Integration of BOOST Into an Electronic Health Record (EHR) Case Study: Northern Arizona Healthcare

Size: px
Start display at page:

Download "Integration of BOOST Into an Electronic Health Record (EHR) Case Study: Northern Arizona Healthcare"

Transcription

1 Integration of BOOST Into an Electronic Health Record (EHR)

2 Overview, a nonprofit healthcare system, provides healthcare services through two hospitals (Flagstaff Medical Center and Verde Valley Medical Center) and serves more than 700,000 patients in communities across the region. In October 2015, Cerner, a global leader in healthcare technology, and the Society of Hospital Medicine (SHM) announced the integration of SHM s Project BOOST into Cerner s Readmission Prevention Solution, available within the Cerner Millennium Electronic Health Record (EHR). The integration included: >A utomated early identification of specific readmission risk factors and corresponding interventions >G eneral Assessment of Preparedness checklist to help identify patient concerns about their readiness to leave the hospital >S implified patient-centered discharge instructions to help safely transition a patient home > Teach Back education process and documentation to help patients comprehend pertinent information related to their hospitalization and transition 1

3 The Problem Prior to the integration with Project BOOST, the transition team at had been disorganized, didn t have a multi-disciplinary approach and needed to identify a model to help guide them forward in a comprehensive way. The Timeline began implementing SHM s award-winning Project BOOST (Better Outcomes by Optimizing Safe Transitions) in A national initiative designed to improve the care of patients and reduce risks for medical complications as they transition from hospital to home, the BOOST program was instrumental in helping their team analyze their situation more deeply and ask the right questions. Tiffany Ferguson, LMSW, ACM, social work manager, stated, The program was great but we originally started with paper and were losing data and had a hard time tracking BOOST assessment. Then, in May 2014, became one of the first to pilot the Cerner EHR/Project BOOST integrated solution. The Solution The administration at made their case to be part of Project BOOST and received the C-level buy-in and support to move forward with this program. The program was great but we originally started with paper and were losing data and had a hard time tracking BOOST assessment. 2

4 The Experience Since the implementation of Project BOOST through the Cerner EHR system, many processes and work flows have changed in the institution. The health system was able to create a note addressing all of the 8 Ps. This is a risk assessment tool comprising of a checklist of risks that should be identified and addressed for each hospitalized patient. What was once a huge manual undertaking could now be integrated into the system. The team worked with readmissions and pushed to have BOOST incorporated into the platforms, and began to add risk scores and Patient Health Questionnaires (PHQ-2s) on every patient who screened to the care management team. The PHQ-2 or PHQ-9 processes were very beneficial, especially with ambulatory measures. It put Northern Arizona Healthcare ahead of the curve and helped with the behavioral health and depression scores. Teach Back is a patient-centered communication style in which providers confirm that patients actually comprehend what the providers say to them. Providers can accomplish this by speaking slowly with their patients, avoiding medical jargon and explaining important skills or new knowledge carefully to the patients. It is vital to take the time to ask patients to explain in their own words their understanding of what they learned. It takes practice and is an approach that every hospital should be doing as a routine process. Teach Back was implemented across the hospital in year one and continued with education the next few years until it became part of the organizational culture and part of the discharge and follow-up phone call process. With the implementation of interdisciplinary geographic rounds, we saw a decrease in LOS and increase in satisfaction of the care team. After several years, the rounds stopped for various reasons. We are hoping we can implement rounds again in the future as they did work well, said Lisa Brugh RN, MS, ACM System Director of Care Management at. The automation of Project BOOST workflow is saving our clinicians an average of one hour per patient, said Ferguson. This allows our clinicians to reach more patients and spend more time at the bedside, resulting in better patient care and outcomes. The implementation and automation of Project BOOST has helped to build up the hand-off and transitions of care especially on the inpatient side and has brought disciplines together. The system transitioned from being siloed to now having a multi-disciplinary approach. For example, pharmacy now has a focus on high medications, and a 9th P called Physical Limitations was added to bring therapy services into the interdisciplinary team. 3

5 Conclusion/Results Since having BOOST as part of the Cerner system, : >H as received 5 stars for quality within Medicare s Hospital Compare >N umber 31 in the country for lowest readmission rates >R ealized a reduction of all-cause readmissions by more than 45 percent >W as rated in the top 1 percent for all-cost readmission rate >H as not received a readmission penalty in the last three years ( ) >S cored in the top 10 percentile on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) illustrating that patient satisfaction has improved Cerner clients can take advantage of resources including a step-by-step instruction and project management Implementation Guide, the BOOST Online Community (equips) to learn from and collaborate with other sites, and the BOOST Data Center that allows users to sort and benchmark data against control units and other providers. In addition, provider sites, can elect to join the Project BOOST Mentored Implementation Program, which includes in-person training and a year of mentoring and coaching. Transitions Team celebrating their low readmission rate in

Coordinating Transitions of Care: It Takes a Village

Coordinating Transitions of Care: It Takes a Village Coordinating Transitions of Care: It Takes a Village Ken Laube RN, BSN, MBA: Vice President Clinical Excellence Situation/Background Patients face significant challenges when moving from one health care

More information

WHITE PAPER. How a multi-tiered strategy can reduce readmission rates and significantly enhance patient experience

WHITE PAPER. How a multi-tiered strategy can reduce readmission rates and significantly enhance patient experience WHITE PAPER How a multi-tiered strategy can reduce readmission rates and significantly enhance patient experience Vocera Communications, Inc. June, 2014 SUMMARY Hospitals that reduce readmission rates

More information

IT S TIME! PRIMARIS EHR SOLUTION. Benefits of Operational Efficiency. Why Primaris?

IT S TIME! PRIMARIS EHR SOLUTION. Benefits of Operational Efficiency. Why Primaris? IT S TIME! PRIMARIS EHR SOLUTION For years, Primaris has advocated the use of health information technology to improve patient care. We help providers take full advantage of their electronic health records

More information

Leadership Summit for Hospital and Post-Acute Long Term Care Providers May 12, 2015

Leadership Summit for Hospital and Post-Acute Long Term Care Providers May 12, 2015 Leveraging the Continuum to Avoid Unnecessary Utilization While Improving Quality Leadership Summit for Hospital and Post-Acute Long Term Care Providers May 12, 2015 Karim A. Habibi, FHFMA, MPH, MS Senior

More information

Person-Centered Nurse Care Management in Home Based Care: Impact on Well-Being and Cost Containment

Person-Centered Nurse Care Management in Home Based Care: Impact on Well-Being and Cost Containment Person-Centered Nurse Care Management in Home Based Care: Impact on Well-Being and Cost Containment Donna Zazworsky, RN, MS, CCM, FAAN Vice President: Community Health and Continuum Care Carondelet Health

More information

University Hospitals. May 2010

University Hospitals. May 2010 University s May 2010 The Organization University s (UH) is a diverse, not-for-profit integrated delivery system serving northeastern Ohio. The UH system consists of UH Case Medical Center, a major academic

More information

Changing the culture of any organization is well known to be a long process,

Changing the culture of any organization is well known to be a long process, Creative Nursing, Volume 18, Issue 4, 2012 Impact of Unit Practice Councils on Culture and Outcomes Susan Wessel, MS, MBA, RN, NEA-BC This article describes positive outcomes in culture, Hospital Consumer

More information

The Power of One: The Challenge of Centralized Scheduling. Tamela Dodds, Danielle Stern

The Power of One: The Challenge of Centralized Scheduling. Tamela Dodds, Danielle Stern The Power of One: The Challenge of Centralized Scheduling Tamela Dodds, Danielle Stern Your Speakers Tamela Dodds Operations Manager Cincinnati Children s Hospital Medical Center Danielle Stern, MHA Service

More information

Advanced Clinical Decision Support Software. tools for Nurses

Advanced Clinical Decision Support Software. tools for Nurses Advanced Clinical Decision Support Software tools for Nurses PowerForm Search Measurements Height / Weight / Allergy Advisor Why did we develop this software? Why did we develop this software? This software

More information

Running head: APPLICATION OF CONCEPTUAL FRAMEWORK 1. The Nursing Role Effectiveness Model. Theoretical Application to a Proposed Scholarly Project

Running head: APPLICATION OF CONCEPTUAL FRAMEWORK 1. The Nursing Role Effectiveness Model. Theoretical Application to a Proposed Scholarly Project Running head: APPLICATION OF CONCEPTUAL FRAMEWORK 1 The Nursing Role Effectiveness Model Theoretical Application to a Proposed Scholarly Project Lesley L. Loder University Alabama, Birmingham APPLICATION

More information

Creating an environment for patient-centered care

Creating an environment for patient-centered care Cerner Smart Room: Creating an environment for patient-centered care Prepared by Cerner Corporation TM When Cerner came along with this technology, we said, that s it that s going to make a huge difference.

More information

REACHING ZERO DEFECTS IN CORE MEASURES. Mary Brady, RN, MS Ed, Senior Nursing Consultant, Healthcare Transformations LLC,

REACHING ZERO DEFECTS IN CORE MEASURES. Mary Brady, RN, MS Ed, Senior Nursing Consultant, Healthcare Transformations LLC, REACHING ZERO DEFECTS IN CORE MEASURES Mary Brady, RN, MS Ed, Senior Nursing Consultant, Healthcare Transformations LLC, 165 Lake Linden Dr., Bluffton SC 29910, 843-364-3408, marybrady6@gmail.com Primary

More information

RED, BOOST, and You: Improving the Discharge Transition of Care

RED, BOOST, and You: Improving the Discharge Transition of Care RED, BOOST, and You: Improving the Discharge Transition of Care Jeffrey L. Greenwald, MD, SFHM Massachusetts General Hospital - Clinician Educator Service Co-Investigator Project RED & Project BOOST The

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

ADDRESSING HEALTHCARE DATA INTEGRATION TO AUTOMATE PATIENT ENGAGEMENT WORKFLOWS

ADDRESSING HEALTHCARE DATA INTEGRATION TO AUTOMATE PATIENT ENGAGEMENT WORKFLOWS ADDRESSING HEALTHCARE DATA INTEGRATION TO AUTOMATE PATIENT ENGAGEMENT WORKFLOWS STAFF COMMUNICATION EMR NURSE CALL SYSTEM REAL-TIME LOCATION PATIENT EDUCATION ADT DIETARY SYSTEMS ENTERTAINMENT ORDERS CHARTING

More information

Our Patient-Centered Medical Home a Process, not a Click

Our Patient-Centered Medical Home a Process, not a Click Our Patient-Centered Medical Home a Process, not a Click Richard Johnston, M.D. President, Medical Clinic of North Texas, P.A. Medical Clinic of North Texas, P.A. MCNT Physician Owned Primary Care Medical

More information

Reducing Readmissions with Predictive Analytics

Reducing Readmissions with Predictive Analytics Reducing Readmissions with Predictive Analytics Conway Regional Health System uses analytics and the LACE Index from Medisolv s RAPID business intelligence software to identify patients poised for early

More information

THE ACTIVELY CONNECTED PHYSICIAN

THE ACTIVELY CONNECTED PHYSICIAN THE ACTIVELY CONNECTED PHYSICIAN How Direct Messaging Leads to Improved Patient Care OVERVIEW Health care connectivity made great strides in 2014. As more health delivery networks, hospitals and physicians

More information

Transitions of Care: The need for a more effective approach to continuing patient care

Transitions of Care: The need for a more effective approach to continuing patient care H O T T O P I C S I N H E A L T H C A R E Transitions of Care: The need for a more effective approach to continuing patient care The need for a more effective approach to continuing patient care This paper

More information

Kick off Meeting November 11 13, 2015. MERCY CLINIC EAST COMMUNITIES Management of Patients with Heart Failure (HF)

Kick off Meeting November 11 13, 2015. MERCY CLINIC EAST COMMUNITIES Management of Patients with Heart Failure (HF) Kick off Meeting November 11 13, 2015 MERCY CLINIC EAST COMMUNITIES Management of Patients with Heart Failure (HF) Team Composition Justin Huynh, MD Internal Medicine, Physician Champion Mary Laubinger,

More information

Adopting a Continuous Integration / Continuous Delivery Model to Improve Software Delivery

Adopting a Continuous Integration / Continuous Delivery Model to Improve Software Delivery Customer Success Stories TEKsystems Global Services Adopting a Continuous Integration / Continuous Delivery Model to Improve Software Delivery COMMUNICATIONS AGILE TRANSFORMATION SERVICES Executive Summary

More information

Patient-Centered Care. Patient-Centered Care: QSEN Competency Definition. Learner Objectives. Patient-Centered Care 01/29/2014

Patient-Centered Care. Patient-Centered Care: QSEN Competency Definition. Learner Objectives. Patient-Centered Care 01/29/2014 Patient-Centered Care Karen N. Drenkard, PhD, RN, NEA-BC, FAAN Chief Clinical/Nursing Officer GetWellNetwork, Inc. This program generously funded by the Robert Wood Johnson Foundation Patient-Centered

More information

NYSPFP Preventable Readmissions Initiative: Pilot Review and Post Hospital Care

NYSPFP Preventable Readmissions Initiative: Pilot Review and Post Hospital Care NYSPFP Preventable Readmissions Initiative: Pilot Review and Post Hospital Care June 17, 2014 A partnership of the Healthcare Association of New York State and the Greater New York Hospital Association

More information

UW Health strategic plan Refocus and Renew

UW Health strategic plan Refocus and Renew UW Health strategic plan Refocus and Renew 2013-2015 MISSION: Our Reason for Being Advancing health without compromise through: Service Scholarship Science Social Responsibility VISION: Our place in the

More information

Test Content Outline Effective Date: January 12, 2016. Nurse Executive Board Certification Examination

Test Content Outline Effective Date: January 12, 2016. Nurse Executive Board Certification Examination Board Certification Examination There are 175 questions on this examination. Of these, 150 are scored questions and 25 are pretest questions that are not scored. Pretest questions are used to determine

More information

PCMH and Care Management: Where do we start?

PCMH and Care Management: Where do we start? PCMH and Care Management: Where do we start? Patricia Bohs, RN, BSN Quality Assurance Manager Kelly McCloughan QA Data Manager Wayne Memorial Community Health Centers Honesdale, PA Wayne Memorial Community

More information

Patient Reported Outcomes for Mental Health Services: Current Practice and Future Possibilities

Patient Reported Outcomes for Mental Health Services: Current Practice and Future Possibilities Patient Reported Outcomes for Mental Health Services: Current Practice and Future Possibilities Arne Beck, PhD Kaiser Permanente Colorado Institute for Health Research September 12, 2012 DRAFT For Discussion

More information

Emerging g Trends in Home Care

Emerging g Trends in Home Care Emerging g Trends in Home Care Dana Sheer, ACNP, MSN Susan Beausoliel, BSN, MS, DNP 1 The Triple Aim Goals Quality Improve Patient Outcomes Goal Readmissions Cost Reduce costs/penalties associated w/ readmissions

More information

Oils. Heart-Healthy CONFERENCE ISSUE. American Heart Month. The Newest Trends in the Dairy-Free Aisle. Plan Healthful Vegan Diets

Oils. Heart-Healthy CONFERENCE ISSUE. American Heart Month. The Newest Trends in the Dairy-Free Aisle. Plan Healthful Vegan Diets CONFERENCE ISSUE Vol. 17 No. 2 February 2015 The Magazine for Nutrition Professionals Heart-Healthy Oils Learn about the latest varieties and science on the healthful fats they contain. American Heart

More information

HCAHPS and Hospital Value-Based Purchasing (Hospital VBP)

HCAHPS and Hospital Value-Based Purchasing (Hospital VBP) Agency for Healthcare Research and Quality Advancing Excellence in Health Care www.ahrq.gov HCAHPS and Hospital Value-Based Purchasing (Hospital VBP) Agency for Healthcare Research and Quality Centers

More information

Emerging Technologies That Support Transitions of Care. 8 June 2016 Elaine Remmlinger, Senior Partner, and Robin Settle, Partner

Emerging Technologies That Support Transitions of Care. 8 June 2016 Elaine Remmlinger, Senior Partner, and Robin Settle, Partner Emerging Technologies That Support Transitions of Care 8 June 2016 Elaine Remmlinger, Senior Partner, and Robin Settle, Partner Topics of Discussion Drivers of Transitions of Care Technology Perspective:

More information

Patient Centered Medical Home: An Approach for the Health Plan

Patient Centered Medical Home: An Approach for the Health Plan : An Approach for the Health Plan By Marissa A. Harper and JoAnn E. Balara Excellence in healthcare consulting The Medical Home Concept Works Recent Medicare demonstration projects on Patient Centered

More information

Sanford Improvement Making Lean Work in Healthcare

Sanford Improvement Making Lean Work in Healthcare Sanford Improvement Making Lean Work in Healthcare David Peterson Enterprise Director of Continuous Improvement Outline/Agenda Office of Continuous Improvement Who are we and what do we do? History/Journey

More information

Realizing ACO Success with ICW Solutions

Realizing ACO Success with ICW Solutions Realizing ACO Success with ICW Solutions A Pathway to Collaborative Care Coordination and Care Management Decrease Healthcare Costs Improve Population Health Enhance Care for the Individual connect. manage.

More information

Combined Assessment Program Summary Report. Evaluation of Pressure Ulcer Prevention and Management at Veterans Health Administration Facilities

Combined Assessment Program Summary Report. Evaluation of Pressure Ulcer Prevention and Management at Veterans Health Administration Facilities Department of Veterans Affairs Office of Inspector General Report No. 14-05132-90 Office of Healthcare Inspections Combined Assessment Program Summary Report Evaluation of Pressure Ulcer Prevention and

More information

Example of a CNL sm Job Description for An Acute Care Setting

Example of a CNL sm Job Description for An Acute Care Setting Example of a CNL sm Job Description for An Acute Care Clinical Nurse Leader sm Required Competencies & Role Responsibilities NOTE: This job description was developed using the broad areas of the role and

More information

Improving Care Transitions using PDSA Methodology

Improving Care Transitions using PDSA Methodology Improving Care Transitions using PDSA Methodology Catherine Payne, MD, FHM Care Transitions Physician Champion Medical Director of Clinical Informatics Erlanger Medical Center Chattanooga, Tennessee Objectives

More information

ORGANIZATIONAL ASSESSMENT TOOLKIT FOR PRIMARY AND BEHAVIORAL HEALTH CARE INTEGRATION

ORGANIZATIONAL ASSESSMENT TOOLKIT FOR PRIMARY AND BEHAVIORAL HEALTH CARE INTEGRATION ORGANIZATIONAL ASSESSMENT TOOLKIT FOR PRIMARY AND BEHAVIORAL HEALTH CARE INTEGRATION SEPTEMBER 2014 ACKNOWLEDGEMENTS This document was prepared for the SAMHSA-HRSA Center for Integrated Health Solutions

More information

BENCHMARKING EMR ADOPTION FOR HELSIT 2013

BENCHMARKING EMR ADOPTION FOR HELSIT 2013 Subtitle BENCHMARKING EMR ADOPTION FOR HELSIT 2013 Introduction to EMRAM & status as of Q2/2013 PRESENTED BY: DANIEL CZERMAK-WÄNN, NORDIC CLIENT RELATIONS MANAGER, HIMSS ANALYTICS EUROPE HIMSS Analytics

More information

Project BOOST: A Return On Investment Analysis

Project BOOST: A Return On Investment Analysis Project BOOST: A Return On Investment Analysis dsfjk Project BOOST: A Return On Investment Analysis SHM 2010 1 Reducing Hospital Readmissions: Who benefits? Who pays? The US Department of Health and Human

More information

Indiana University Interprofessional Collaborative Practice (IPCP)

Indiana University Interprofessional Collaborative Practice (IPCP) Indiana University Interprofessional Collaborative Practice (IPCP) Julie LaMothe, MSN, CPNP, RN, Grant Project Manager, Indiana University School of Nursing Jennifer Dunscomb, MSN, RN, CCRN IU Health Methodist

More information

Tips and Strategies on Handoffs

Tips and Strategies on Handoffs Tips and Strategies on Handoffs In 2007, the Handoffs & Transitions Learning Network (H&T) was established to support the mid-atlantic healthcare community in tackling the complex problem of handoffs and

More information

Assessing Risk of Readmission. NoCVA Preventing Avoidable Readmission Collaborative Laura Maynard, MDiv, NCQC Amanda Hobbs, NCQC July 31, 2013

Assessing Risk of Readmission. NoCVA Preventing Avoidable Readmission Collaborative Laura Maynard, MDiv, NCQC Amanda Hobbs, NCQC July 31, 2013 Assessing Risk of Readmission NoCVA Preventing Avoidable Readmission Collaborative Laura Maynard, MDiv, NCQC Amanda Hobbs, NCQC July 31, 2013 Collaborative Goals Reduce readmission rates by 20% Increase

More information

MaineCare Value Based Purchasing Initiative

MaineCare Value Based Purchasing Initiative MaineCare Value Based Purchasing Initiative The Accountable Communities Strategy Jim Leonard, Deputy Director, MaineCare Peter Kraut, Acting Accountable Communities Program Manager Why Value-Based Purchasing

More information

The Electronic Health Record in Private Practice

The Electronic Health Record in Private Practice The Electronic Health Record in Private Practice A choice or Just putting off the Inevitable Claude Garbarino, CCS Why the EHR? Medical care getting more complex. New information overwhelming physicians

More information

1a-b. Title: Clinical Decision Support Helps Memorial Healthcare System Achieve 97 Percent Compliance With Pediatric Asthma Core Quality Measures

1a-b. Title: Clinical Decision Support Helps Memorial Healthcare System Achieve 97 Percent Compliance With Pediatric Asthma Core Quality Measures 1a-b. Title: Clinical Decision Support Helps Memorial Healthcare System Achieve 97 Percent Compliance With Pediatric Asthma Core Quality Measures 2. Background Knowledge: Asthma is one of the most prevalent

More information

NICHE: Innovations and Nursing Practice

NICHE: Innovations and Nursing Practice NICHE: Innovations and Nursing Practice nicheprogram.org Linda Bub MSN, RN, GCNS-BC Director of Education and Program Development, NICHE Objectives Describe the NICHE program and the impact on nursing

More information

Agenda. Topic Industry Today - Quality Measure Reporting Stage 1 Meaningful Use - Overview - Tenet Experience

Agenda. Topic Industry Today - Quality Measure Reporting Stage 1 Meaningful Use - Overview - Tenet Experience Achieving Meaningful Use Symposium Eligible Hospital Perspective Stage 1 Learnings, Stage 2 Preparation Liz Johnson, MS, FHIMSS, CPHIMS, RN-BC, VP, Applied Clinical Informatics, Tenet Health DISCLAIMER:

More information

Patient Experience. The Cleveland Clinic Journey. American Medical Group Association Orlando, Florida March 14, 2013

Patient Experience. The Cleveland Clinic Journey. American Medical Group Association Orlando, Florida March 14, 2013 Patient Experience The Cleveland Clinic Journey American Medical Group Association Orlando, Florida March 14, 2013 James Merlino, MD Chief Experience Officer Overview How did Cleveland Clinic change their

More information

Moving Ethics into Ambulatory Care: The Future of Catholic Health Care Ethics in Shifting Delivery Trends

Moving Ethics into Ambulatory Care: The Future of Catholic Health Care Ethics in Shifting Delivery Trends Moving Ethics into Ambulatory Care: The Future of Catholic Health Care Ethics in Shifting Delivery Trends Rachelle Barina Ethics Consultant SSM Health Care Saint Louis, MO rachelle_barina@ssmhc.com Emily

More information

Risk Assessment Model

Risk Assessment Model Transitions of Care and Readmissions Focus on Risk Assessment (and what to do with results) Greg Maynard MD, MSc Clinical Professor of Medicine, Division of Hospital Medicine Director, UCSD Center for

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

AHRQ Patient Safety Tools and Resources

AHRQ Patient Safety Tools and Resources AHRQ Patient Safety Tools and Resources The Agency for Healthcare Research and Quality (AHRQ) offers practical, research-based tools and resources to help a variety of health care organizations, providers,

More information

Profile: Incorporating Routine Behavioral Health Screenings Into the Patient-Centered Medical Home

Profile: Incorporating Routine Behavioral Health Screenings Into the Patient-Centered Medical Home 104 A LOOK TO THE FUTURE Profile: Incorporating Routine Behavioral Health Screenings Into the Patient-Centered Medical Home Background Management of chronic diseases can be challenging in primary care,

More information

How MissionPoint Health is Using Population Health Insights to Achieve ACO Success

How MissionPoint Health is Using Population Health Insights to Achieve ACO Success How MissionPoint Health is Using Population Health Insights to Achieve ACO Success Background The United States spends more per capita on healthcare than other country, yet is ranked last among industrialized

More information

Home Health Care: A More Cost-Effective Approach to Medicaid in Illinois Illinois HomeCare & Hospice Council December 2010

Home Health Care: A More Cost-Effective Approach to Medicaid in Illinois Illinois HomeCare & Hospice Council December 2010 Home Health Care: A More Cost-Effective Approach to Medicaid in Illinois Illinois HomeCare & Hospice Council December 2010 As the Illinois Legislature prepares to act on the future of Medicaid, it is important

More information

Nancy L. Wilson Department of Medicine-Geriatrics Houston Center for Quality of Care& Utilization Studies Texas Consortium of Geriatric Education

Nancy L. Wilson Department of Medicine-Geriatrics Houston Center for Quality of Care& Utilization Studies Texas Consortium of Geriatric Education 1 Nancy L. Wilson Department of Medicine-Geriatrics Houston Center for Quality of Care& Utilization Studies Texas Consortium of Geriatric Education Centers Care for Elders Governing Council Acknowledge

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

Leveraging EHR to Improve Patient Safety: A Davies Story

Leveraging EHR to Improve Patient Safety: A Davies Story Leveraging EHR to Improve Patient Safety: A Davies Story Claudia Colgan, Vice President of Quality Initiatives Bruce Darrow, MD, PhD, Interim Chief Medical Information Officer Jill Kalman, MD, Director

More information

CARE MANAGEMENT SERIES Part 6 Developing a Staffing Model That Works

CARE MANAGEMENT SERIES Part 6 Developing a Staffing Model That Works CARE MANAGEMENT SERIES Part 6 Developing a Staffing Model That Works We will get to staffing but let s start by reviewing core functions. Care Management As we have discussed previously, Care Management

More information

Elim Park Health Care Center. Clinical Excellence and Quality Report

Elim Park Health Care Center. Clinical Excellence and Quality Report 2014 Elim Park Health Care Center Clinical Excellence and Quality Report Welcome to Elim Park Health Care Center s 2014 Clinical Excellence and Quality Report. We have been providing patient focused quality

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

6/10/2010 DISCLOSURES - NONE INTEGRATING QSEN COMPETENCIES INTO NURSING EDUCATION

6/10/2010 DISCLOSURES - NONE INTEGRATING QSEN COMPETENCIES INTO NURSING EDUCATION INTEGRATING QSEN COMPETENCIES INTO NURSING EDUCATION Brenda Zierler, PhD, RN, RVT University of Washington School of Nursing DISCLOSURES - NONE Brenda Zierler, PhD, RN, RVT University of Washington School

More information

Delivering Value for a New Generation of Hospital Medicine. www.hospitalistsnow.com

Delivering Value for a New Generation of Hospital Medicine. www.hospitalistsnow.com Delivering Value for a New Generation of Hospital Medicine www.hospitalistsnow.com 1 Welcome to hospitalistsnow. Advancing the health of your hospital. Management Services 1 Quality-focused Metrics-driven

More information

Comments to the HIT Standards Committee Implementation Workgroup Implementation Experiences Panel Monday, March 8, 2010

Comments to the HIT Standards Committee Implementation Workgroup Implementation Experiences Panel Monday, March 8, 2010 Comments to the HIT Standards Committee Implementation Workgroup Implementation Experiences Panel Monday, March 8, 2010 Mitzi G. Cardenas, Vice President/ Chief Information Officer Truman Medical Centers,

More information

Hand-Off Communications Targeted Solutions Tool (TST ) Implementation Guide for Health Care Organizations

Hand-Off Communications Targeted Solutions Tool (TST ) Implementation Guide for Health Care Organizations Hand-Off Communications Targeted Solutions Tool (TST ) Implementation Guide for Health Care Organizations Key Features of TST Hand-Off Communications Module Facilitates the examination of the current hand-off

More information

Members respond to help identify what makes RNs unique and valuable to healthcare in Alberta.

Members respond to help identify what makes RNs unique and valuable to healthcare in Alberta. CARNA - Uniquely RN Members respond to help identify what makes RNs unique and valuable to healthcare in Alberta. RNs have expressed that their role is not always understood by colleagues, employers and

More information

Joan Carroll RN, CDMS, CCM Director of Care Transitions Lee Memorial Health System

Joan Carroll RN, CDMS, CCM Director of Care Transitions Lee Memorial Health System Joan Carroll RN, CDMS, CCM Director of Care Transitions Lee Memorial Health System 1 Explain how patients experience transitions of care Identify variables that affect transitions due to lack of patient

More information

HCAHPS, Value-Based Purchasing and A Culture of Always

HCAHPS, Value-Based Purchasing and A Culture of Always Objectives HCAHPS, Value-Based Purchasing and A Culture of Always Karen Cook, RN BSN www.studergroup.com 1. Describe the history and current usage of the CAHPS family of surveys and other relevant outpatient

More information

Implementing an Evidence Based Hospital Discharge Process

Implementing an Evidence Based Hospital Discharge Process Implementing an Evidence Based Hospital Discharge Process Learning from the experience of Project Re-Engineered Discharge (RED) Webinar January 14, 2013 Chris Manasseh, MD Director, Boston HealthNet Inpatient

More information

Designing the Role of the Embedded Care Manager

Designing the Role of the Embedded Care Manager Designing the Role of the Embedded By Patricia Hines, Ph.D., RN and Marge Mercury, RN, MS, CMCE The Embedded The use of an Embedded ( ECM ) to coordinate within the complex delivery system is sharply increasing.

More information

Analytic-Driven Quality Keys Success in Risk-Based Contracts. Ross Gustafson, Vice President Allina Performance Resources, Health Catalyst

Analytic-Driven Quality Keys Success in Risk-Based Contracts. Ross Gustafson, Vice President Allina Performance Resources, Health Catalyst Analytic-Driven Quality Keys Success in Risk-Based Contracts March 2 nd, 2016 Ross Gustafson, Vice President Allina Performance Resources, Health Catalyst Brian Rice, Vice President Network/ACO Integration,

More information

Nurse Transition Coach Model: Innovative, Evidence-based, and Cost Effective Solutions to Reduce Hospital Readmissions

Nurse Transition Coach Model: Innovative, Evidence-based, and Cost Effective Solutions to Reduce Hospital Readmissions Nurse Transition Coach Model: Innovative, Evidence-based, and Cost Effective Solutions to Reduce Hospital Readmissions Leslie Becker RN, BS Jennifer Smith RN, MSN, MBA Leslie Frain MSN, RN Jan Machanis

More information

Framework for Improving Medicare Plan Star Ratings

Framework for Improving Medicare Plan Star Ratings Framework for Improving Medicare Plan Star Ratings Designed by the Center of Medicaid and Medicare Services (CMS), the five-star rating system is a quality and performance scoring method used for certain

More information

Managing Patients with Multiple Chronic Conditions

Managing Patients with Multiple Chronic Conditions Best Practices Managing Patients with Multiple Chronic Conditions Advocate Medical Group Case Study Organization Profile Advocate Medical Group is part of Advocate Health Care, a large, integrated, not-for-profit

More information

Board of Governors Exam Compilation

Board of Governors Exam Compilation 10 Core Knowledge Areas for Board Certification in Healthcare Management Business This area includes knowledge that pertains to specific areas/concepts of the organization (e.g., marketing, business planning,

More information

PARTNERSHIPS IN MANAGED CARE Improving Quality and Satisfaction with Home Health Services WHITE PAPER 99-001

PARTNERSHIPS IN MANAGED CARE Improving Quality and Satisfaction with Home Health Services WHITE PAPER 99-001 PARTNERSHIPS IN MANAGED CARE Improving Quality and Satisfaction with Home Health Services WHITE PAPER 99-001 PARTNERSHIPS IN MANAGED CARE Improving Quality and Satisfaction with Home Health Services Alexis

More information

Population Health 2.0: Bending the Cost Curve by Moving Beyond the Pyramid

Population Health 2.0: Bending the Cost Curve by Moving Beyond the Pyramid Population Health 2.0: Bending the Cost Curve by Moving Beyond the Pyramid Advocate Health Care $5 Billion Annual Revenue AA Rated 12 Acute Care Hospitals 1 Children s Hospital 5 Level 1 Trauma Centers

More information

Nursing Strategic Plan. Fiscal Year 2015. Shaping the Future of UCLA Nursing at Ronald Reagan UCLA Medical Center

Nursing Strategic Plan. Fiscal Year 2015. Shaping the Future of UCLA Nursing at Ronald Reagan UCLA Medical Center Nursing Strategic Plan Fiscal Year 2015 Shaping the Future of UCLA Nursing at Ronald Reagan UCLA Medical Center The strategic plan of the Ronald Reagan UCLA Medical Center Department of Nursing aligns

More information

Transitions of Care: The need for collaboration across entire care continuum

Transitions of Care: The need for collaboration across entire care continuum H O T T O P I C S I N H E A L T H C A R E, I S S U E # 2 Transitions of Care: The need for collaboration across entire care continuum Safe, quality Transitions Effective C o l l a b o r a t i v e S u c

More information

Learning Objectives 4/19/2016. The Five-Star Ratings Have Changed IMPROVING YOUR CMS FIVE-STAR QUALITY RATING KAY HASHAGEN, PT, MBA, RAC-CT

Learning Objectives 4/19/2016. The Five-Star Ratings Have Changed IMPROVING YOUR CMS FIVE-STAR QUALITY RATING KAY HASHAGEN, PT, MBA, RAC-CT IMPROVING YOUR CMS FIVE-STAR QUALITY RATING KAY HASHAGEN, PT, MBA, RAC-CT Learning Objectives How to analyze the current Star Rating in each area Evaluate current operations to determine the most critical

More information

DATA DRIVEN HEALTH CARE TRANSFORMATION

DATA DRIVEN HEALTH CARE TRANSFORMATION DATA DRIVEN HEALTH CARE TRANSFORMATION Population Health Analytics as the Foundation for Primary Care Redesign Sylvia Meltzer, MD, LSSGBC Laura Spurr, MPS, PMP Learning Objectives Organization description

More information

CHLH 494: Rural and Urban Health Care

CHLH 494: Rural and Urban Health Care CHLH 494: Rural and Urban Health Care Click to edit Master subtitle style A Comparison April 7th, 2011 Project Review Project Objectives: 1. Identify differences in patient demographics 2. Compare patient

More information

MANAGING RISING HEALTHCARE COSTS SOLUTIONS TO A FRAGMENTED SYSTEM

MANAGING RISING HEALTHCARE COSTS SOLUTIONS TO A FRAGMENTED SYSTEM Copyright 2014 Veridicus Health tm. All rights reserved. CONTENTS EXECUTIVE SUMMARY 1 INTRODUCTION 2 BY THE NUMBERS HOW VERIDICUS CARE MANAGEMENT IS DIFFERENT 4 COLLABORATION RIGHT PATIENT, RIGHT TIME

More information

Is Your Digital Health Strategy Thriving, Surviving or Non-Existent?

Is Your Digital Health Strategy Thriving, Surviving or Non-Existent? Is Your Digital Health Strategy Thriving, Surviving or Non-Existent? 5 Key Steps Companies Can Take to Start or Accelerate Their Digital Health Strategy More people than ever before are using technology

More information

Costs and Limitations Disclosure For MEDITECH s 2014 Edition Certified Products

Costs and Limitations Disclosure For MEDITECH s 2014 Edition Certified Products Costs and Limitations Disclosure For MEDITECH s 2014 Edition Certified Products Prepared by Medical Information Technology, Inc. (MEDITECH) on May 2, 2016 1 Table of Contents: General Costs and Limitations

More information

Health Care System. Troyen Brennan, M.D., M.P.H. Executive Vice President & Chief Medical Officer

Health Care System. Troyen Brennan, M.D., M.P.H. Executive Vice President & Chief Medical Officer Creating a More Connected Health Care System Troyen Brennan, M.D., M.P.H. Executive Vice President & Chief Medical Officer Agenda Our Role in the Changing Health Care System CVS/minuteclinic: Growth and

More information

UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS DEPARTMENT OF PHARMACY SCOPE OF PATIENT CARE SERVICES FY 2014 October 1 st, 2014

UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS DEPARTMENT OF PHARMACY SCOPE OF PATIENT CARE SERVICES FY 2014 October 1 st, 2014 UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS DEPARTMENT OF PHARMACY SCOPE OF PATIENT CARE SERVICES FY 2014 October 1 st, 2014 Department Name: Department of Pharmacy Department Director: Steve Rough, MS,

More information

Aaisha Ghauri Savvas Amber Curry

Aaisha Ghauri Savvas Amber Curry The CATCH Program Aaisha Ghauri Savvas, Manager, Complex Continuing Care & Outpatient Rehab Services Amber Curry, Manager, Inpatient Surgery, ACU, Pre- Admit & Fracture clinic Copyright RVHS 2012 1 Objectives

More information

Heart Failure Best Practice Strategies: Featuring Target: HF Honor Roll Hospitals

Heart Failure Best Practice Strategies: Featuring Target: HF Honor Roll Hospitals Heart Failure Best Practice Strategies: Featuring Target: HF Honor Roll Hospitals 12/18/2013 12/18/13 2013, American Heart Association 1 Thank you for Joining the Webinar Today. The Presentation will Begin

More information

Glossary of Terms IHealth and the Electronic Health Record

Glossary of Terms IHealth and the Electronic Health Record Activation: The time that a specific site or region will start to use new information system functionality. See also: Go-live, Implementation. Ad-Hoc Charting Allows for entry of static, point-in-time

More information

Patient-Centered Care

Patient-Centered Care Patient-Centered Care Karen N. Drenkard, PhD, RN, NEA-BC, FAAN Executive Director American Nurses Credentialing Center This program generously funded by the Robert Wood Johnson Foundation Patient-Centered

More information

INTERAGENCY COORDINATION OF MENTAL HEALTH AND TRANSITION SERVICES IN MINNESOTA PUBLIC SCHOOLS: A Snapshot

INTERAGENCY COORDINATION OF MENTAL HEALTH AND TRANSITION SERVICES IN MINNESOTA PUBLIC SCHOOLS: A Snapshot INTERAGENCY COORDINATION OF MENTAL HEALTH AND TRANSITION SERVICES IN MINNESOTA PUBLIC SCHOOLS: A Snapshot Kathy Kosnoff June 2012 Contents INTRODUCTION... 1 BACKGROUND... 1 GOAL OF THIS REPORT... 2 FOCUS

More information

2/14/2015. Liz Cooke RN NP

2/14/2015. Liz Cooke RN NP Liz Cooke RN NP Quality of Life studies with HCT pts began at City of Hope in 1991 for Tool validation Retrospective Chart Review in 2000 of 100 HCT patients looking at readmission patterns. (published

More information

REAL-TIME INTELLIGENCE FOR FASTER PATIENT INTERVENTIONS. MICROMEDEX 360 Care Insights. Real-Time Patient Intervention

REAL-TIME INTELLIGENCE FOR FASTER PATIENT INTERVENTIONS. MICROMEDEX 360 Care Insights. Real-Time Patient Intervention REAL-TIME INTELLIGENCE FOR FASTER PATIENT INTERVENTIONS MICROMEDEX 360 Care Insights Real-Time Patient Intervention Real-Time Intelligence for Fast Patient Interventions At your patient s side, developments

More information

Medweb Telemedicine 667 Folsom Street, San Francisco, CA 94107 Phone: 415.541.9980 Fax: 415.541.9984 www.medweb.com

Medweb Telemedicine 667 Folsom Street, San Francisco, CA 94107 Phone: 415.541.9980 Fax: 415.541.9984 www.medweb.com Medweb Telemedicine 667 Folsom Street, San Francisco, CA 94107 Phone: 415.541.9980 Fax: 415.541.9984 www.medweb.com Meaningful Use On July 16 2009, the ONC Policy Committee unanimously approved a revised

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

LEVERAGING EXISTING IT INFRASTRUCTURE FOR IMPLEMENTING & INTEGRATING A PATIENT ENGAGEMENT SYSTEM

LEVERAGING EXISTING IT INFRASTRUCTURE FOR IMPLEMENTING & INTEGRATING A PATIENT ENGAGEMENT SYSTEM LEVERAGING EXISTING IT INFRASTRUCTURE FOR IMPLEMENTING & INTEGRATING A PATIENT ENGAGEMENT SYSTEM COAXIAL CABLE RF CAT 5/CAT 6 ETHERNET WIFI STAFF COMMUNICATION EMR NURSE CALL SYSTEM REAL-TIME LOCATION

More information

Nutrition in the Multidisciplinary Oncology Team: Risk Identification and Intervention

Nutrition in the Multidisciplinary Oncology Team: Risk Identification and Intervention Nutrition in the Multidisciplinary Oncology Team: Risk Identification and Intervention SUMMARY Nutrition services play a key role in quality patient care in the oncology setting. As multidisciplinary teams

More information

Kaiser Permanente: Transition Care Performance and Strategies

Kaiser Permanente: Transition Care Performance and Strategies Kaiser Permanente: Transition Care Performance and Strategies Carol Ann Barnes, PT, DPT, GCS carbarne@gmail.com April 2009 Netta Conyers-Haynes, October, 2014 Principal Consultant, Communications Agenda

More information