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, 20143:00-4:15 pm (ET)

Welcome

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Martin HatlieNCD

Partnership for Patients Campaign

196 Days and Counting!Our Patients are Counting

on You!

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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 Patients2 Bold Aims: 40/20 by 12/31/14

http://partnershipforpatients.cms.gov

Who is on the call today?

a) Hospital administratorb) Hospital staffc) HEN (Director or Staff)d) QIOe) Federal Agency Partnerf) Patient / Patient Advocateg) Other

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Maximizing PFE to Improve Outcomes

Dennis Wagner and Paul McGann, MDCMS

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

• 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

Fall Prevention Center Mission

• 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. 6,000 avoidable hospital readmissions2. 24,000 nights sleep in patients’ own beds3. 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. Comprehensive discharge planning3. Medication management4. Transition care support5. 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

• 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

MHA’s “RARE” Campaign Reducing Avoidable Readmissions Effectively

Source: Data from RARE website http://www.rarereadmissions.org/

Patient & Family EngagementPfP Campaign Metrics

Patient and Family Advisory CouncilA 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 35Pennsylvania 106 104AHA/HRET Massachusetts SHA 16 16AHA/HRET Connecticut SHA 25 24AHA/HRET Alaska SHA 12 10AHA/HRET DC 2 2Rhode Island SHA 8 6

Patient Perspective

Linda K. Kenney, President and FounderMITSS - Medically Induced Trauma Support Services

Roundtable ParticipantNPSF Lucian Leape Institute, Safety is Personal

NPSF Lucian Leape Institute FacultyLucian L. Leape, MDChair, NPSF Lucian Leape Institute Adjunct Professor of Health Policy Harvard School of Public Health

Susan Edgman-Levitan, PAMember, NPSF Lucian Leape Institute Executive Director, John D. Stoeckle Center for Primary Care Innovation, Massachusetts General Hospital

Tejal K. Gandhi, MD, MPH, CPPSPresident, National Patient Safety Foundation and NPSF Lucian Leape Institute

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The National Patient Safety Foundation’s Lucian Leape Institute

• Mission• Strategic Focus• Transforming Concepts

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Members of the NPSF Lucian Leape InstituteLucian L. Leape, MD, ChairAdjunct Professor of Health PolicyHarvard School of Public Health

Tejal K. Gandhi, MD, MPH, CPPSPresident, NPSF Lucian Leape InstitutePresident, NPSF

Carolyn M. Clancy, MDAssistant Deputy Undersecretary for Health, Quality, Safety and ValueVeterans Health Administration

Janet M. Corrigan, PhD, MBADistinguished FellowThe Dartmouth Institute for Health Policy and Clinical Practice

Susan Edgman-Levitan, PAExecutive DirectorJohn D. Stoeckle Center for Primary Care InnovationMassachusetts General Hospital

Gary S. Kaplan, MD, FACMPEChairman and CEOVirginia Mason Medical Center

Julianne M. Morath, RN, MSPresident & CEOHospital Quality Institute of California

Dennis S. O’Leary, MDPresident EmeritusThe Joint Commission

Paul O'NeillFormer Chairman and CEO, Alcoa72nd Secretary of the U.S. Treasury

Robert M. Wachter, MDAssociate ChairDepartment of MedicineUniversity of California San Francisco

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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

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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.

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-is-personal

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Four Levels of Engagement

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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

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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

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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

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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

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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

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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.

• The ability to ask tough questions constructively.

• The ability to connect with people.

• A sense of humor.• Representative of the

relevant patients/families/conditions.

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Chinese Proverb

Those who say it cannot be done should not interrupt the person doing it. - Chinese proverb

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Organizations in Action

Susan E. Sheridan, MBA MIM, Director of Patient Engagement, Patient Centered

Outcomes Research Institute

J. Michael McGinnis, MD MA, MPPSenior 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 Medicineof the National Academy of Science

http://www.iom.edu/

Sue SheridanPatient Engagement

From Partnership in Care to Partnership in Research

MissionPCORI 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 DateTotal 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)

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Our National Priorities for Research

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Improving Healthcare SystemsProjects 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

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Facilitating Patient Partnership in Research

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Pipeline to Proposals

Find Us Online

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Insights and Responses

Bernard RobersonAdministrative Director of

Patient Family Centered Care, Georgia Regents Medical

Center

Lisa Morrise, MAConsumer Co-Chair, Patient and Family

Affinity Group

Knitasha Washington, DHA, FACHE

NCD

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 LeadershipIn 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 Groups in ActionPatient Advocacy

Groups in Action with the PFE Campaign

• Institute for Patient and Family Centered Care

• National Partnership for Women and Families

• Beryl Institute• Caregiver Action

Network• Others

Patient Advocacy Groups in Action on PFE

as a Strategy for SAB

• 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 AdvocatesWhich 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 HospitalsWhich 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 HENsWhich 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