The Michigan Value Collaborative

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

Tag: post-acute care (page 1 of 2)

McLaren- Lansing: Using Change as an Opportunity for Optimizing Palliative Care

Kim Hecksel

McLaren- Lansing Palliative Care nurses from left to right: Kim, RN, Paula, CNP and Carol, RN

Although the palliative care program at McLaren- Lansing has been around for about a decade, health care organizations are constantly changing and evolving to meet patient and family needs. The MVC Coordinating Center had the opportunity to speak to the team of case managers and nurses from McLaren- Lansing to hear about the different successes and barriers to palliative care at this facility. One distinct characteristic of this palliative care program is that patients and families are seen by and interact with consistent faces, rather than different clinicians, each time they visit. McLaren uses this consistency as leverage through transitions of care, especially at a time when clinician duties and health organizations are constantly changing.

The palliative care program at McLaren- Lansing also keeps up with the constant changes in health care by utilizing different online resources. One resource available to hospitals interested in palliative care programs is the Center to Advance Palliative Care (CAPC). CAPC offers a platform to help provide different health care organizations across the nation the tools and resources needed to advance palliative care programs in their respective institutions. For example, some CAPC resources help palliative care teams set up and develop a business plan for their respective palliative care programs. CAPC resources are helping guide the McLaren- Lansing team in creating a business model that illustrates the financial impact of a palliative care program on the health system. For more information on CAPC and the resources they can provide, visit www.capc.org.

The palliative care team also looks at the big picture of the care provided to patients and consequently putting together different pieces of information to ultimately develop a course of treatment that best meets the needs of the patients and the family involved. One of the barriers McLaren- Lansing has with their palliative care program is working with patients, family members and other health care providers on understanding the value of palliative care and what it really offers. When met with this resistance, the palliative care team works in different ways on learning about and discussing the care plan and goal setting to find the right format for communication and understanding a diverse patient population. For example, the palliative care team engages with physicians one-on-one and attends presentations on the benefits of palliative care to better understand and work with patients and their families about their diagnosis and individualized care plan. Taking advantage of different resources available, such as CAPC, and instilling a strong support system among the palliative care team and liaising teams are factors that aid in instituting a successful palliative care program.

If you are interested in learning more about the palliative care program at McLaren- Lansing, please feel free to reach out to Deby (debevans@med.umich.edu) or Abeer (abeery@med.umich.edu) for more information and contact.

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.

 

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