Rehab Program-

Rural Pulmonary Rehab Program- Rural Pulmonary Rehab Program- Saskatchewan s s First Presented by: Sandra Pieterse, Nurse Practitioner and Lia Boxall, Nurse Practitioner Kelsey Trail Health Region Kelsey Trail RHA 41,500 population

More information

How an Integrated Care Management Solution Can Help Employers and Third-Party Administrators (TPAs) Reduce Health Care Spend

How an Integrated Care Management Solution Can Help Employers and Third-Party Administrators (TPAs) Reduce Health Care Spend How an Integrated Care Solution Can Help Employers and Third-Party Administrators (TPAs) Reduce Health Care Spend It s no secret that as a nation, the United States is becoming increasingly unhealthy.

More information

Office of Rural Health Policy MEDICARE BENEFICIARY QUALITY IMPROVEMENT PROJECT

Office of Rural Health Policy MEDICARE BENEFICIARY QUALITY IMPROVEMENT PROJECT Office of Rural Health Policy MEDICARE BENEFICIARY QUALITY IMPROVEMENT PROJECT Paul Moore, DPh Senior Health Policy Advisor Office of Rural Health Policy Health Resources and Services Administration Department

More information

Pharmacology of the Respiratory Tract: COPD and Steroids

Pharmacology of the Respiratory Tract: COPD and Steroids Pharmacology of the Respiratory Tract: COPD and Steroids Dr. Tillie-Louise Hackett Department of Anesthesiology, Pharmacology and Therapeutics University of British Columbia Associate Head, Centre of Heart

More information

Readmissions as an Enterprise Priority. Presenters 4/17/2014

Readmissions as an Enterprise Priority. Presenters 4/17/2014 Readmissions as an Enterprise Priority April 24, 2014 Presenters Vincent A. Maniscalco, MPA, LNHA Administrator Middletown Park Rehabilitation and Health Care Center Vmaniscalco@parkmanorrehab.com Eileen

More information

AGENCY-SPECIFIC PLAN FOR THE NATIONAL QUALITY STRATEGY

AGENCY-SPECIFIC PLAN FOR THE NATIONAL QUALITY STRATEGY AGENCY-SPECIFIC PLAN FOR THE NATIONAL QUALITY STRATEGY Adult Medicaid Quality Grants Program The Adult Medicaid Quality Grants Program is a 2-year funding opportunity designed to support grantee Medicaid

More information

The meeting was called to order at 5:27 by the Chairman of the Executive Committee, Joseph Szot, M.D.

The meeting was called to order at 5:27 by the Chairman of the Executive Committee, Joseph Szot, M.D. Minutes Carver College of Medicine Fall Faculty Forum: Health Care Reform Legislation - Its Implementation and Impact on UI Health Care Tuesday, October 26, 2010 Presenters: Vice-President Jean Robillard,

More information

Marilyn Borkgren-Okonek, APN, CCNS, RN, MS Suburban Lung Associates, S.C. Elk Grove Village, IL

Marilyn Borkgren-Okonek, APN, CCNS, RN, MS Suburban Lung Associates, S.C. Elk Grove Village, IL Marilyn Borkgren-Okonek, APN, CCNS, RN, MS Suburban Lung Associates, S.C. Elk Grove Village, IL www.goldcopd.com GLOBAL INITIATIVE FOR CHRONIC OBSTRUCTIVE LUNG DISEASE GLOBAL STRATEGY FOR DIAGNOSIS, MANAGEMENT

More information

FY2015 Final Hospital Inpatient Rule Summary

FY2015 Final Hospital Inpatient Rule Summary FY2015 Final Hospital Inpatient Rule Summary Interventional Cardiology (IC) Peripheral Interventions (PI) Rhythm Management (RM) On August 4, 2014, the Centers for Medicare & Medicaid Services (CMS) released

More information

Creating Strategic Alliances for Post-Acute Coordination of Care

Creating Strategic Alliances for Post-Acute Coordination of Care Creating Strategic Alliances for Post-Acute Coordination of Care Kathleen Yosko, PhD President/CEO Wheaton Franciscan Health Care Sole Illinois property Free-standing facility 101 IRF beds 27 SNF beds

More information

Managing Surgical Services Lines Under Accountable Care and Value-Based Purchasing. Becker s Healthcare Jeffry Peters February 28, 2013

Managing Surgical Services Lines Under Accountable Care and Value-Based Purchasing. Becker s Healthcare Jeffry Peters February 28, 2013 Managing Surgical Services Lines Under Accountable Care and Value-Based Purchasing Becker s Healthcare Jeffry Peters February 28, 2013 Learning Objective How ACA/VBP changes how we measure surgical services

More information

Integrated Comprehensive Care Bundled Care

Integrated Comprehensive Care Bundled Care Integrated Comprehensive Care Bundled Care Health Council of Canada National Symposium on Integrated Care Oct 10, 2012 C. Gosse, K. Ciavarella St. Joseph s Health System SJHS is one of Canada s largest

More information

Post-Acute/Long- Term Care Planning for Accountable Care Organizations

Post-Acute/Long- Term Care Planning for Accountable Care Organizations White Paper Post-Acute/Long- Term Care Planning for Accountable Care Organizations SCORE A Model for Using Incremental Strategic Positioning as a Planning Tool for Participation in Future Healthcare Integrated

More information

Errors in the Operating Room. Patrick E. Voight RN BSN MSA CNOR President Association of perioperative Registered Nurses (AORN)

Errors in the Operating Room. Patrick E. Voight RN BSN MSA CNOR President Association of perioperative Registered Nurses (AORN) Errors in the Operating Room Patrick E. Voight RN BSN MSA CNOR President Association of perioperative Registered Nurses (AORN) What What We All We Strive All Strive For: For: Patient Patient Safety Safety

More information

Navigation and Cancer Rehabilitation

Navigation and Cancer Rehabilitation Navigation and Cancer Rehabilitation Messina Corder, RN, BSN, MBA Manager, MWHC Regional Cancer Center Regina Kenner, RN Cancer Navigator, MWHC Regional Cancer Center Cancer Action Coalition of Virginia

More information

RE: THO North Cardiac Health and Rehabilitation Submission on the Green Paper

RE: THO North Cardiac Health and Rehabilitation Submission on the Green Paper One Health System, Better Outcomes Department of Health and Human Services, GPO Box 125, Hobart, TAS, 7001 RE: THO North Cardiac Health and Rehabilitation Submission on the Green Paper The Cardiac Health

More information

All Patient Refined DRGs (APR-DRGs) An Overview. Presented by Treo Solutions

All Patient Refined DRGs (APR-DRGs) An Overview. Presented by Treo Solutions All Patient Refined DRGs (APR-DRGs) An Overview Presented by Treo Solutions Presentation Highlights History of inpatient classification systems APR-DRGs: what they are, how they work, and why they are

More information

Inpatient Cardiac Rehabilitation

Inpatient Cardiac Rehabilitation Inpatient Cardiac Rehabilitation John G. Leech, M.A. Manager of Cardiovascular and Pulmonary Rehabilitation Lexington Medical Center, West Columbia, S.C. Disclosures I have no commercial interests to disclose.

More information

The Impact of Accountable Care Organizations (ACOs) on Credentialing and Privileging

The Impact of Accountable Care Organizations (ACOs) on Credentialing and Privileging The Impact of Accountable Care Organizations (ACOs) on Credentialing and Privileging Michael R. Callahan Katten Muchin Rosenman LLP 525 W. Monroe Chicago, Illinois 312.902.5634 michael.callahan@kattenlaw.com

More information

caresy caresync Chronic Care Management

caresy caresync Chronic Care Management caresy Chronic Care Management THE PROBLEM Chronic diseases and conditions, including heart disease, diabetes, COPD and obesity, are among the most common, expensive, and preventable health problems in

More information

Regulatory and Legislative Action Since the September 2010 Membership Meeting:

Regulatory and Legislative Action Since the September 2010 Membership Meeting: MEMBERSHIP MEETING January 19, 2011 Delivery System Reform: Healthcare Workforce Issue: The passage of health reform will bring millions of newly insured individuals into the system and drive patients

More information

Measures for the Australian health system. Belinda Emms Health Care Safety and Quality Unit Australian Institute of Health and Welfare

Measures for the Australian health system. Belinda Emms Health Care Safety and Quality Unit Australian Institute of Health and Welfare Measures for the Australian health system Belinda Emms Health Care Safety and Quality Unit Australian Institute of Health and Welfare Two sets of indicators The National Safety and Quality Indicators Performance

More information

Concept Series Paper on Disease Management

Concept Series Paper on Disease Management Concept Series Paper on Disease Management Disease management is the concept of reducing health care costs and improving quality of life for individuals with chronic conditions by preventing or minimizing

More information

FROM DATA TO KNOWLEDGE: INTEGRATING ELECTRONIC HEALTH RECORDS MEANINGFULLY INTO OUR NURSING PRACTICE

FROM DATA TO KNOWLEDGE: INTEGRATING ELECTRONIC HEALTH RECORDS MEANINGFULLY INTO OUR NURSING PRACTICE FROM DATA TO KNOWLEDGE: INTEGRATING ELECTRONIC HEALTH RECORDS MEANINGFULLY INTO OUR NURSING PRACTICE Rayne Soriano MS, RN Manager of Nursing Informatics and Clinical Transformation Program Kaiser Permanente

More information

The Medicare Readmissions Reduction Program

The Medicare Readmissions Reduction Program The Medicare Readmissions Reduction Program Impact on Rural Hospitals Harvey Licht Varela Consulting Group August, 2013 CMS Readmissions Reduction Program: Authority Section 3025 of the Patient Protection

More information

Brandeis University The Heller School for Social Policy and Management

Brandeis University The Heller School for Social Policy and Management Health Care Cost Management in Massachusetts: A Discussion of Options Meeting #3: Boston, MA Conference Report Sponsored by: Health Care Cost Containment and Value-Based Insurance Design Presenter: Michael

More information

Why would we want to change a practice with a track record that has proven safe and that works well?

Why would we want to change a practice with a track record that has proven safe and that works well? Good morning, Mr. Chairman and distinguished members of the House Professional Licensure Committee. My name is Dr. Erin Sullivan. I am president of the Pennsylvania Society of Anesthesiologists and a board

More information

YOUR LUNG HEALTH THE ROLE OF THE RESPIRATORY THERAPIST. A seminar presented by the American Association for Respiratory Care

YOUR LUNG HEALTH THE ROLE OF THE RESPIRATORY THERAPIST. A seminar presented by the American Association for Respiratory Care YOUR LUNG HEALTH & THE ROLE OF THE RESPIRATORY THERAPIST A seminar presented by the American Association for Respiratory Care OVERVIEW The American Association for Respiratory Care has launched a national

More information

Achieving Quality and Value in Chronic Care Management

Achieving Quality and Value in Chronic Care Management The Burden of Chronic Disease One of the greatest burdens on the US healthcare system is the rapidly growing rate of chronic disease. These statistics illustrate the scope of the problem: Nearly half of

More information

EMR Effectiveness: The Positive Benefit Electronic Medical Record Adoption has on Mortality Rates

EMR Effectiveness: The Positive Benefit Electronic Medical Record Adoption has on Mortality Rates EMR Effectiveness: The Positive Benefit Electronic Medical Record Adoption has on Mortality Rates With clinical data and analytics support provided by Healthgrades 2 Executive Summary Given the billions

More information

Patient Flow and Care Transitions Strategy 2013-2018. Updated September 2014

Patient Flow and Care Transitions Strategy 2013-2018. Updated September 2014 Patient Flow and Care Transitions Strategy 2013-2018 Updated Introduction Island Health s Patient Flow and Care Transitions 2013-2018 Strategy builds on the existing work within the organization to address

More information

Prescription For Pennsylvania

Prescription For Pennsylvania Prescription for Pennsylvania A set of integrated practical strategies for Improving the health care of all Pennsylvanians, Making the health care system more efficient, and Containing costs. PA Family

More information

How Health Reform Will Affect Health Care Quality and the Delivery of Services

How Health Reform Will Affect Health Care Quality and the Delivery of Services Fact Sheet AARP Public Policy Institute How Health Reform Will Affect Health Care Quality and the Delivery of Services The recently enacted Affordable Care Act contains provisions to improve health care

More information

Project 2015: It s 2015 and Where are We?

Project 2015: It s 2015 and Where are We? Project 2015: It s 2015 and Where are We? 6-2-15 CSRT Bob Kacmarek PhD, RRT Harvard Medical School Massachusetts General Hospital Boston, Massachusetts Conflict of Interest Disclosure Robert M Kacmarek

More information

ESSENTIA HEALTH AS AN ACO (ACCOUNTABLE CARE ORGANIZATION)

ESSENTIA HEALTH AS AN ACO (ACCOUNTABLE CARE ORGANIZATION) ESSENTIA HEALTH AS AN ACO (ACCOUNTABLE CARE ORGANIZATION) Hello and welcome. Thank you for taking part in this presentation entitled "Essentia Health as an ACO or Accountable Care Organization -- What

More information

NEVER EVENT LISTS ENDORSED BY NATIONAL QUALITY FORUM & MEDICARE

NEVER EVENT LISTS ENDORSED BY NATIONAL QUALITY FORUM & MEDICARE Never Events : Medicare s and Health Plan s Policies on Providing Payment for Serious and Preventable Hospital Errors BACKGROUND Preventable medical errors are a leading cause of death in the United States

More information

The Value Quadrant of Healthcare Reform. 2008 Pharos Innovations, LLC. All Rights Reserved.

The Value Quadrant of Healthcare Reform. 2008 Pharos Innovations, LLC. All Rights Reserved. The Value Quadrant of Healthcare Reform ACOs in PPACA Provider Organizations or networked groups Accountable for quality, cost and overall care of defined population of Medicare FFS benes Key metrics to

More information

Waterloo Wellington Rehabilitative Care System Integrated Care Pathway for COPD Stream of Care (short version)

Waterloo Wellington Rehabilitative Care System Integrated Care Pathway for COPD Stream of Care (short version) Waterloo Wellington Rehabilitative Care System Integrated Care Pathway for COPD Stream of Care (short version) Care Setting ACUTE Activity Confirmation of COPD diagnoses: If time and the patient s condition

More information

Improving Care for Chronic Obstructive Pulmonary Disease (COPD) Coalition Grant Program PROJECT OVERVIEW & RECOMMENDATIONS

Improving Care for Chronic Obstructive Pulmonary Disease (COPD) Coalition Grant Program PROJECT OVERVIEW & RECOMMENDATIONS Improving Care for Chronic Obstructive Pulmonary Disease (COPD) Coalition Grant Program PROJECT OVERVIEW & RECOMMENDATIONS Executive Summary Chronic Obstructive Pulmonary Disease (COPD) is a common chronic

More information

2015 and Beyond. The Process of Charting a Future for the Respiratory Therapy Profession

2015 and Beyond. The Process of Charting a Future for the Respiratory Therapy Profession 2015 and Beyond The Process of Charting a Future for the Respiratory Therapy Profession Questions to Be Addressed How will patients receive healthcare services in the future? How will respiratory therapy

More information

Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases

Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases Epidemiology Over 145 million people ( nearly half the population) - suffer from asthma, depression and other chronic

More information