Nursing Home INTERACT Pilot Project

Thomas P. Meehan, MD, MPHChief Medical Officer

Qualidigm

Progress in Decreasing Hospital Readmissions in Connecticut

Jun-09Sep-09

Dec-09Mar-10

Jun-10Sep-10

Dec-10Mar-11

Jun-11Sep-11

Dec-11Mar-12

Jun-12Sep-12

Dec-12Mar-13

Jun-13Sep-13

Dec-13

20

22

24

26

28

30

32

34

30-d

ay R

eadm

issi

ons

per 1

,000

FFS

Ben

efici

arie

s

Medicare Public Reporting of Hospital Readmissions July 2009

Communities of Care Heart Failure Project February 2010

Last Month of 6-Month Rolling Average

Greater New Haven Community-Based Care Transitions Project March 2012

All-Cause Readmissions Project February 2012

Connecticut Hospital Association – Hospital Engagement Network May 2012

Greater Hartford Community-Based Care Transitions Project August 2012

Medicare Readmissions Financial Penalties October 2012

Reasons to Develop Quality Improvement Programs in Nursing Homes

• Clinical integration – bundled payments• Preferred provider networks• Financial penalties• Public reporting of outcomes• Improve quality, safety, cost, and patient satisfaction• Marketing opportunity

Qualidigm’s Nursing Home QI Pilot in the Middletown Community

• Recruit 14 NHs with ≥ 10% 30-day readmission rates• Obtain leadership support in on-site visits• Collect and analyze Needs Assessment data• Train/assist staff on use of INTERACT data tracking

tools• Train/assist staff on QI process and use of other

INTERACT tools• Follow-up quarterly after six-month training period

(January – June, 2014)

Progress as of May, 2014

• Leadership meeting/commitment to QI pilot – completed at six NHs

• Needs Assessment data collection and analysis– completed at six NHs

• Training and assistance on use of INTERACT data tracking tools – completed at seven NHs

• Training and assistance on QI and INTERACT tools, e.g. SBAR, Stop and Watch – ongoing at six NHs

30-Day All Cause Nursing Home Readmission Rates

Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-140

5

10

15

20

25

NH A NH B NH C NH D NH E NH F NH G

Aggregate

Rolling 3-Month Time Period(label Indicates the last month of the time period)

Perc

ent (

%)

Lessons Learned

• Barriers to Success– Lack of previous QI experience and infrastructure– Inadequate resources– Staff turnover

• Facilitators of Success– Leadership commitment to quality improvement– Sequential implementation of INTERACT tools