How to Avoid Fumbled Handoffs When Discharging Patients
Poor communication can lead to serious medical errors. Project RED (reengineering discharge) promotes useful discharge discussion points for hospitals concerned about poor handoffs, which can often lead to patients being readmitted shortly after discharge.
Care Transitions Community Discussion List Now Available
Safe Care for Stroke Patients—Preventing Aspiration and Other Risks: Virtual Program Begins 9/28/09
Planning for an Influenza Pandemic in the Home Health Care Sector: Web Conference 9/23/09
Flu and Other Immunization Resources Free on MLN
Look for New Web-Based Application for Tracking and Analyzing Discharge Data
National Care Transitions Call: Thursday, September 17, 2009 2:00-3:00 CT
How to Avoid Fumbled Handoffs When Discharging Patients
Patients with Diabetes and Limited English Capabilities Benefit from Weekly Calls
Groups Focus on Cutting Hospital Readmission of Medicare Patients
Patient-Centered Medical Homes Benefit Patients and Practice
Medicare Demonstrations Show That Paying for Quality Health Care Pays Off
Nursing Home Residents with Lower Respiratory Tract Infection: Improving Outcomes
What’s New at AHRQ’s Health Care Innovation Exchange: Long-Term Care
Oncology Outcomes May Be Improved by Nurse-Led, Palliative Care-Focused Intervention
How Do They Do That? Low Cost, High-Quality Health Care in America
Money-Driven Medicine: What’s Wrong with America’s Healthcare and How to Fix It
Four Ways Health Reform Can Improve Patient Medication Adherence
Comparative Effectiveness Research: Obama’s “Stimulus Package”
Officials Urge Providers to Brace for Swine Flu
Analysis of 2006-2007 Home Health Case-Mix Change
EHR and the 21st Century Health Care System
Engineering Tactics Can Identify Broader Inefficiencies in Your Hospital
Revised Skilled Nursing Facility PPS Fact Sheet (August 2009)
Care Transitions Community Discussion List Now Available
To join, find the Auto-Notification link in the lower left corner of the home page at www.qualtiynet.org. Click the “Sign up for Notifications” link and follow the directions for registering. Look for Care Transitions under the “Discussions” heading.
Safe Care for Stroke Patients—Preventing Aspiration and Other Risks: Virtual Program Begins 9/28/09
This Institute for Healthcare Improvement three-month virtual program provides guidance for standardizing processes and reducing variation. AHA/ASA’s Get With the Guidelines Stroke Program highlights are covered, with an eye toward practical implementation of best practices to improve the quality of stroke care at your hospital.
Planning for an Influenza Pandemic in the Home Health Care Sector: Web Conference 9/23/09
To showcase resources that can support emergency preparedness planning within the home health care sector, particularly in the face of a potential H1N1 pandemic, the Agency for Healthcare Research and Quality (AHRQ) will host this Web conference. Emergency preparedness planners and providers, as well as federal, state and local community health and home care planners, are invited to attend.
Flu and Other Immunization Resources Free on MLN
As the flu season kicks in, visit the Medicare Learning Network (MLN) to find resources that will help you protect the health of your Medicare patients. Click the link for help educating patients about risk factors involved and the importance of flu, pneumonia and other vaccinations.
Look for New Web-Based Application for Tracking and Analyzing Discharge Data
According to the Robert Wood Johnson Foundation, the U.S. Agency for Healthcare Research and Quality (AHRQ) will soon introduce new software hospitals can use to document discharge data on quality of care, rates for conditions or procedures, length of stay and more. Called My Own Network Powered by AHRQ (MONAHRQ), the Web-based program will use data entered to populate a central, statewide Web site with information posted by hospitals that can also be accessed by consumers.
National Care Transitions Call: Thursday, September 17, 2009 2:00-3:00 CT
Download and print the handouts prior to the call. Dial 1-800-410-9381 and enter pass code 147005#. You can view the agenda under upcoming events on the Care Transitions Web site.
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How to Avoid Fumbled Handoffs When Discharging Patients
Poor communication can lead to serious medical errors. Project RED (reengineering discharge), a project developed by Brian Jack, MD, and the department of family medicine at Boston Medical Center, promotes 11 useful discharge discussion points for hospitals concerned about poor handoffs leading to patients being readmitted shortly after discharge.
Patients with Diabetes and Limited English Capabilities Benefit from Weekly Calls
Automated telephone self-management support (ATSM) results in fewer bed days per month and is less disruptive of daily activities compared to nurse follow-up with monthly group visits (with a physician and health educator) and compared to usual care, according to this Agency for Healthcare Research and Quality (AHRQ) research. No differences in HbA1C change were observed across the various types of care.
Groups Focus on Cutting Hospital Readmission of Medicare Patients
With one in five Medicare patients who are discharged from the hospital being readmitted within a month, a concerted effort to prevent avoidable readmissions is imperative. The Alabama QIO is looking at patient discharge processes and how providers and patients interrelate. The Louisiana and Georgia QIOs are using transition coaches to work with patients and caregivers. The idea is to improve the discharge process and ensure patients/caregivers understand the advice and information they are given when patients leave the hospital. For information on these and other Medicare initiatives, sign up for HealthLeaders InterStudy at http://home.healthleaders-interstudy.com.
Patient-Centered Medical Homes Benefit Patients and Practices
A medical home is a model for providing multidisciplinary, coordinated, comprehensive care to patients. In the September 2 issue of the Innovations Exchange, an online newsletter published by the Agency for Healthcare Research and Quality (AHRQ), learn about two different populations served by medical home programs and find practical tools and guidance for starting your own successful medical home.
Medicare Demonstrations Show That Paying for Quality Health Care Pays Off
Hospital and physician group and solo practice demonstrations conducted by the Centers for Medicare & Medicaid Services continue to provide strong evidence that offering financial incentives for improving or delivering high quality care increases quality and can reduce the growth of Medicare expenditures.
Nursing Home Residents with Lower Respiratory Tract Infection: Improving Outcomes
Pneumonia and other lower respiratory tract infections (LRIs) are responsible for most deaths in nursing home residents, yet are difficult to diagnose. Nursing home clinicians may now ascertain pneumonia without a chest X-ray using the prediction rule from this study. An additional analytic model may help to decide the most suitable treatment by determining those residents at low risk for LRIs.
What’s New at AHRQ’s Health Care Innovation Exchange: Long-Term Care
At this Agency for Healthcare Research and Quality Web site, find innovations that detail quality improvement interventions that reduce high rates of ventilator-associated pneumonia, pressure ulcers and staff turnover in long-term care facilities. Also provided are tools and practical information and resources for improving long-term care.
Oncology Outcomes May Be Improved by Nurse-Led, Palliative Care-Focused Intervention
An intervention that addresses physical, psychosocial and care coordination, called Project ENABLE (Educate, Nurture, Advise, Before Life Ends), improved some, but not all, outcomes for cancer patients. Results of this randomized controlled trial were published in the August 19 issue of the Journal of the American Medical Association.
Talking Often, and Calmly About Dying
Health care providers and family members may worry about dashing hopes, but Holly G. Prigerson, director of the Center for Psycho-Oncology and Palliative Care Research at the Dana-Farber Cancer Institute in Boston and her colleagues say that most patients are relieved when the topic of dying is raised. End-of-life discussions also benefit those who survive a loved one’s death, studies show.
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How Do They Do That? Low Cost, High-Quality Health Care in America
Publicly available quality and cost data was used to identify ten of the highest performing Hospital Referral Regions also representative of geographic, demographic and institutionally diverse communities across the U.S. These ten HRRs spend 16 percent less and show a slower real annual growth rate per Medicare patient than the national average.
Money-Driven Medicine: What’s Wrong with America’s Healthcare and How to Fix It
This one-hour video is based on former Barrens financial journalist Maggie Mahar’s popular book. It offers a candid view of our $2.6 trillion health care system, points out avoidable deficiencies and provides information on how health care can be made more accountable, efficient and effective.
Four Ways Health Reform Can Improve Patient Medication Adherence
Roughly 13 percent of national health care costs, or $290 billion a year, are due to patients neglecting to take medications as prescribed, reports a new study published by the New England Healthcare Institute. The problem is widespread, with one-third to one-half of all U.S. patients disregarding physicians’ directions when taking prescription medications. Human costs of poorer health are also extensive. This article offers four suggestions to encourage adherence and improve outcomes.
Comparative Effectiveness Research: Obama’s “Stimulus Package”
The American Recovery and Reinvestment Act of 2009 (ARRA)—known as the “stimulus package”—allocates $1.1 billion to support “the development and dissemination of research assessing the comparative effectiveness of health care treatments and strategies.” Priority research areas recommended by the Institute of Medicine (IOM) include the health delivery system, disparities, cardiovascular health, geriatrics, women’s health and end-of-life care. Some CER projects will succeed in shedding light on the true drivers of health outcomes. Whether these successes justify the substantial federal investment will depend upon the extent to which they transform care delivery.
(Adapted from “Lumetra Quality Insights: Comparative Effectiveness Research (CER)” by Mark Elson, PhD, Lumetra, San Francisco.)
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Officials Urge Providers to Brace for Swine Flu
Officials advise hospitals to prepare for an outbreak of H1N1 in the next year and recommend administrators in primary-care networks keep abreast of the latest H1N1 information, which is continually being updated, by visiting Web sites of state public health departments (http://www.dshs.state.tx.us) and the federal centralized depository of everything associated with flu (http://www.flu.gov).
Analysis of 2006-2007 Home Health Case-Mix Change
This report describes updates to the home health case-mix change analysis since the CY 2008 Home Health Prospective Payment System Final Rule, up to and through the recently published CY 2010 proposed rule (CMS-1560-P).
EHR and the 21st Century Health Care System
In this message from Dr. David Blumenthal, National Coordinator for Health Information Technology, he states that the goal of assuring an electronic health record (EHR) for every American may be daunting and that it will be hard for some clinicians and hospitals to accept. However, his office stands ready to help with resources provided by the Congress and the Administration. Look for a number of initiatives to roll out soon under the Health Information Technology for Economic and Clinical Health (HITECH) Act.
Engineering Tactics Can Identify Broader Inefficiencies in Your Hospital
While you can visit any McDonald’s nationwide and know what to expect, hospitals don’t use a similar business model, leading to disoriented customers, says Stephen Mayfield, DHA, MBA, MBB, and director of the American Hospital Association’s Quality Center. Leaders should consult their facility directors and engineers for help identifying inefficiencies and improving patient care.
Revised Skilled Nursing Facility PPS Fact Sheet (August 2009) (PDF)
This revised prospective payment system (PPS) fact sheet is now available in downloadable format.
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Care Transitions is a Centers for Medicare & Medicaid Services quality improvement project for Texas' Lower Rio Grande Valley administered through TMF Health Quality Institute. It is a regional, collaborative effort to reduce avoidable hospitalizations by improving patient care transitions.
http://caretransitions.tmf.org | 1-866-439-6863 | 512-334-1775 fax | caretransitions@tmf.org
This material was prepared by TMF Health Quality Institute, the Medicare Quality Improvement Organization for Texas, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 9SOW-TX-CT-09-89