The Michigan Value Collaborative

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

Tag: palliative care (page 1 of 2)

MVC Heart Failure Workgroup Updates and 2018 Opportunities

Deby Evans

Deb Evans is the MVC Site Engagement Manager

The Michigan Value Collaborative (MVC) Congestive Heart Failure (CHF) workgroup has had a productive year of virtual meetings and many useful discussions about a variety of topics that can influence reducing readmissions. Every other month, in collaboration with I-MPACT, another Blue Cross Blue Shield of Michigan quality improvement collaborative focusing on transitions of care, the group has held discussions on a variety of topics pertaining to CHF. The MVC Coordinating Center will be opening up the workgroup for other hospitals to join in 2018 and additional information can be found below. A synopsis of the findings of each 2017 workgroup discussion is detailed below, although more details can be found on the MVC registry under the resource tab or by contacting the Coordinating Center.

Using Skilled Nursing Facilities: This discussion encouraged working closely with skilled nursing facilities to help provide education to staff, patients, family members and care givers in respect to fluid intake and nutrition.  Additionally, the discussion included how to allow staff to facilitate medication administration and finding alternative ways of medication delivery such as giving Lasix via intramuscular injection rather than intravenously.

CHF Referrals to Palliative Care: The discussion centered around getting this patient population referred to palliative care as soon as possible in the course of their disease process. The conversation included triggers for referral along with some benefits of being in a palliative care program and initiatives that Michigan hospitals had implemented or were working on implementing in relation to palliative care programs in their facilities.

Use of Outpatient Heart Failure (HF) Clinics: The group discussed the effectiveness of having a HF clinic to refer their CHF patients too and how attendance at these clinics had helped reduce CHF readmission rates. Some hospitals discussed the collaborative work they had done to implement a HF clinic in their facility. Templates of business plans were provided and members provided information on how they had presented and made the case to open a HF clinic at their facility. An interview with a Michigan hospital ranked number 3 in the country was utilized for a blog post.

Diet and Nutrition Education: Some dieticians from member hospitals joined us to discuss the tools and information they share with HF patients at their facilities. Information sheets containing information on alternative spices to use instead of salt were shared and also initiatives and education on how to provide heart healthy meals to patients either by the facility or via a vendor such as Meals on Wheels.

Medication Reconciliation: Pharmacists joined the discussion about their role or potential role in medication reconciliation and also provided some recommendations for the use of different stakeholders in the medication reconciliation process, not only for CHF patients but for other patient populations too. Some facilities discussed how they have also integrated parts of the reconciliation process into their electronic health record systems.

The CHF longitudinal workgroup will be continuing into 2018 with more discussion topics pertaining to CHF and opportunities for collaboration. If you are interested in joining the workgroup, please sign up here.  Further details will be provided in 2018.

If you have any questions about the workgroup or 2018 workgroup registration  please contact Abeer Yassine (abeery@med.umich.edu) or Deb Evans (debevans@med.umich.edu)

 

Why I’m excited for the November 3rd Semi-annual collaborative meeting

Jim Dupree

Jim Dupree, M.D., M.P.H. is the Director of MVC

The next MVC collaborative-wide meeting is coming up soon, November 3rd at Schoolcraft College http://www.schoolcraft.edu/vistatech/maps-parking

I wanted to take a minute to explain why I’m particularly excited for this fall’s meeting. In the six months since our last collaborative-wide meeting, the coordinating center has been hard at work across several fronts:

  • We have expanded our peer-to-peer workgroups program to offer more hospitals a platform for learning from and teaching each other about best practices for improving care. This has included new workgroups about optimizing skilled nursing facility/extended care facility use for patients with congestive heart failure. We have also expanded these workgroups to cover topics such as palliative care and how to establish a heart failure clinic. For more information about joining these workgroups, please contact Abeer Yassine at abeery@med.umich.edu
  • We have added two new services lines: Atrial Fibrillation and Nephrolithiasis. Atrial Fibrillation represents a common reason for inpatient admission and the service line data expands our ability to provide actionable data about medial admissions. Nephrolithiasis is a high-volume surgery, and we now have a window into emergency department (ED) visits and/or hospital admissions that occur after this outpatient procedure.
  • In response to your comments, we have made several improvements to the registry website and its underlying data. For example, we have improved the accuracy of the National Provider Identification (NPI) number available on Blue Cross Blue Shield of Michigan (BCBSM) claims. In addition, we added patient age, gender and comorbidities (COPD, diabetes and ESRD) filters to the BCBSM claims. Finally, in response to your suggestions, we have added an index place of service indicator that allows users to identify episodes beginning in the hospital inpatient, outpatient, or ED settings.

On November 3rd, we will discuss the next opportunities for value improvement in Michigan.  These include:

  1. A focus on the emergency department as a location for improving healthcare value. We will learn from Donna Fox from Michigan Medicine about their program that leverages social and medical supports to reduce ED visits and readmissions. We will also learn from Lauran Hardin about a population-based intervention to reduce ED utilization and cost for high-need patients.
  2. A special presentation from Dr. Keith Kocher Program Director for the Michigan Emergency Department Improvement Collaborative (MEDIC). MVC members have asked previously for increased collaboration with other BCBSM collaborative quality initiatives, and Dr. Kocher will introduce the PATH initiative to prevent avoidable hospitalizations after ED visit.
  3. The launch of an important new initiative aimed at improving safe births in Michigan. Many hospitals are working to reduce the use of C-section for low-risk births, and we now have new tools to assist in those efforts. Dr. Dan Morgan will discuss this initiative at the collaborative-wide meeting and seek your feedback.

The November 3rd meeting will offer the Collaborative a chance to decide how we, collectively, want to improve the value of health care in Michigan.  We look forward to seeing you at Schoolcraft College (http://www.schoolcraft.edu/vistatech/maps-parking) on November 3rd . Please be sure to register by clicking here.  And as always, contact us at shiyuan@med.umich.edu with any suggestions or questions.

 

 

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