The Michigan Value Collaborative

Helping Michigan hospitals achieve their best possible patient outcomes at the lowest reasonable cost

Tag: checklist

5 ways MVC can help you develop a post-acute care strategy

Kristyn Vermeesch

Kristyn Vermeesch is the Project Manager for MVC.

As highlighted in previous blog posts, the transition to value-based purchasing has brought greater attention to post-discharge care, and how to improve its value for patients.  This is not an easy riddle to solve. A previous blog post, “Optimizing Post-Acute Care Spending: Care Setting or Intensity?”, showed improvements could be made regarding the type of post-acute care chosen for patients. An example of how to translate these findings into action is the post-acute strategy checklist developed by the Deloitte Center for Health Solutions. The checklist was developed based on recommendations from a broad interviewee list including health systems, health plans, professional organizations and post-acute care companies.  Whether by using the Deloitte checklist or another alternative, the Michigan Value Collaborative (MVC) can help hospitals develop their own personal roadmap for post-acute care success.

  1. Identification of post-acute partners: One of the biggest challenges faced by hospitals is understanding where and what additional care patients are receiving after discharge. This is especially true when patients receive post-acute care from an unaffiliated provider.

How can MVC help?  On the MVC registry, member hospitals are able to identify the skilled nursing facilities (SNFs) utilized by their patients and for what conditions.  Spoiler alert: the Coordinating Center is creating a similar report to help hospitals gain more information about their home health care partners.  For more information on how to access the SNF report, check out our YouTube videos.

  1. Building post-acute care partnerships: Understanding where patients receive care is important, but it is also critical to know which post-acute providers are delivering high-quality care. This includes scrutinizing clinical measures such as average length of stay, readmission rates, infection rates, and ED visit rates. This knowledge will help to solidify strong partnerships and help with patient referrals.

How can MVC help?  The SNF report on the MVC registry displays the total length of stay and price-standardized, risk-adjusted cost associated with each SNF utilized by your hospital.  Each SNF’s adjusted costs are a derivative of the length of stay and services provided – not payer contractual rates, which can help to assess the quality of care provided by each partner SNF.  The report also includes any readmission payment associated with the patient visit, and in the next few months, the registry will be expanding to provide greater analytic support for post-acute decision-making. More details to come at the April semi-annual meeting!

In addition to the SNF report, members may assess their performance in other downstream post-acute care components such as readmissions, ED visits, and inpatient and outpatient rehabilitation to help improve patient care.  The MVC data can not only inform hospitals on what providers perform greater high-quality care, but it may also be used to develop quality improvement initiatives both within the hospital as well as with its strategic partners. The Coordinating Center is another resource to help hospitals understand the data as well as provide customized analytics. 

  1. Decide where to begin improving performance: Identifying an opportunity is only half the equation.  The next step is deciding where to focus quality improvement efforts.   

How can MVC help?  The MVC registry allows hospitals to compare themselves to hospitals throughout the state and soon to their MVC cohort (facilities with comparable patient case mix and structural similarities).  Hospitals can evaluate which care component(s) have the greatest impact on post-acute spend and whether they have higher utilization rates of more expensive services, such as SNFs or inpatient rehab. 

  1. Develop achievable goals: Goals for hospitals and post-acute partners should be realistic and not compromise patient care.

How can MVC help?  Performance data from post-acute partners, as well as benchmarking data from other Michigan hospitals, can be used to develop achievable goals that can be tracked over time to assess progress.

  1. Implement evidence-based practices: Identifying successful initiatives and best-practices from other institutions can help hospitals implement positive change; however, identifying those opportunities can present a challenge.

How can MVC help?  In addition to data analytics, MVC provides a platform for cross-institutional learning and sharing of best practices.  MVC’s peer-to-peer virtual workgroups allow hospitals throughout the state to discuss challenges and innovative quality improvement initiatives, including strategies to reduce readmissions and inappropriate SNF utilization.  The workgroup discussions are captured in “Toolkits”, which identify root causes and best practices to address the challenges faced by many Michigan hospitals.  The Toolkits are freely available to all MVC hospitals. In addition to the workgroups, the MVC blog features articles on statewide and national initiatives as well as highlighting key research findings that may be useful to hospitals. Finally, the MVC semiannual meetings allow hospitals to learn more about how other members are addressing similar challenges, provides an opportunity to ask questions and network.


Want to learn more?  Register for our April semi-annual meeting or contact the Coordinating Center using the form at the bottom of this page.

 

Using Checklists to Improve Patient Outcomes

Phyllis Wright-Slaughter

Phyllis Wright-Slaughter is a senior data architect working with the Michigan Value Collaborative.

A recent article in the New York Times reported on the success of a checklist for blood clot prevention at Johns Hopkins Hospital in Baltimore.  Through the collection of data on trauma patients, a team led by a trauma surgeon found that women had a “considerably” greater danger of dying from preventable blood clots.  The team found that 45% of female patients did not receive proper blood clot prevention compared to 31% of males.

To address this disparity and improve rates for all patients, the team developed and implemented a computerized checklist.  Every physician was required to review the checklist for all patients seen in the ER. After the checklist was implemented, the number of patients receiving proper clot prevention treatment greatly increased for both men and women.  In fact, incidents of potentially preventable blood clots for medical patients decreased to 0.

Why was the checklist such a great success?  The article notes several reasons:

  • The checklist breaks down decisions at critical points and habitual biases are removed from the process
  • The checklist reduces the human judgement factor for treatment decisions

Checklists have been put to good use by MVC hospitals as well. At the November 2016 Semi-annual MVC meeting, Michelle Moccia from St. Mary Mercy Hospital Livonia presented on the development of checklists for use by skilled nursing facilities and EMTs when transporting patients to the Emergency Room.  By providing ER staff with critical patient information, these checklists improved the coordination of treatment and patient experiences.  Read more about Michelle’s presentation here.


Questions or comments? We’d love to hear from you!  You can comment on this article, or use the form at the bottom of the page