Partnership for Patients
Safety Is Personal: Partnering with
Patients and Families
A Dialogue with Leaders from the NPSF Lucian
Leape Institute, the Institute of Medicine and
the Patient Centered Outcomes Research
Institute
Tuesday, May 27, 2014
3:00-4:15 pm (ET)
Welcome
Martin Hatlie
NCD
2
Partnership for Patients Campaign
196 Days and Counting!
Our Patients are Counting
on You!
3
Objectives
• To learn about the recommendations of the NPSF
Lucian Leape Institute for hospital leaders, clinicians
and staff, consumers and policy makers in advancing
PFE.
• To understand what PCORI and IOM are doing to
support research, disseminate evidence and engage
PFACs
• To spur action on emerging opportunities for patient
advocates, hospitals and HENs to operationalize PFE as
an SAB strategy
Questions to Run on
• What more can HENs, hospitals and patient advocates
do to achieve the recommendations of the NPSF Lucian
Leape Institute’s Safety Is Personal report?
• How can PFACs use the resources & opportunities
created by IOM, PCORI and others to best use the
forward energy of patient advocates to improve
outcomes?
• Safety IS personal, so what more can I do to engage
patient advocates in improving Safety Across the Board
as quickly as possible?
Partnership for Patients
2 Bold Aims: 40/20 by 12/31/14
http://partnershipforpatients.cms.gov
Who is on the call today?
a)
b)
c)
d)
e)
f)
g)
Hospital administrator
Hospital staff
HEN (Director or Staff)
QIO
Federal Agency Partner
Patient / Patient Advocate
Other
7
Maximizing PFE to Improve Outcomes
Dennis Wagner and Paul McGann, MD
CMS
PfP Co-Directors
Partnership for Patients
Signature Attributes of the
Campaign
•
•
•
•
•
Thrilling goals
Urgency
Relentless focus on results
Inclusion & health equity
Safety Across the Board
(SAB)
• PFE
– Important in itself
– Embedded in the Campaign
– An SAB strategy
Goal line in Sight
• 196 days
• Harvesting results so far
• Relentless focus on more
results
– LEAPT
• Partnering to sustain action
• Reducing cycle time
• Expediting use of PFE
structures to achieve SAB
and reduce disparity
PFE Success Story - Falls
Fall Prevention Center Mission
• Alameda Health System has a Fall Prevention Center
(FPC) whose mission is to identify older adults who
are at risk for falls
• Alameda provides screenings, medication reviews,
fall prevention education, Geriatrician consults and
interventions as needed that help decrease their fall
risk and therefore reduce the number of preventable
falls
• Since its inception (Sept. 2011) the FPC
has been successful in keeping 93% of its
patients out of the Emergency
Department due to an additional fall
RARE: Reducing Avoidable
Readmissions Effectively in Minnesota
• Goal: Engage hospitals and care
providers in Minnesota across the
continuum of care to prevent 6,000
avoidable hospital readmissions
within 30 days of hospital discharge
• Dates: 7/1/2011 - 12/31/2013
• Participants: 82 hospitals, 100
community partners
• Triple Aim:
1.
2.
3.
6,000 avoidable hospital readmissions
24,000 nights sleep in patients’ own
beds
Tens of millions of dollars saved
RARE (continued)
Areas of Focus:
1.
Patient and family engagement:
Ensuring processes are in place to:
– Engage patients/family
– Elevate the status of family caregivers as
essential members of the team
– Prepare the patient and family to
manage care at home.
– Interventions may include:
– Teach back
– Collaborative conversations and
communication
– Simulations with the patient and family
member
2.
3.
4.
5.
Comprehensive discharge planning
Medication management
Transition care support
Transition communications
Results
• 7,030 readmissions avoided (as
of Q3 2013)
– Exceeded original goal of 6,000
readmissions
• Helped patients spend 24,844
more nights sleeping
comfortably in their own beds
• Reduced inpatient costs by an
estimated $55 million
• 2013 winner of the John M.
Eisenberg Patient Safety and
Quality Award for Innovation in
Patient Safety and Quality
MHA’s “RARE” Campaign
Reducing Avoidable Readmissions Effectively
• Minnesota hospitals have collectively prevented
7,975 Readmissions and helped patients spend
31,900 nights at home instead of in the hospital
• In the last quarter of 2013, Minnesota hospitals
reached a collective reduction in Readmissions of
19 percent
Source: Data from RARE website http://www.rarereadmissions.org/
Patient & Family Engagement
PfP Campaign Metrics
Patient and Family Advisory Council
A hospital-wide champion for Safety Across the Board
Where are we today on
establishing hospital PFACs?
Does your hospital have a Patient and Family Advisory
Council?
41% of 1,438 responding hospitals have a PFAC; 28% are
hospital-wide. (AHA/HRET 2013 survey of all hospitals)
HENs Report As of May, 2014 there are
1,483 hospitals with PFACs or Patients on
Safety Committee
Time for a Boost: HENs report formation of PFAC
or Patient on Safety Committee has leveled out.
How are the HENs doing in spreading
PFACs among member hospitals?
Percent of HEN Network Hospitals with PFACs or
Patients on Safety Committees, as of May 2014
Percent of AHA/HRET Network Hospitals with PFACs/Pt
on Pt Safety Committee in Place – May 2014
Shout out!
HENs and HRET/SHAs who have over 75% of their hospitals
with PFACs/Pts on Patient Safety Committees in place.
Hospital
Engagement Network
Number of Hospitals
In Network
With PFAC/Pt on
Pt Safety Comm.
Dignity
35
35
Pennsylvania
106
104
AHA/HRET Massachusetts SHA
16
16
AHA/HRET Connecticut SHA
25
24
AHA/HRET Alaska SHA
12
10
AHA/HRET DC
2
2
Rhode Island SHA
8
6
Patient Perspective
Linda K. Kenney, President and Founder
MITSS - Medically Induced Trauma Support Services
Roundtable Participant
NPSF Lucian Leape Institute, Safety is Personal
NPSF Lucian Leape Institute Faculty
Lucian L. Leape, MD
Chair, NPSF Lucian Leape Institute Adjunct
Professor of Health Policy Harvard School of
Public Health
Susan Edgman-Levitan, PA
Member, NPSF Lucian Leape Institute
Executive Director, John D. Stoeckle Center
for Primary Care Innovation, Massachusetts
General Hospital
Tejal K. Gandhi, MD, MPH, CPPS
President, National Patient Safety Foundation
and NPSF Lucian Leape Institute
26
The National Patient Safety Foundation’s
Lucian Leape Institute
• Mission
• Strategic Focus
• Transforming Concepts
27
Members of the NPSF Lucian Leape Institute
Lucian L. Leape, MD, Chair
Adjunct Professor of Health Policy
Harvard School of Public Health
Gary S. Kaplan, MD, FACMPE
Chairman and CEO
Virginia Mason Medical Center
Tejal K. Gandhi, MD, MPH, CPPS
President, NPSF Lucian Leape Institute
President, NPSF
Julianne M. Morath, RN, MS
President & CEO
Hospital Quality Institute of California
Carolyn M. Clancy, MD
Assistant Deputy Undersecretary for Health,
Quality, Safety and Value
Veterans Health Administration
Dennis S. O’Leary, MD
President Emeritus
The Joint Commission
Janet M. Corrigan, PhD, MBA
Distinguished Fellow
The Dartmouth Institute for Health Policy
and Clinical Practice
Susan Edgman-Levitan, PA
Executive Director
John D. Stoeckle Center for Primary Care
Innovation
Massachusetts General Hospital
28
Paul O'Neill
Former Chairman and CEO, Alcoa
72nd Secretary of the U.S. Treasury
Robert M. Wachter, MD
Associate Chair
Department of Medicine
University of California San Francisco
NPSF LLI Transforming Concepts
• Medical education reform
• Integration of care within and across delivery
systems
• Restoration of joy and meaning in work and
ensuring the safety of the health care workforce
• Active consumer engagement in health care
• Transparency as a practiced value in everything we
do in health care
Leape L, Berwick D, Clancy C, et al., for the Lucian Leape Institute at the National Patient Safety Foundation. 2009. Transforming
healthcare: a safety imperative. Qual Saf Health Care 18(6):424-428. doi:10.1136/qshc.2009.036954.
29
Safety Is Personal: Partnering with Patients
and Families for the Safest Care
From the NPSF Lucian Leape
Institute Roundtable on
Consumer Engagement
Download at
http://www.npsf.org/lli/safety-ispersonal
30
Four Levels of Engagement
31
NPSF LLI Patient Engagement
Recommendations
• Leaders of health care systems:
– Establish patient and family engagement as a core
value for the organization
– Involve patients and families as equal partners in
the design and improvement of care across the
organization and or practice. Educate and train all
clinicians and staff to be effective partners with
patients and families
– Partner with patient advocacy groups and other
community resources to increase public awareness
and engagement
32
NPSF LLI Patient Engagement
Recommendations
• Health care clinicians and staff:
– Provide information and tools to support patients
and families to engage effectively in their own care
– Engage patients as equal partners in safety
improvement and care design activities
– Provide clear information, apologies and support to
patients and families when things go wrong
33
NPSF LLI Patient Engagement
Recommendations
• Health care policy makers:
– Involve patients in all policy-making committees and
programs
– Develop, implement and report safety measures
that foster transparency, accountability, and
improvement
– Require that patients be involved in setting and
implementing the research agenda
34
NPSF LLI Patient Engagement
Recommendations
• Patients, families and the public:
– Ask questions about the risks and benefits of
recommendations until you understand the answers
– Don’t go alone to the hospital or doctor visits
– Always know why and how you take your
medications, and their names
– Be really clear about the plan of action
– Say back in your own words what you think you
hear from clinicians
35
NPSF LLI Patient Engagement
Recommendations
• Patients, families and the public (cont’d):
– Arrange to get any recommended lab tests done
before a visit
– Determine who is in charge of your care
36
Characteristics of Excellent Patient/Family
Partners
• The ability to share
personal experiences in
ways that others will
listen and learn from
them.
• The ability to see the
“big” picture.
• Interested in more than
one issue.
• Interested in improving
health care or research.
37
• The ability to ask tough
questions constructively.
• The ability to connect
with people.
• A sense of humor.
• Representative of the
relevant patients/
families/conditions.
Chinese Proverb
Those who say it cannot be
done should not interrupt the
person doing it.
- Chinese proverb
38
Organizations in Action
Susan E. Sheridan, MBA MIM, Director of
Patient Engagement, Patient Centered
Outcomes Research Institute
J. Michael McGinnis, MD MA, MPP
Senior Scholar and Executive Director,
Roundtable on Value & Science-Driven
Health Care Institute of Medicine
Networking, Learning and Evidence:
Strengthening the Foundation for
Progress
Institute of Medicine
of the National Academy of Science
http://www.iom.edu/
From Partnership in Care to
Partnership in Research
Sue Sheridan
Patient Engagement
Mission
PCORI helps people make informed health care decisions, and improves
health care delivery and outcomes, by producing and promoting high
integrity, evidence-based information that comes from research guided
by patients, caregivers and the broader health care community.
PCORI Emphasizes Engagement for
Getting to Practical, Useful Research
Funded Projects to Date
Total number of research
projects awarded: 279
Total funds awarded:
$464.2 million
Number of states where
we are funding research:
38 states (plus the District of
Columbia and Quebec, Canada)
15
Our National Priorities for Research
9
Improving Healthcare Systems
Projects that address critical decisions that face
healthcare systems, the patients and caregivers who
rely on them, and the clinicians who work within them.
41 Awards
$76.5 Million
19
Facilitating Patient Partnership in
Research
47
Pipeline to Proposals
Find Us Online
39
Insights and Responses
Bernard Roberson
Administrative Director of
Patient Family Centered
Care, Georgia Regents
Medical Center
Knitasha Washington,
DHA, FACHE
NCD
Lisa Morrise, MA
Consumer Co-Chair,
Patient and Family
Affinity Group
HENs in Action with HEN-wide PFE
Collaboratives
• Joint Commission
Resources
• Minnesota
• Carolinas
• Dignity
• Pennsylvania
• Washington State
• Ohio Children’s
• UHC
•
•
•
•
•
NoCVa
VHA
AHA/HRET
Georgia
America’s Essential
Hospitals
• LifePoint
• New Jersey
• Premier
PFE as an SAB Strategy
• NoCVa
– HEN-wide collaborative to assist hospitals plan, get
leadership on board & implement PFACs focused on SAB
ASAP
• VHA
– HEN level “partnership council with patient advocates and
hospital executives
– VHA member hospital collaborative
• HRET
– BoD level initiative to “eliminate harm across the board”
– July 2014 “Roadmap” event to enroll hospital safety
leaders and PFAC members in SAB works
– CanDOR Project funded by AHRQ
2nd Annual Quality & Patient Safety Roadmap
(San Diego, July 19-22)
Symposium for
Leadership
In Healthcare Quality
Focus:
• Eliminating HAB
• High Reliability Organizations
• BoD engagement
• PFACs as integral to success
Opportunity:
• AHA/HRET pays costs of up to
125 PFAC members who come
with hospital leaders
• Increase diversity of PFAC
members
Patient Advocacy
Patient Advocacy
Patient
Advocacy
Groups
in Action
in Action
on PFE
Groups
in Action
with Groups
as a Strategy for SAB
the PFE Campaign
• Institute for Patient and
Family Centered Care
• National Partnership for
Women and Families
• Beryl Institute
• Caregiver Action
Network
• Others
• Patient and Family
Centered Care Partners
• Consumers Advancing
Patient Safety
• Mothers Against Medical
Error
PfP HEN Disparities Matrix
PfP HEN Disparities Matrix
Offers & Requests
• PCORI research pipeline
• HRET support for PFAC members to attend
SAB Roadmap event in July
• Collaborative to engage senior leaders in
establishing PFACs to advise on SAB
• Collaborative to engage patient advocates in
understanding SAB and their role in hospital
SAB work
Polling Question for Patient Advocates
Which of the following statements best describes your interest in
participating in a in webinar series designed to inform and give you
command of Safety Across the Board (SAB) and the roles you can
play in advancing SAB at the hospital(s) you rely on for care?
a)
I am on a PFAC and am interested in this opportunity.
b)
I am interested in this opportunity and will inform others in my
PFAC who might also be interested.
c)
I am not ready to take advantage of this opportunity at this
time, but will inform others in my PFAC about the opportunity.
d)
I am not ready to take advantage of this opportunity at this
time and am not on a PFAC, but will inform other patient
advocates in my network about this opportunity.
Polling Question for Hospitals
Which of the following statements best describes your hospital’s
interest in a campaign designed to get hospital senior leadership
commitment to install by Dec. 2014 a PFAC with a role in Safety
Across the Board?
a) Our hospital would definitely participate in this opportunity if
offered.
b) Our hospital would potentially consider this opportunity if
offered.
c) In our hospital, senior leadership is already fully committed to
PFE as a SAB strategy and we are in action.
d) We are not interested in this opportunity at this time, but may
be interested in the future.
Polling Question for HENs
Which of the following statements best describes your HEN’s
interest in a campaign designed to get hospital senior leadership
commitment to install by Dec. 2014 a PFAC with a role in Safety
Across the Board?
a) Our HEN would definitely participate in this opportunity if
offered.
b) Our HEN would potentially consider this opportunity if
offered.
c)
In our HEN, senior leadership is already fully committed to
PFE as a SAB strategy and we are in action.
d) We are not interested in this opportunity at this time, but
may be interested in the future.
Join Our PFE Network
To add patient advocates to the
National PFE Network please contact Kelly at
Weber Shandwick by email at:
KAbrahamson@webershandwick.com
Links and Resources
•
•
•
•
NPSF LLI Safety is Personal
www.IOM.edu
www.PCORI.org
AHA/HRET 2nd Annual Roadmap Event, San
Diego, July 19-22, 2014
Thank you for joining us today!
Upcoming pacing event:
Aligning Forces For CAUTI
Prevention
June 3, 2014