The Michigan Value Collaborative

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

Tag: CHF (page 1 of 4)

Recognizing the Value of Palliative Care as Part of Comprehensive Health Care

Abeer Yassine

Abeer is the MVC Hospital Engagement Associate

Palliative care programs aim to maximize patient comfort, relieve distress, and provide support to patients and their families.  Patients do not need to be diagnosed as terminal to benefit from palliative care. Studies have found palliative care programs increase patient satisfaction with treatment while decreasing costs.  As a result, health care organizations around the nation are working on introducing or strengthening palliative care programs to help advocate for more holistic patient care beyond the chronic illness.

According to America’s Care of Serious Illness: 2015 state-by-state report card on access to palliative care in our nation’s hospitals by the National Palliative Care Registry, Ohio has a 2015 Report Card letter grade of A, compared to Michigan’s B grade.1 In this report, hospitals were given a letter grade of A-F based on its access to palliative care programs.Despite its benefits, physician referrals to palliative care are low – only 13% of cardiac patients are referred to palliative care.2  To improve access, some outpatient clinics in Ohio have partnered with community-based programs specializing in palliative care.  In addition to providing care to the patient, the community-based program offers education to clinicians on what palliative care entails and how to refer patients.

Similarly, a recent study at John Hopkins Medical Institution (JHMI) explored the cost-effectiveness of its existing palliative care program to determine whether an expansion was warranted. By using admissions data, JHMI studied the financial outcomes of their palliative care program on patient care over the course of 13 months. The impact of the palliative care program was significant, as there was a total positive financial payoff of nearly $3.5 million for the health system. This financial impact emphasizes that value-based program models focusing on patient-centered care not only benefit the patient experience but also benefit health system finances. More about this study and the methods used can be found here: http://ascopubs.org/doi/full/10.1200/JOP.2016.014860

Nonetheless, palliative care programs across the nation are each unique and beneficial in their own ways. Some health systems have taken a community approach to palliative care, while others seek to strengthen their programs through clinical fellowships, consultation programs, and expansion. Following the CHF workgroup last month, the Coordinating Center created a Palliative Care and CHF brochure that highlights different facts, figures, and initiatives related to palliative care that can be helpful for hospitals interested in refining or expanding their respective programs. This can be found in the MVC Registry under Resources. For more information on the brochure or workgroup, please contact Deby (debevans@med.umich.edu) or Abeer (abeery@med.umich.edu).

Also keep an eye out for future blog posts highlighting hospitals in Michigan that have exceptional palliative care programs and emphasize a positive patient experience!

 

1 National Palliative Care Registry. America’s Care of Serious Illness: 2015 state-by-state report card on access to palliative care in our nation’s hospitals. https://registry.capc.org/wp-content/uploads/2016/01/2015-State-by-state-Report-Card.pdf

2 National Palliative Care Registry. How we work: Trends and Insights in Hospital Palliative Care https://registry.capc.org/wp-content/uploads/2017/02/How-We-Work-Trends-and-Insights-in-Hospital-Palliative-Care-2009-2015.pdf

How Michigan can be the best in CHF readmissions

Deby Evans

Deb Evans is the MVC Site Engagement Manager

Last November, the Michigan Value Collaborative (MVC) launched its goal to work together to be number one in the country for CHF readmissions. MVC hospitals have shared best practices and challenges with one another through workgroups, toolkits and blogs to collaboratively meet this goal.  In addition to learning from one another, there is information to be gained in how hospitals outside of Michigan are addressing readmissions.

A report from the Commonwealth Fund titled “Reducing Hospital Readmissions: Lessons from Top-Performing Hospitals” identified quality improvement strategies implemented with measurable impacts on reducing readmissions. One of the hospitals studied is in Utah, which currently has the lowest CHF readmission rate in the nation according to CMS Hospital Compare.  According to the study, successful quality improvement strategies included incorporating evidence-based practice into daily protocols, standardizing procedures along with information gathering, providing feedback and supporting clinical decisions through electronic information systems.

Specific initiatives underway include:

Providing clinically excellent patient care with a focus on patient safety. Doing this leads to a fall in readmission rates, improvement in quality measures and savings are realized as a byproduct.

Using information technologies as tools that improve quality, integrate care and ease patient transitions.

Early involvement of case management and discharge planning.

Targeting high risk patients and ensuring frequent communication across the whole care team.

Teaching patients and families how to manage their conditions.

Maintaining a life-line with high risk patients after discharge.

Aligning the efforts of hospital and community providers to ease transitions across care settings.

The authors noted that hospital environments played a role in each facility’s ability to reduce admissions. Specifically, the success of the initiatives were influenced by policy environment, local health care markets, association with an integrated health system and the priorities set by hospital leaders.

Many of the programs implemented by the top performing hospitals are similar to initiatives discussed by the MVC CHF readmission workgroup. For more information on the workgroup or toolkit, please contact Deby (debevans@med.umich.edu ) or Abeer (abeery@med.umich.edu ).

Read the full article here http://www.emergingrnleader.com/wp-content/uploads/2012/08/1473_SilowCarroll_readmissions_synthesis_web_version2.pdf

 

 

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