Drupal blog posts https://qioprogram.org/ en TMF Partners with Large Arkansas Hospital to Achieve Significant Improvements in Sepsis Rates https://qioprogram.org/quality-in-action-blog-series/tmf-partners-large-arkansas-hospital-achieve-significant-improvements <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--title--blog-post.html.twig x field--node--title.html.twig * field--node--blog-post.html.twig * field--title.html.twig * field--string.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--title.html.twig' --> <span class="field field--name-title field--type-string field--label-hidden">TMF Partners with Large Arkansas Hospital to Achieve Significant Improvements in Sepsis Rates</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--title.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--body--blog-post.html.twig * field--node--body.html.twig * field--node--blog-post.html.twig * field--body.html.twig x field--text-with-summary.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--text-with-summary.html.twig' --> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>The Centers for Medicare &amp; Medicaid Services (CMS) Quality Improvement Organization (QIO) Program is dedicated to improving health care quality at the community level. Hospital Quality Improvement Contractors (HQICs) are strategic partners of the QIO Program dedicated to improving the quality of care delivered to people with Medicare in hospitals.</p> <p>Through its role as an HQIC, TMF Health Quality Institute (TMF) and the Arkansas Hospital Association, partnered with a large Arkansas hospital to decrease its sepsis rate. Working with TMF, the hospital achieved a 25 percent Relative Improvement Rate (RIR) in sepsis mortality between January 2019 and July 2023 and a 51 percent RIR for post-op sepsis achieved between January 2019 and August 2023.</p> <p><img alt="Sepsis bar chart" data-entity-type="file" data-entity-uuid="f56d3fb4-351b-4a2e-9d2f-fb0536890bca" src="/sites/default/files/inline-images/Sepsis_Bar_Charts_01.png" /></p> <p>The hospital completed a mortality analysis and a Patient Safety Indicator 90 (PSI90) analysis, which identified an opportunity for the septic population. The hospital cross-functional team identified sepsis for documentation and coding improvements due to its high volume. TMF worked with the hospital’s quality improvement point of contact and provided their <a href="https://tmfnetworks.org/Portals/0/Resource%20Center/Sepsis%20Tool_508.pdf?ver=2021-06-25-153113-673">Process Improvement Discovery Tool</a> to assist the hospital in identifying process improvement opportunities for reducing cases of sepsis. TMF’s <a href="https://tmfnetworks.org/Portals/0/Resource%20Center/Sepsis%20top%20ten_508.pdf?ver=2021-06-21-133004-957">Sepsis Mortality Reduction Top Ten Checklist</a> was also provided to assist in reviewing current interventions or initiating new ones, to reduce sepsis mortality. The <a href="https://tmfnetworks.org/Portals/0/Resource%20Center/Process%20Improvement%20Tool_Post-Op_508.pdf?ver=2021-03-08-121437-397">Process Improvement Discovery Tool (Post-op Sepsis Prevention Process)</a> was shared to identify improvement opportunities for post-op sepsis prevention. To address the opportunities for improvement, the hospital and TMF identified the following interventions:</p> <ul> <li>Improve communication between hospital staff about sepsis cases</li> <li>Develop logic in EHR to identify sepsis cases</li> <li>Implement physician-to-physician education</li> </ul> <p><em>Improve communication between hospital staff about sepsis cases </em>– Support from senior-level hospital executives and the hospital medical board was key to adopting sepsis as an institutional priority and achieving its goals. Senior leaders were very involved in priority and goal setting. They sponsored the work, attended regular meetings and made sure any barriers were removed. Additionally, hospital leaders spoke at the hospital medical board and QUEST (the hospital’s quality, experience, safety oversight committee) about the importance of working to decrease sepsis, the sepsis pathway, and the communication exchange expected between physicians and nurses regarding patients’ septic status. To reinforce messaging, emails were sent to all residents and physicians, and unit managers were responsible for educating bedside nurses.</p> <p>One key component of improving communication between hospital staff was the implementation of a no-harm approach to identifying sepsis patients. If the emergency department (ED) called for a hospital consult for a possible sepsis case and it turned out that the patient did not have sepsis, this was not frowned upon. The hospital’s approach is that there is “no harm” in calling a physician to evaluate a patient. Like the <em>Preoccupation with Failure </em>principle in a High-Reliability Organization (HRO), employees are encouraged to report their concerns about potential failures. This no-harm approach eliminated hesitation for hospital staff to alert physicians of a patient with possible sepsis. The hospital quality department also played a key role by sharing data with members of a management guidance team made up of representatives from medical and surgical specialties, quality, billing, coding and nursing.</p> <p><img alt="Impatient Sepsis Pathway" data-entity-type="file" data-entity-uuid="510ab70a-3bc4-4a6d-a76e-fc7269a78530" src="/sites/default/files/inline-images/Impatient%20Sepsis%20Pathway.jpg" class="align-right" /></p> <p><em>Develop logic in the EHR to identify sepsis cases</em> – The management guidance team worked together to develop a sepsis protocol referred to as the Inpatient Sepsis Pathway. This protocol set the foundational work that allowed for infectious disease physicians and nurse leaders to be notified of sepsis cases to provide treatment.</p> <p>To make it easy for staff to comply with the new sepsis protocol, the hospital hardwired alerts and bundled orders into its Electronic Health Record (EHR). The hospital’s EHR Inpatient Sepsis Pathway is used to screen patients, which begins calculating at admission. Once a patient reaches a certain score, a best practice alert (BPA) is sent to both the infectious disease nurse and the physician. As a result, the nurse contacts the physician, and the physician follows the sepsis order set or justifies why the order set is not needed.</p> <p><em>Implement physician-to-physician education</em> – In addition to the alerts and order sets hardwired into the EHR, the hospital implemented physician-to-physician education about the need to order lactate labs and repeat labs when needed. Education was provided in grand rounds and resident systems conferences. TMF’s Sepsis Mortality Reduction Top Ten Checklist was given to attending physicians and training physicians.</p> <p> </p> <p> </p> <img alt="TMF HQIC Keys to Success" data-entity-type="file" data-entity-uuid="e94e539a-7bb4-474f-a56e-a653f425ec07" src="/sites/default/files/inline-images/TMF_HQIC_Keys_To_Success_V4%20%28002%29.png" class="align-center" /> <p><strong>Keys to Success</strong></p> <p>TMF’s success can be replicated by taking the following steps:</p> <ol> <li>Gain hospital leadership support for health care-acquired infection goals.</li> <li>Improve the use of EHR by building logic into the system to alert physicians and nurses about suspected sepsis cases and make it easy to order appropriate labs.</li> <li>Provide resources to hospitals based on identified areas of improvement.</li> </ol> <p>For more information, visit <a href="https://tmfnetworks.org/Networks/Hospital-Quality-Improvement-Initiative/Patient-Safety/itg/HQICSQI1">tmfnetworks.org</a>.</p> <p> </p> <p> </p> <p> </p> <p><em>This material was prepared by The Bizzell Group (Bizzell), the Data Validation and Administrative (DVA) contractor, under contract with the Centers for Medicare &amp; Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. 12SOW/Bizzell/DVA-1267-12/22/23</em></p></div> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--text-with-summary.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--uid--blog-post.html.twig x field--node--uid.html.twig * field--node--blog-post.html.twig * field--uid.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--uid.html.twig' --> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'username' --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/user/username.html.twig' --> <span lang="" about="/user/846" typeof="schema:Person" property="schema:name" datatype="">lchatman</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/user/username.html.twig' --> </span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--uid.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--created--blog-post.html.twig x field--node--created.html.twig * field--node--blog-post.html.twig * field--created.html.twig * field--created.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--created.html.twig' --> <span class="field field--name-created field--type-created field--label-hidden">Thu, 03/07/2024 - 11:50 AM</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--created.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--field-tags--blog-post.html.twig x field--node--field-tags.html.twig * field--node--blog-post.html.twig * field--field-tags.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--field-tags.html.twig' --> <div class="field field--name-field-tags field--type-entity-reference field--label-hidden clearfix"> <ul class='links field__items'> <li>HQIC</li> <li>Patient Safety</li> <li>Partnership for Community Health</li> <li>Care Coordination</li> </ul> </div> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--field-tags.html.twig' --> Thu, 07 Mar 2024 16:50:23 +0000 lchatman 3733 at https://qioprogram.org TMF QIN’s Persistence and Focus on Partnership Helps Nursing Home Increase its Resident COVID-19 Vaccination Rate to 100 Percent https://qioprogram.org/quality-in-action-blog-series/tmf-qins-persistence-and-focus-partnership-helps-nursing-home <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--title--blog-post.html.twig x field--node--title.html.twig * field--node--blog-post.html.twig * field--title.html.twig * field--string.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--title.html.twig' --> <span class="field field--name-title field--type-string field--label-hidden">TMF QIN’s Persistence and Focus on Partnership Helps Nursing Home Increase its Resident COVID-19 Vaccination Rate to 100 Percent</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--title.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--body--blog-post.html.twig * field--node--body.html.twig * field--node--blog-post.html.twig * field--body.html.twig x field--text-with-summary.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--text-with-summary.html.twig' --> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>In January 2023, a large metro-area facility in Texas was referred by the Centers for Medicare &amp; Medicaid Services (CMS) to TMF Quality Innovation Network (TMF QIN), a Quality Innovation Network-Quality Improvement Organization (QIN-QIO), to increase nursing home resident COVID-19 vaccinations. To make improvements, the 90-bed facility needed additional support and resources. By leveraging the expertise of TMF QIN, the facility increased its rate from 33.33 to 100 percent as reported to the National Healthcare Safety Network (NHSN) database in September 2023.</p> <p>TMF QIN has a successful record of providing nursing homes in its region with access to on-going support, training, and education. In this specific case, significant turnover at the facility made it difficult to contact the appropriate member of the leadership team. TMF QIN remained persistent, however, and was able to reach the facility’s regional nurse consultant. Together, TMF QIN and the consultant acted as partners to increase the facility’s staff and resident COVID-19 bivalent vaccination rates.</p> <p>To understand the challenges the facility was facing and the opportunities for improvement, TMF QIN conducted a <a href="https://tmfnetworks.org/link?u=d891ad">root-cause analysis (RCA)</a>. As part of their RCA, TMF QIN had multiple conversations with the regional nurse consultant over the phone and via email. These discussions shed light on the significance of the facility’s staff turnover in both leadership and clinical positions. The impact of staffing fluctuations led to gaps in the transition of information, operations and procedures. The remaining facility staff was spread thin, which contributed to immunization resources, education and best practices falling through the cracks and resulting in a decline in the administration of COVID-19 vaccines.</p> <p><strong>The Importance of Accessing Data</strong></p> <p>In addition to uncovering inconsistencies in vaccination education and processes, TMF QIN discovered that the facility’s new staff did not have access to National Healthcare Safety Network (NHSN) data. This information is critical for establishing and verifying resident and staff immunization status. Assisting in obtaining NHSN access was one of the first positive impacts of the partnership between the facility’s leadership and the TMF QIN. Simply having access to accurate immunization data opened the door to continued improvements in staff and resident vaccination rates.</p> <p><strong>Defining Up to Date</strong></p> <p>Another challenge the RCA revealed was misinformation about the definition of being up to date with COVID-19 vaccinations. To help clarify this information and educate facility staff, TMF QIN provided <a href="https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html">What is Up to Date? Understanding the Centers for Disease Control and Prevention (CDC) definitions of "up to date" for the COVID-19 vaccine</a> (Please note: this link is updated regularly with current guidance). This resource was used by the facility as training for staff and information was shared with residents and their families. To help clarify up-to-date terminology in NHSN, TMF QIN also shared <a href="https://www.cdc.gov/nhsn/pdfs/ltc/covidvax/ltc-vaccination-surveillance-definition-sept-2022-508.pdf">Vaccination Status: Surveillance Definition Change for Long-Term Care Facilities</a> assisting the nursing home to understand the change in definition for up to date. Having a clear, ongoing understanding of what the CDC defines as Up to Date is critical to the continued success for the facility.  At the time TMF QIN delivered these resources, the facility was focusing was on the bivalent vaccine. However, the same strategies are applicable to the 2023-24 vaccine.</p> <p><strong>Supporting Vaccination Access</strong></p> <p>In addition to confusion about the definition of being up to date, the facility’s access to the vaccine was inconsistent. This led to a decline in immunizations for staff and residents and contributed to the facility’s low vaccination rates. To address this challenge, TMF QIN worked with the facility’s regional nurse consultant and the on-site pharmacy to schedule and establish a cadence of quarterly vaccination clinics.</p> <p><strong>Providing Resources for Continued Success</strong></p> <p>To ensure the facility’s continued success, TMF QIN recommended the facility initiate a standard practice to educate new hires and provide information about COVID-19 and other immunizations to residents and their families at admission. In addition, TMF recommended the facility implement quarterly care plan education and vaccine offerings for residents, their families, and representatives.</p> <p>To promote vaccine clinics, TMF QIN-QIO also provided the following seasonal flyers:</p> <ul> <li><u><a href="https://tmfnetworks.org/Portals/0/Resource%20Center/2024%20Vaccine%20Flyer-508.pdf">2024 New Year's Resolution COVID-19 Vaccine Flyer</a></u> <ul> <li><u><a href="https://tmfnetworks.org/Portals/0/Resource%20Center/2024%20Vaccine%20Flyer-US%20Spanish-508.pdf">U.S. Spanish</a></u></li> <li><u><a href="https://tmfnetworks.org/Portals/0/Resource%20Center/2024%20Vaccine%20Flyer-Spanish%20for%20Puerto%20Rico-508.pdf">Spanish for Puerto Rico</a></u></li> </ul> </li> <li><u><a href="https://tmfnetworks.org/Portals/0/Resource%20Center/Vaccines%20Are%20Important%20for%20Adults-508.pdf">Vaccines are Important for Adults, Too</a></u></li> <li><u><a href="https://tmfnetworks.org/Portals/0/Resource%20Center/5%20COVID-19%20Facts%20for%20Grandparents%20-%20508.pdf">5 COVID-19 Facts for Grandparents</a></u> <ul> <li><u><a href="https://tmfnetworks.org/Portals/0/Resource%20Center/5%20COVID-19%20Facts%20for%20Grandparents%20-%20US%20Spanish%20-%20508.pdf">U.S. Spanish</a></u></li> <li><u><a href="https://tmfnetworks.org/Portals/0/Resource%20Center/5%20COVID-19%20Facts%20for%20Grandparents%20-%20Spanish%20for%20PR%20-%20508.pdf">Spanish for Puerto Rico</a></u></li> </ul> </li> <li><u><a href="https://tmfnetworks.org/Portals/0/Resource%20Center/Valentines%20Get%20Boosted%20flyer-508.pdf">2023 Valentine's Day COVID-19 Vaccine Flyer</a></u></li> </ul> <p><strong>Keys to Success </strong></p> <p>TMF QIN’s success can be replicated by taking the following steps:</p> <ol> <li>Remain persistent in your efforts to reach key nursing home staff.</li> <li>Ensure nursing home staff have access to NHSN data.</li> <li>Adapt the delivery of tools and training based on the facility’s specific needs.</li> </ol> <img alt="Infographic of three Keys to Success" data-entity-type="file" data-entity-uuid="343afc63-dfe1-4140-a548-2506aac5e46a" src="/sites/default/files/inline-images/TMF_Keys_To_Success%20%28002%29_1.png" class="align-center" /> <p> </p> <ol> </ol> <p> </p> <p> </p> <p> </p> <p> </p> <p><em>This material was prepared by The Bizzell Group (Bizzell), the Data Validation and Administrative (DVA) contractor, under contract with the Centers for Medicare &amp; Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. 12SOW/Bizzell/DVA-1272-1/04/2024. </em></p> </div> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--text-with-summary.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--uid--blog-post.html.twig x field--node--uid.html.twig * field--node--blog-post.html.twig * field--uid.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--uid.html.twig' --> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'username' --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/user/username.html.twig' --> <span lang="" about="/user/846" typeof="schema:Person" property="schema:name" datatype="">lchatman</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/user/username.html.twig' --> </span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--uid.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--created--blog-post.html.twig x field--node--created.html.twig * field--node--blog-post.html.twig * field--created.html.twig * field--created.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--created.html.twig' --> <span class="field field--name-created field--type-created field--label-hidden">Wed, 01/31/2024 - 12:30 PM</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--created.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--field-tags--blog-post.html.twig x field--node--field-tags.html.twig * field--node--blog-post.html.twig * field--field-tags.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--field-tags.html.twig' --> <div class="field field--name-field-tags field--type-entity-reference field--label-hidden clearfix"> <ul class='links field__items'> <li>COVID-19 and Infection Control</li> <li>Immunizations</li> <li>Long-term Care - Nursing Homes</li> <li>QIN-QIO</li> <li>Training</li> </ul> </div> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--field-tags.html.twig' --> Wed, 31 Jan 2024 17:30:26 +0000 lchatman 3658 at https://qioprogram.org HQI HQIC Facilitates CLABSI Interventions to Achieve Cost Savings of $2M https://qioprogram.org/quality-in-action-blog-series/hqi-hqic-facilitates-clabsi-interventions-achieve-cost-savings-2m <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--title--blog-post.html.twig x field--node--title.html.twig * field--node--blog-post.html.twig * field--title.html.twig * field--string.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--title.html.twig' --> <span class="field field--name-title field--type-string field--label-hidden">HQI HQIC Facilitates CLABSI Interventions to Achieve Cost Savings of $2M</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--title.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--body--blog-post.html.twig * field--node--body.html.twig * field--node--blog-post.html.twig * field--body.html.twig x field--text-with-summary.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--text-with-summary.html.twig' --> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>The Centers for Medicare &amp; Medicaid Services (CMS) Quality Improvement Organization (QIO) Program is dedicated to improving the quality of health care at the community level. Hospital Quality Improvement Contractors (HQICs) are strategic partners of the QIO Program dedicated to improving the quality of care delivered to people with Medicare in hospitals.</p> <p>Through its role as an HQIC, Health Quality Innovators (HQI) has been working with a large Mississippi hospital to improve its Central Line-Associated Bloodstream Infection (CLABSI) rate. Working with HQI, the hospital achieved an 80.9 percent relative improvement rate (RIR) from September 2021 to September 2023. During this timeframe, 34.87 total harms were avoided, and 5.23 lives were saved for an estimated cost savings of $1,977,330. Cost savings and lives saved were calculated using methodology recommended by CMS which was based on the white paper titled <em>Estimating the Additional Hospital Inpatient Cost and Mortality Associated with Selected Hospital Acquired Conditions</em><sup>1</sup>.</p> <p><img alt="PDSA Cycle Graphic" data-entity-type="file" data-entity-uuid="018da1d1-f707-44c8-901b-8af967384962" src="/sites/default/files/inline-images/PDSA_Graphic_3.png" class="align-right" />HQI worked with the hospital to use the <a href="https://www.cdc.gov/nhsn/index.html">Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network</a> (NHSN) <a href="https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources/ref-guide/TAP-Reports_Facility_CDI.pdf">Targeted Assessment for Prevention (TAP) Reports</a> to identify nursing units for targeted CLABSI prevention and maintenance education. The <a href="https://www.cdc.gov/hai/pdfs/tap/TAP-Infographic-P.pdf">Targeted Assessment for Prevention Strategy,</a> provides a framework for quality improvement that uses data for action to prevent HAIs by targeting hospitals with an excess burden of infections, assessing for gaps, and implementing prevention strategies. The TAP reports provide information on HAIs needed to assess infection prevention goals in a hospital. Through the hospital TAP report, infection caused by improper central line insertion and two hospital units (telemetry and medical-surgical), were identified as leading contributors to CLABSI events. HQI assisted the hospital with completing a <a href="https://www.ihi.org/resources/how-to-improve">Plan-Do-Study-Act (PDSA) cycle</a>. Opportunities for improvement included:</p> <ul> <li>Hire dedicated central line nurses to train on proper catheter insertion technique and line maintenance</li> <li>Increase staff knowledge of CLABSIs, targeting nurses and night and weekend hospital staff whose knowledge may vary on this topic </li> <li>Improve CLABSI documentation in the hospital’s electronic health record (EHR)</li> <li>Provide additional hand hygiene protocols to support a reduction in CLABSI rates</li> </ul> <p>As a result, with HQI tools and guidance, the hospital implemented the following strategies to reduce CLABSI infection rates:</p> <p><em>Hired additional nursing staff</em> – The hospital hired nurses with expertise in maintaining, monitoring, and utilizing central venous catheters. They provide documentation of CLABSI protocols in the hospital EHR that were previously omitted and work closely with the hospital infection preventionist and quality department to share efforts to decrease CLABSIs.</p> <p><em>Daily shift huddles</em> – To increase CLABSI knowledge, these daily, short meetings were led by a trained central venous catheter nurse and held for general nursing staff to learn the teaching definitions of CLABSI; maintaining, monitoring, and utilizing central venous catheters; and proper use of dressing for the catheter site. HQI provided the hospital with the <a href="https://www.ahrq.gov/hai/patient-safety-resources/cli-checklist/index.html">AHRQ CLABSI Insertion Checklist</a> which outlines sequential critical steps for central line insertion. The hospital uses the checklist during insertion and removal procedures.</p> <p><em>Improved CLABSI documentation</em> – The addition of central line nursing staff improved CLABSI documentation in the hospital EHR. These nurses are responsible for entering and maintaining CLABSI data and information, in addition to educating staff nurses on CLABSI documentation in the EHR.</p> <p><em>Education and monitoring of hand hygiene</em> – The team incorporated an educational hand hygiene learning module that all hospital staff were required to complete every month. For every CLABSI event, the hospital manager completed an event tool and root cause analysis (RCA). All hospital managers were required to present their results regarding infections and RCAs at monthly CLABSI/CAUTI reduction committee meetings. Hand hygiene is monitored through an EHR audit tool and data is sent to hospital managers weekly.</p> <p>The hospital’s hand hygiene goal of 90 percent escalated to 100 percent. A minimum of five observations per day were completed – observing every shift and different units with “just in time” coaching that spontaneously occurs when hospital managers observe an opportunity for a hospital staff member to be coached.</p> <p>Additionally, at HQI’s recommendation, the hospital incorporated a nasal sanitizer antiseptic to reduce the risk of CLABSI for patients by killing bacteria in the nasal vestibule. This product also aids in the prevention of other types of HAIs, such as catheter-associated urinary tract and surgical site infections<sup>2</sup>.</p> <p>Figure 1 below illustrates the hospital’s progress between September 2021 to September 2023 to reduce their CLABSI rate.</p> <p><strong>Figure 1. CLABSI SIR – ICU + Other Units</strong></p> <img alt="Hospital’s progress between September 2021 to September 2023 to reduce their CLABSI rate." data-entity-type="file" data-entity-uuid="d3f85feb-5fc6-436b-aaaf-0463d745f03c" src="/sites/default/files/inline-images/CLABSI%20SIR.png" class="align-center" /> <p><strong>Creating Hospital Mentorship</strong><br /> HQI has utilized the opportunity as an HQIC to create mentoring relationships between hospitals. Partnering mentor hospitals with like-size underperforming hospitals, has allowed mentor hospitals to share experiences and best practices to help underperforming hospitals decrease infections.  </p> <p>The featured hospital in this article served as a mentor hospital. They partnered with another hospital to help improve CAUTI rates. One intervention shared was the use of a nasal sanitizer antiseptic that the mentee<sup>3</sup> hospital adopted.</p> <p><strong>Keys to Success</strong><br /> HQI’s success can be replicated by taking the following steps:</p> <ol> <li>Assist hospitals through data to help identify HAIs that need improvement. </li> <li>Coach hospitals and provide existing tools and resources to assist them in reducing HAIs.</li> <li>Facilitate hospital mentorship to share best practices between hospitals to reduce HAIs.</li> </ol> <p>For more information, visit <a href="https://hqin.org/">hqin.org</a>.</p> <p><sup>1</sup> Bysshe, T., et al. "<a href="https://www.ahrq.gov/sites/default/files/publications2/files/hac-cost-report2017.pdf">Estimating the additional hospital inpatient cost and mortality associated with selected hospital‐acquired conditions.</a>" (2018).<br /> <sup>2,3</sup> Increased Risk of HAIs and the Case for Patient Decolonization in the COVD-19 Era. <a href="https://www.nozin.com/increased-risk-of-hai-and-the-case-for-patient-decolonization-white-paper/">https://www.nozin.com/increased-risk-of-hai-and-the-case-for-patient-decolonization-white-paper/</a></p> <p>__________________</p> <p><em>This material was prepared by The Bizzell Group (Bizzell), the Data Validation and Administrative (DVA) contractor, under contract with the Centers for Medicare &amp; Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. 12SOW/Bizzell/DVA-1223-10/24/23</em></p> </div> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--text-with-summary.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--uid--blog-post.html.twig x field--node--uid.html.twig * field--node--blog-post.html.twig * field--uid.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--uid.html.twig' --> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'username' --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/user/username.html.twig' --> <span lang="" about="/user/169" typeof="schema:Person" property="schema:name" datatype="">rsmith</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/user/username.html.twig' --> </span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--uid.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--created--blog-post.html.twig x field--node--created.html.twig * field--node--blog-post.html.twig * field--created.html.twig * field--created.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--created.html.twig' --> <span class="field field--name-created field--type-created field--label-hidden">Wed, 01/03/2024 - 03:30 PM</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--created.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--field-tags--blog-post.html.twig x field--node--field-tags.html.twig * field--node--blog-post.html.twig * field--field-tags.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--field-tags.html.twig' --> <div class="field field--name-field-tags field--type-entity-reference field--label-hidden clearfix"> <ul class='links field__items'> <li>HQIC</li> <li>Quality Improvement Initiatives (QII)</li> <li>Patient Safety</li> <li>CMS</li> <li>Care Coordination</li> </ul> </div> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--field-tags.html.twig' --> Wed, 03 Jan 2024 20:30:14 +0000 rsmith 3575 at https://qioprogram.org Quality Insights Helps a Nursing Facility with Short-term Rehab Patients Achieve a 91.4 Percent COVID-19 Vaccination Rate https://qioprogram.org/quality-in-action-blog-series/quality-insights-helps-nursing-facility-short-term-rehab-patients <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--title--blog-post.html.twig x field--node--title.html.twig * field--node--blog-post.html.twig * field--title.html.twig * field--string.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--title.html.twig' --> <span class="field field--name-title field--type-string field--label-hidden">Quality Insights Helps a Nursing Facility with Short-term Rehab Patients Achieve a 91.4 Percent COVID-19 Vaccination Rate</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--title.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--body--blog-post.html.twig * field--node--body.html.twig * field--node--blog-post.html.twig * field--body.html.twig x field--text-with-summary.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--text-with-summary.html.twig' --> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p><img alt="91.4 percent data call out" data-entity-type="file" data-entity-uuid="704616f6-2741-4c94-96ba-34f91553f6fe" src="/sites/default/files/inline-images/Quality_Insignts_Data_Callout.png" class="align-right" />A 96-bed, in-patient rehabilitation and nursing facility was referred by the Centers for Medicare &amp; Medicaid Services (CMS) to Quality Insights, a CMS Quality Innovation Network-Quality Improvement Organization (QIN-QIO), for assistance with increasing its resident COVID-19 vaccination rate. The QIN-QIO conducted a root-cause analysis (RCA) and helped the facility identify underlying barriers and create a solution-oriented plan to address the obstacles uncovered by the RCA. This led to 91.4 percent of residents receiving a COVID-19 vaccination, a 58.4 percent increase from when the facility was first referred to the QIN-QIO and the last report to the National Healthcare Safety Network (NHSN) database in January 2023.</p> <p><strong>Obtaining Consents from Transient Patient Population is the First Step</strong><br /> Due to 50 percent of the facility’s patients being short-term rehabilitation residents, achieving and maintaining a high resident COVID-19 vaccination rate is very challenging. Many residents only spend one to two weeks at the facility as patients. The result is that facility staff are continually evaluating, educating, and attempting to gain consent from residents to ensure a high COVID-19 vaccination rate.</p> <p>The facility administrator shared with Quality Insights that the facility staff was strong in educating and consenting patients. The team’s process is to ask new admits if they are up to date on their COVID-19 vaccine and then educate and ask for consent to administer the vaccine for those who are not. A member of the facility’s social services staff receives a list of residents who did not consent upon admission. They follow up with these residents to provide further education, resulting in more consents. </p> <p>Despite being able to obtain consents from many new admitted patients, some were still not vaccinated by the time of discharge. Therefore, there was another underlying root cause for the facility’s low vaccination rates.</p> <p><strong>Using Root-Cause Analysis to Shed Light on an Obvious Solution</strong><br /> Asking the right questions is critical in discovering opportunities to make improvements. Quality Insights collaborated with the facility through email and phone communications using a variety of descriptive questions to understand more about their admission consent and vaccination process. Through this discovery, it was learned that 50 percent of their residents are only in rehabilitation treatment for a short period of time. The main issue that surfaced was that many of the rehabilitation residents are often discharged by the time an outside pharmacy vaccine clinic could be coordinated and conducted. Not having easy, on-site access to the vaccine was contributing to the facility’s low resident COVID-19 vaccination rate. </p> <p>During the RCA meeting with the facility administrator, Quality Insights recommended contacting the pharmacy to request utilizing single-dose COVID vaccine vials onsite. Once the facility had a supply of vials on hand, the nursing staff was able to administer the vaccine onsite soon after gaining consent. The success is the facility increased its resident vaccination rate by 58.4 percent, resulting in 91.4 percent of residents being up to date on their vaccines, overcoming the challenge posed by the facility’s high population turnover.</p> <p><strong>Helpful Resources for Facilities Facing Challenges Raising Resident Vaccination Rates</strong><br /> Quality Insights provides the following resources to facilities facing challenges raising resident vaccination rates:</p> <ul> <li><a href="https://acrobat.adobe.com/link/review?uri=urn%3Aaaid%3Ascds%3AUS%3A715928c3-c2b9-3167-9dc0-647acebabbb5">Adult Immunization Toolkit for Clinicians</a> <br /> This toolkit provides clinicians with resources to help improve adult immunization rates.</li> <li><a href="https://stacks.cdc.gov/view/cdc/103167">COVID-19 Vaccine Communication and Confidence Checklist</a><br /> Use this checklist to promote COVID-19 vaccine confidence among your healthcare personnel.</li> <li><a href="https://www.cdc.gov/vaccines/covid-19/downloads/Appendix-B-Conversation-Starter.pdf">The COVID-19 Vaccine Confidence Conversation Starter</a><br /> Engage health facility/clinic staff at different levels to identify practical ways to promote vaccine confidence and support high vaccine uptake.  </li> <li><a href="https://www.cdc.gov/vaccines/covid-19/hcp/engaging-patients.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fvaccines%2Fhcp%2Fcovid-conversations%2Fengaging-patients.html">CDC Meaningful Conversations with Patients</a><br /> An introduction to motivational interviewing for healthcare professionals.</li> <li><a href="https://www.ahrq.gov/nursing-home/materials/prevention/vaccine-trust.html"><em>Invest in Trust</em>: A Guide for Building COVID-19 Vaccine Trust Among Certified Nursing Assistants (CNAs)</a><br /> Designed to help nursing home leaders build COVID-19 vaccine confidence among CNAs and overcome barriers to vaccination by applying insights from social, behavioral, and cognitive science.</li> </ul> <p>Quality Insights also offers a weekly e-bulletin, the <a href="https://mailchi.mp/qualityinsights/last-minute-lowdown-112423"><em>Last-Minute Lowdown</em></a>, that provides the latest news on immunizations, long-term care, and skilled nursing facilities — plus resources from CDC, CMS, state health agencies, and Quality Insights. These ongoing support strategies continue to encourage the facility’s progress.</p> <p><strong><img alt="Keys to success graphic " data-entity-type="file" data-entity-uuid="92cfdf12-6874-455d-92a0-f8ec90e95864" src="/sites/default/files/inline-images/Quality_Insights_Keys_To_Success.png" class="align-left" />Keys to Success</strong><br /> Quality Insights’ success helping the facility achieve a 91.4 percent resident COVID-19 vaccination rate can be replicated by taking the following steps:</p> <ol> <li><strong>Ask the right questions</strong>. Through an RCA ask in-depth, clarifying questions. Examples are: Have you had a recent vaccine clinic? How many residents and staff participated? What are your barriers to increasing your vaccination rates? </li> <li><strong>Identify a simple solution</strong>. Remember to consider easy and obvious answers to overcome barriers. Doing something slightly different can garner big results.</li> <li><strong>Quick to action</strong>. Utilizing the appropriate resources to implement turn-key improvements.</li> </ol> <p><em>This material was prepared by The Bizzell Group (Bizzell), the Data Validation and Administrative (DVA) contractor, under contract with the Centers for Medicare &amp; Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. 12SOW/Bizzell/DVA-1242-11/30/2023.</em></p></div> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--text-with-summary.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--uid--blog-post.html.twig x field--node--uid.html.twig * field--node--blog-post.html.twig * field--uid.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--uid.html.twig' --> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'username' --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/user/username.html.twig' --> <span lang="" about="/user/169" typeof="schema:Person" property="schema:name" datatype="">rsmith</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/user/username.html.twig' --> </span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--uid.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--created--blog-post.html.twig x field--node--created.html.twig * field--node--blog-post.html.twig * field--created.html.twig * field--created.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--created.html.twig' --> <span class="field field--name-created field--type-created field--label-hidden">Mon, 12/18/2023 - 06:44 PM</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--created.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--field-tags--blog-post.html.twig x field--node--field-tags.html.twig * field--node--blog-post.html.twig * field--field-tags.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--field-tags.html.twig' --> <div class="field field--name-field-tags field--type-entity-reference field--label-hidden clearfix"> <ul class='links field__items'> <li>QIN-QIO</li> <li>Long-term Care - Nursing Homes</li> <li>COVID-19 and Infection Control</li> <li>Immunizations</li> <li>Patient Safety</li> </ul> </div> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--field-tags.html.twig' --> Mon, 18 Dec 2023 23:44:53 +0000 rsmith 3535 at https://qioprogram.org HQI Helps Nursing Home Successfully Implement Motivational Interviewing to Address Vaccine Hesitancy https://qioprogram.org/quality-in-action-blog-series/hqi-helps-nursing-home-successfully-implement-motivational <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--title--blog-post.html.twig x field--node--title.html.twig * field--node--blog-post.html.twig * field--title.html.twig * field--string.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--title.html.twig' --> <span class="field field--name-title field--type-string field--label-hidden">HQI Helps Nursing Home Successfully Implement Motivational Interviewing to Address Vaccine Hesitancy</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--title.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--body--blog-post.html.twig * field--node--body.html.twig * field--node--blog-post.html.twig * field--body.html.twig x field--text-with-summary.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--text-with-summary.html.twig' --> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>A medium-sized nursing facility in Missouri was referred by the Centers for Medicare &amp; Medicaid Services (CMS) to Health Quality Innovators (HQI), a CMS Quality Innovation Network-Quality Improvement Organization (QIN-QIO), for assistance with improving its resident COVID-19 vaccination rate. The facility serves individuals with psychological behavior issues and many of the residents have public administrators assigned to them as guardians. Due to COVID-19 misinformation, a number of guardians refused vaccines for the residents whose care they managed. Using targeted resources, HQI helped the facility achieve a 38.64 percent increase in its resident COVID-19 vaccination rate from the time the QIN-QIO made its initial outreach to the nursing home in January 2023. From the last report to the National Healthcare Safety Network (NHSN) in September 2023, the facility reported an 84.42 percent vaccination rate for current residents.</p> <p><strong>Root Cause Analysis Reveals Several Challenges</strong></p> <p>To assist the facility’s efforts in increasing vaccination rates, HQI conducted a root cause analysis (RCA) that revealed a concerning trend. Some of the public administrator guardians were consistently refusing vaccinations for the residents under their care; and, while the Infection Prevention (IP) nurse documented the refusals, the underlying concerns were not being effectively addressed. Many of the guardians were frequently saying no to vaccinations without proper justification. The opportunity for the facility to improve educational efforts became apparent. Together with HQI, the facility set an initial, but achievable goal, of increasing its resident vaccination rate by 10 percent through the use of motivational interviewing techniques.</p> <p><strong>Motivational Interviewing Coaching to Boost Guardian Confidence and Reduce Hesitancy</strong></p> <p>As a result of the support and training from HQI, the nursing home leadership’s perspective changed from “no one will consent” to looking for opportunities to shift the conversation with guardians and residents to address their individual concerns. HQI suggested prioritizing conversations with guardians who initially did not identify “why” they were refusing the vaccine and had been open to new care plan interventions in the past. HQI and facility leadership agreed that these individuals may be more likely to consider vaccination once their "why" was identified and addressed.</p> <p>HQI then trained nursing home leadership by introducing Motivational Interviewing best practices during team calls and via email. Emphasizing patience during guardian conversations, HQI equipped the facility team with tools to navigate consent discussions, highlighting that overcoming fears is a gradual process. In addition, HQI encouraged persistence and maintaining open communication rather than pushing for immediate agreement. Although initial frustrations arose, the perseverance and HQI’s ongoing support paid off when consents began flowing in, proving the value of understanding, and addressing the root causes of reluctance. HQI enhanced motivational interviewing technique training using the following tools:</p> <ol> <li> <p><a href="https://hqin.org/wp-content/uploads/2022/10/Motivational-Interviewing-Strategies-for-Vaccination-Readiness.pdf">Motivational Interviewing Strategies for Vaccination Readiness</a> - Implementing motivational interviewing techniques to engage residents and guardians effectively.</p> </li> <li> <p><a href="https://hqin.org/wp-content/uploads/2022/09/Mining-for-Motivation-Presentation.pdf">Mining for Motivation: Finding Others’ Internal Motivation with Person-Centered Interviewing</a> - Identifying the internal motivations of residents to encourage vaccination.</p> </li> <li> <p><a href="https://www.cdc.gov/vaccines/covid-19/health-departments/addressing-vaccine-misinformation.html">How to Address COVID-19 Vaccine Misinformation</a> - Equipping staff with the skills to address and correct misinformation about COVID-19 vaccines.</p> </li> <li> <p><a href="https://www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html">Myths and Facts about COIVD-19 Vaccines</a> - Providing accurate information to counter misconceptions.</p> </li> <li> <p><a href="https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fhqin.org%2Fwp-content%2Fuploads%2F2023%2F06%2FVaccine-Letter-to-Residents_rev05.23.docx&amp;wdOrigin=BROWSELINK">Vaccine Letter to Residents and Family Members/Responsible Party</a> - Offering clear and informative communication to residents and their guardians.</p> </li> </ol> <p>With these new skills, the IP nurse was able to navigate person-centered conversations with each guardian and effectively address their concerns by learning more about their original motivation for declining the vaccine. This individualized approach helped build trust and openness with the guardians which ultimately led to increased approvals for vaccines to be administered to residents.</p> <p>As the infection prevention nurse gained confidence using motivational interviewing techniques, they ultimately reached out to all the guardians who initially refused vaccinations for their residents to achieve the 38.64 percent increase in its resident COVID-19 vaccination rate. </p> <p><strong>Keys to Success</strong></p> <p>HQI successfully achieved their goal, improved vaccination rates, and ensured the health and safety of the residents. HQI’s success can be replicated by taking the following steps:</p> <img alt="HQI Keys to Success graphic" data-entity-type="file" data-entity-uuid="b100138a-8077-4666-8d78-bc7d9001a144" src="/sites/default/files/inline-images/HQI_Keys_To_SuccessV3.png" class="align-center" /> <p><strong>Regional Impact of HQI’s Assistance</strong><br /> Per the NHSN weekly report dated September 24, 2023, the percentage of residents who are up to date in nursing homes that received assistance from HQI increased by 11 percent as compared to the average change in resident vaccination across all nursing homes in HQIs region.</p> <p> </p> <p><em>This material was prepared by The Bizzell Group (Bizzell), the Data Validation and Administrative (DVA) contractor, under contract with the Centers for Medicare &amp; Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. 12SOW/Bizzell/DVA-1224-11/07/2023.</em><br />  </p> </div> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--text-with-summary.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--uid--blog-post.html.twig x field--node--uid.html.twig * field--node--blog-post.html.twig * field--uid.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--uid.html.twig' --> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'username' --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/user/username.html.twig' --> <span lang="" about="/user/169" typeof="schema:Person" property="schema:name" datatype="">rsmith</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/user/username.html.twig' --> </span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--uid.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--created--blog-post.html.twig x field--node--created.html.twig * field--node--blog-post.html.twig * field--created.html.twig * field--created.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--created.html.twig' --> <span class="field field--name-created field--type-created field--label-hidden">Wed, 11/22/2023 - 10:31 AM</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--created.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--field-tags--blog-post.html.twig x field--node--field-tags.html.twig * field--node--blog-post.html.twig * field--field-tags.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--field-tags.html.twig' --> <div class="field field--name-field-tags field--type-entity-reference field--label-hidden clearfix"> <ul class='links field__items'> <li>Patient Safety</li> <li>Long-term Care - Nursing Homes</li> <li>COVID-19 and Infection Control</li> <li>CMS</li> <li>QIN-QIO</li> </ul> </div> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--field-tags.html.twig' --> Wed, 22 Nov 2023 15:31:06 +0000 rsmith 3481 at https://qioprogram.org Beneficiary and Family Centered Care-Quality Improvement Organizations Supporting Medicare Beneficiaries with Timely Patient-Centered Care https://qioprogram.org/quality-in-action-blog-series/beneficiary-and-family-centered-care-quality-improvement <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--title--blog-post.html.twig x field--node--title.html.twig * field--node--blog-post.html.twig * field--title.html.twig * field--string.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--title.html.twig' --> <span class="field field--name-title field--type-string field--label-hidden">Beneficiary and Family Centered Care-Quality Improvement Organizations Supporting Medicare Beneficiaries with Timely Patient-Centered Care</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--title.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--body--blog-post.html.twig * field--node--body.html.twig * field--node--blog-post.html.twig * field--body.html.twig x field--text-with-summary.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--text-with-summary.html.twig' --> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>To protect Medicare beneficiaries and the Medicare Trust Fund, the Centers for Medicare &amp; Medicaid Services (CMS) established Beneficiary and Family Centered Care-Quality Improvement Organizations (BFCC-QIOs). BFCC-QIOs help Medicare beneficiaries exercise their right to high-quality health care by providing assistance when beneficiaries have a concern about their care.</p> <img alt="Discharge Appeals graphic" data-entity-type="file" data-entity-uuid="fa0efcb7-53c8-4258-8fba-6f5227dac82f" src="/sites/default/files/inline-images/Discharge_Appeals_Graphic.png" class="align-center" /> <p>From June 2019 through April 2023, the BFCC-QIOs completed more than 1 million Discharge Appeal Reviews for Medicare beneficiaries, conducted almost 20,000 Quality of Care Reviews, and facilitated more than 40,000 Immediate Advocacy cases.</p> <p><strong>Support Services for Medicare Beneficiaries with a Focus on Timeliness</strong></p> <p>Understanding that coordination of healthcare services can be stressful and time-sensitive, the BFCC QIOs must complete case work within aggressive timelines. BFCC-QIO timeliness metrics ensure that beneficiaries and their families have the information they need for decision-making and next steps. In <strong>more than 95 percent of all cases, BFCC-QIOs met or exceeded their goals for timeliness </strong>and resolved cases for Medicare beneficiaries.</p> <p><strong><img alt="Hospital icon" data-entity-type="file" data-entity-uuid="cb67e12b-0e36-4af0-a86c-8c5eff64a339" src="/sites/default/files/inline-images/Hospital_Icon4.png" class="align-left" />Discharge appeals</strong> vary slightly by setting of care and whether the beneficiary is enrolled in Original Medicare or a Medicare Managed Care plan; after the BFCC-QIO has been notified of the appeal, the team has 24 to 72 hours to complete the appeal, depending on the setting and type of Medicare coverage.</p> <p><img alt="Folder icon" data-entity-type="file" data-entity-uuid="6cf43f84-5526-44e0-9a55-944057653af3" src="/sites/default/files/inline-images/Folder_Icon3.png" class="align-left" />In support of beneficiary-initiated <strong>Quality of Care complaints</strong>, BFCC-QIOs progress through a detailed set of steps to obtain input from the beneficiary or family member/representative about the nature of the complaint, obtain relevant medical records, review all files, and compare documentation of care delivered to current care standards. They then follow up with beneficiaries and providers or practitioners about the findings. At each step of the process, BFCC-QIOs maintain timeliness and ensure that documentation required for the review is available.</p> <p><img alt="Telephone icon" data-entity-type="file" data-entity-uuid="45de0de8-3472-4faa-a9fe-73d69c2d8856" src="/sites/default/files/inline-images/Telephone_Icon3.png" class="align-left" />Given the nature of<strong> Immediate Advocacy</strong>, which is intended to help resolve an issue or complaint in a collaborative and expedited fashion, these cases are typically resolved within two days of initiation. During this time, BFCC-QIOs help Medicare beneficiaries with communication problems between beneficiaries and their providers or practitioners for issues such as getting medical equipment or getting a prescription order sent to the pharmacy.</p> <p><strong>Ensuring Services are Patient and Family Centered</strong></p> <p>In keeping with CMS’ commitment to deliver beneficiary and family-centered care, BFCC-QIOs have a mandate to ensure the support they provide is tailored for beneficiaries and results in a positive beneficiary experience.</p> <p><img alt="87 percent infographic" data-entity-type="file" data-entity-uuid="b8fccd3a-f13a-42d3-8d2c-11b808747a28" src="/sites/default/files/inline-images/87%20Percent.png" class="align-left" />As part of beneficiary-initiated Quality of Care complaint reviews, BFCC-QIOs provide detailed and fact specific findings in a letter to Medicare beneficiaries. While the letter describes complex clinical content, using plain language helps beneficiaries understand the findings of the review and know what supports and next steps are available to them. </p> <p>To ensure that BFCC-QIOs are delivering high quality, beneficiary-and family centered case review services, a sample of beneficiaries who received support from the BFCC-QIO are surveyed about their experience with the process. The survey asks about interactions with the BFCC-QIO, and support received through the process. Survey data provide ongoing feedback for BFCC-QIOs that help them implement quality improvement initiatives to deliver the best experience to Medicare beneficiaries and their families. In the most recent annual evaluation, <strong>87 percent of surveys reflected a positive beneficiary experience</strong> with BFCC-QIO services.</p> <p>Feedback from Medicare beneficiaries suggests the BFCC-QIOs are having the intended impact. One beneficiary who received support commented, “The people I interacted with were helpful with the steps, they got in contact with the facility, got back to me, explained that they would advocate and what steps I could take. I found them to be helpful. I had a good experience.”</p> <p> </p> <p> </p> <p> </p> <p><em>The preparation of this publication was performed under Contract No. 75FCMC19D0068 75CMC19F0001, funded by the Centers for Medicare &amp; Medicaid Services, an agency of the U.S. Department of Health and Human Services. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services and/or CMS nor does mention of organizations imply endorsement by the U.S. government. The authors assume full responsibility for the accuracy and completeness of the ideas presented. </em></p> <p><em>Stephanie Fry is the Deputy Project Director with the BFCC NCORC. </em></p> <p><em>Sandra Zelaya is a Communications Specialist with the BFCC NCORC.</em></p> <p><em>The authors declare no conflicts of interest. </em></p> <p><em>Address for correspondence: Wendy Gary, Avar Consulting, Inc. 1395 Piccard Drive, Suite 200 Rockville, MD 20850. (wgary@avarconsulting.com). Publication Number: ACD-2023-NCORC-0251</em></p></div> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--text-with-summary.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--uid--blog-post.html.twig x field--node--uid.html.twig * field--node--blog-post.html.twig * field--uid.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--uid.html.twig' --> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'username' --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/user/username.html.twig' --> <span lang="" about="/user/846" typeof="schema:Person" property="schema:name" datatype="">lchatman</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/user/username.html.twig' --> </span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--uid.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--created--blog-post.html.twig x field--node--created.html.twig * field--node--blog-post.html.twig * field--created.html.twig * field--created.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--created.html.twig' --> <span class="field field--name-created field--type-created field--label-hidden">Tue, 10/31/2023 - 06:17 PM</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--created.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--field-tags--blog-post.html.twig x field--node--field-tags.html.twig * field--node--blog-post.html.twig * field--field-tags.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--field-tags.html.twig' --> <div class="field field--name-field-tags field--type-entity-reference field--label-hidden clearfix"> <ul class='links field__items'> <li>BFCC-QIO</li> <li>Care Coordination</li> <li>Long-term Care - Nursing Homes</li> <li>Patient and Family Engagement</li> <li>CMS</li> </ul> </div> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--field-tags.html.twig' --> Tue, 31 Oct 2023 22:17:18 +0000 lchatman 3450 at https://qioprogram.org Focused Interventions Drive Success in Reducing CAUTIs at Louisiana Hospital https://qioprogram.org/quality-in-action-blog-series/focused-interventions-drive-success-reducing-cautis-louisiana <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--title--blog-post.html.twig x field--node--title.html.twig * field--node--blog-post.html.twig * field--title.html.twig * field--string.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--title.html.twig' --> <span class="field field--name-title field--type-string field--label-hidden">Focused Interventions Drive Success in Reducing CAUTIs at Louisiana Hospital</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--title.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--body--blog-post.html.twig * field--node--body.html.twig * field--node--blog-post.html.twig * field--body.html.twig x field--text-with-summary.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--text-with-summary.html.twig' --> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>The Centers for Medicare &amp; Medicaid Services (CMS) Quality Improvement Organization (QIO) Program is dedicated to improving the quality of health care at the community level. Hospital Quality Improvement Contractors (HQICs) are strategic partners of the QIO Program that help hospitals improve outcomes in several patient-safety-related areas such as hospital-acquired infections (HAIs).</p> <p>Convergence Health Consulting (Convergence) is one of nine organizations that CMS awarded a HQIC contract. To maximize their HQIC work with 300 hospitals in 11 states, Convergence subcontracts with regional and state hospital associations that have well-established relationships in their communities and serve all types of hospitals, healthcare systems, communities, patients and families. Convergence provides tools and resources the associations can use with hospitals to support the reduction of HAIs through a partnership with Cynosure Health and its <a href="https://clic.thinkific.com/courses/CAUTI-resource-library">Cynosure Learning Improvement Connection (CLIC)</a> virtual learning platform.</p> <p><img alt="Percentage callout graphic of 58.68%" data-entity-type="" data-entity-uuid="" src="https://qioprogram.org/sites/default/files/2023-11/Convergence_Blog_Graphic_V7.png" class="align-right" /></p> <p>One large Louisiana hospital successfully reduced Catheter-Associated Urinary Tract Infection (CAUTI) rates. In partnership with Convergence and the Louisiana Hospital Association (LHA), the hospital achieved a 58.68 percent reduction (percentage change baseline to performance) with a post-intervention period from 10/1/21 – 6/30/23.</p> <p>To better understand their CAUTI rate, LHA provided the hospital with the Convergence <a href="https://clic.thinkific.com/courses/CAUTI-resource-library">CAUTI Discovery Tool</a> to conduct their own mini root cause analysis. LHA, in collaboration with the Convergence infection control lead, reached out to the hospital for a virtual visit to ascertain what the hospital found through the analysis and what they were prioritizing. The analysis revealed opportunities to:</p> <ul> <li>Improve clinical documentation for appropriate indications, sterile techniques, proper catheter and peri-care</li> <li>Conduct two-person insertions</li> <li>Increase organizational knowledge of high-reliability tactics to improve patient outcomes</li> </ul> <p>As a result, with HQIC tools and guidance, the hospital worked to implement the following interventions to reduce CAUTI infection rates:</p> <p>Held daily device huddles – These short meetings are attended by nursing unit directors and hospital leadership and include a review of all devices, including Foley catheters. Attendees review the number of Foleys per unit, indications, and CAUTIs. Huddles increased transparency and accountability, elevated the importance of improving patient outcomes, and decreased the inappropriate use of Foley catheters. A <a href="https://qioprogram.org/tools-resources/report-foleys-daily-device-huddles">Foley report</a> is shared with staff that includes patient information, days inserted, indication/necessity and length of stay shared during daily device huddles.</p> <p>Hired a device nurse – The device nurse is a dedicated expert in the hospital who assesses all devices using a daily Foley Device Report (see Figure 1) in the facility’s electronic health record (EHR). This assessment allows for the development of an escalation process to discontinue Foley catheters if needed. The device nurse provided CAUTI education to staff including Foley alternatives, such as external catheters and intermittent catheters, and with assistance from LHA, created tools such as <a href="https://qioprogram.org/tools-resources/disrupting-lifecycle-urinary-catheter-and-central-line-algorithms">Disrupting the Lifecycle of the Urinary Catheter Algorithm</a> for nursing staff.</p> <p style="margin-bottom:11px"><em>Figure 1. Example Daily Foley Device Report</em></p> <p class="text-align-center"><img alt="A screenshot of a computer&#10;&#10;Description automatically generated" id="Picture_x0020_1" o:borderbottomcolor="#ffbf00 pure" o:borderleftcolor="#ffbf00 pure" o:borderrightcolor="#ffbf00 pure" o:bordertopcolor="#ffbf00 pure" 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/></p> <p>Created CAUTI educational materials – A CAUTI Prevention PowerPoint, the Disrupting the Lifecycle of the Urinary Catheter Algorithm and <a href="https://qioprogram.org/tools-resources/foley-catheter-maintenance-bundle-easy-reference">Maintenance Bundle Easy Reference Guide</a> were created for nursing staff to improve patient care. Working with LHA, the hospital initiated an updated Nurse-Driven Catheter Removal/<a href="https://nam11.safelinks.protection.outlook.com/?url=https%3A%2F%2Flhaonline.org%2Fcommon%2FUploaded%2520files%2FQuality%2FLinks%2FBladderManagementforUrinaryRetentionDiagram5.19.21.pdf&amp;data=05%7C01%7Cmsmith%40lhaonline.org%7C65a26b7332c24c6feeb808dbd01b0851%7C842a2fa021354e6f9dc3a76ee7b9edcf%7C1%7C0%7C638332586754182231%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&amp;sdata=d%2BZMh9Erjph7lGU6zAtVnqhiVNJQ%2FqVizpOUklJNPP4%3D&amp;reserved=0">Management of Urinary Retention Protocol</a> that focused on educating, engaging, and empowering frontline staff to execute the protocol to improve patient outcomes. Additional resources from Cynosure Health’s CLIC learning platform such as a free resource course, <a href="https://clic.thinkific.com/courses/CAUTI-resource-library">Prevention of Catheter-Associated Urinary Tract Infections (CAUTI) (thinkific.com)</a>, the <a href="https://clic.thinkific.com/courses/CAUTI-resource-library">CAUTI Discovery Tool</a> and the <a href="https://clic.thinkific.com/courses/CAUTI-resource-library">CAUTI Change Package</a> were provided. Other no-cost patient safety courses such as <a href="https://clic.thinkific.com/courses/CAUTI-resource-library">Infection Prevention</a> and <a href="https://clic.thinkific.com/courses/CAUTI-resource-library">CAUTI Improvement</a> are also available to hospital staff.</p> <p>Developed CAUTI prevention bundles – Two CAUTI prevention bundles, one for insertion and one for catheter maintenance, were created and built into the hospital’s EHR. An <a href="https://nam11.safelinks.protection.outlook.com/?url=https%3A%2F%2Flhaonline.org%2Fcommon%2FUploaded%2520files%2FQuality%2FLinks%2FFoleyInsertionChecklist12.2.2020.docx&amp;data=05%7C01%7Cmsmith%40lhaonline.org%7C65a26b7332c24c6feeb808dbd01b0851%7C842a2fa021354e6f9dc3a76ee7b9edcf%7C1%7C0%7C638332586754182231%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&amp;sdata=%2FRiQMzGexzHITXBmk9xOhnkUYs2ev9uc%2Bv4hSIKm2pg%3D&amp;reserved=0">Insertion Audit Tool</a> and a <a href="https://nam11.safelinks.protection.outlook.com/?url=https%3A%2F%2Flhaonline.org%2Fcommon%2FUploaded%2520files%2FQuality%2FLinks%2FEPICFoleyMaintenanceFlowsheetTemplate.png&amp;data=05%7C01%7Cmsmith%40lhaonline.org%7C65a26b7332c24c6feeb808dbd01b0851%7C842a2fa021354e6f9dc3a76ee7b9edcf%7C1%7C0%7C638332586754182231%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&amp;sdata=IHs%2FCgUc0s3HIKJ7WMCqcWadcr3jmtbwLcfmG1RVkCU%3D&amp;reserved=0">Maintenance Audit Tool</a> were created by the hospital for the bundle elements. The Insertion Audit Tool documents if the indication was appropriate and aseptic techniques were used. The Maintenance Audit tool documents the following:</p> <ol> <li>How many days the Foley has been in?</li> <li>Was appropriate peri-care documented?</li> <li>Is the location of the bag (i.e., off the floor) appropriate?</li> <li>Is there an unobstructed drainage system?</li> <li>Is an approved securement device in place?</li> <li>What is the urine volume in the bag?</li> <li>Is a closed system maintained?</li> <li>Was catheter necessity discussed with the physician and what is the indication for use?</li> </ol> <p>The infection preventionist and device nurse use these tools in their daily reviews of CAUTI cases.   </p> <p>Implemented a management protocol for difficult urinary catheterizations – This <a href="https://nam11.safelinks.protection.outlook.com/?url=https%3A%2F%2Flhaonline.org%2Fcommon%2FUploaded%2520files%2FQuality%2FLinks%2FManagementofDifficultUrinaryCatheterizations6.30.2021.pdf&amp;data=05%7C01%7Cmsmith%40lhaonline.org%7C65a26b7332c24c6feeb808dbd01b0851%7C842a2fa021354e6f9dc3a76ee7b9edcf%7C1%7C0%7C638332586754182231%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&amp;sdata=ru%2BdwHDsd0Wcc2vM7ay8NCwBVYRVepAB6uWSOGSTUS8%3D&amp;reserved=0">management protocol</a> assists the nursing staff in focusing on bladder management of a patient with cervical or thoracic spinal cord injury or chronic urinary retention including neurogenic bladder. The nursing staff references this protocol when difficult insertions arise.</p> <p><strong>Keys to Success</strong></p> <p>Convergence’s success can be replicated by taking the following steps:</p> <ol> <li>Ensure tools and resources for preventing HAIs, such as the <a href="https://clic.thinkific.com/courses/CAUTI-resource-library">CAUTI Discovery Tool</a> and the <a href="https://clic.thinkific.com/courses/CAUTI-resource-library">CAUTI Change Package</a> are available to hospitals.</li> <li>Build relationships with hospitals through onsite visits, coaching calls, and outreach emails to provide support for HAI prevention.</li> <li>Encourage hospital senior leadership involvement to elevate the importance of infection prevention and improve patient outcomes.</li> </ol> <p>For more information, visit <a href="https://cynosurehealth.org/hospital-quality-improvement-collaborative-hqic/">Convergence HQIC</a>.</p> <p> </p> <p> </p> <p><em>This material was prepared by The Bizzell Group (Bizzell), the Data Validation and Administrative (DVA) contractor, under contract with the Centers for Medicare &amp; Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. 12SOW/Bizzell/DVA-1193-09/13/23</em></p> </div> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--text-with-summary.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--uid--blog-post.html.twig x field--node--uid.html.twig * field--node--blog-post.html.twig * field--uid.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--uid.html.twig' --> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'username' --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/user/username.html.twig' --> <span lang="" about="/user/846" typeof="schema:Person" property="schema:name" datatype="">lchatman</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/user/username.html.twig' --> </span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--uid.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--created--blog-post.html.twig x field--node--created.html.twig * field--node--blog-post.html.twig * field--created.html.twig * field--created.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--created.html.twig' --> <span class="field field--name-created field--type-created field--label-hidden">Tue, 10/31/2023 - 02:07 PM</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--created.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--field-tags--blog-post.html.twig x field--node--field-tags.html.twig * field--node--blog-post.html.twig * field--field-tags.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--field-tags.html.twig' --> <div class="field field--name-field-tags field--type-entity-reference field--label-hidden clearfix"> <ul class='links field__items'> <li>Care Coordination</li> <li>Patient Safety</li> <li>Health Information Technology (HIT)</li> <li>Quality Improvement Initiatives (QII)</li> <li>HQIC</li> </ul> </div> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--field-tags.html.twig' --> Tue, 31 Oct 2023 18:07:51 +0000 lchatman 3447 at https://qioprogram.org Alliant’s Coaching and Targeted Resources Helps Nursing Home Improve Vaccine Confidence and Increase Its Resident COVID-19 Bivalent Booster Rate https://qioprogram.org/quality-in-action-blog-series/alliants-coaching-and-targeted-resources-helps-nursing-home-improve <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--title--blog-post.html.twig x field--node--title.html.twig * field--node--blog-post.html.twig * field--title.html.twig * field--string.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--title.html.twig' --> <span class="field field--name-title field--type-string field--label-hidden">Alliant’s Coaching and Targeted Resources Helps Nursing Home Improve Vaccine Confidence and Increase Its Resident COVID-19 Bivalent Booster Rate</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--title.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--body--blog-post.html.twig * field--node--body.html.twig * field--node--blog-post.html.twig * field--body.html.twig x field--text-with-summary.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--text-with-summary.html.twig' --> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>A 200 bed long- and short-term care facility was referred by the Centers for Medicare &amp; Medicaid Services (CMS) to Alliant Health Solutions (Alliant), a CMS Quality Innovation Network-Quality Improvement Organization (QIN-QIO), for assistance with improving its resident COVID-19 bivalent booster rate. Through one-on-one coaching and targeted resources, Alliant helped the facility achieve a 42.65 percent increase in its resident COVID-19 bivalent booster rate from the time the QIN-QIO made its initial outreach to the nursing home in January 2023 and the last report to the National Healthcare Safety Network (NHSN) in June 2023.</p> <p><strong>Root Cause Analysis Reveals Several Challenges</strong><br /> Upon receiving the referral from CMS, Alliant conducted a root cause analysis to determine the reason for the nursing home’s low resident COVID-19 bivalent booster rate. The analysis revealed several challenges: 1) A lack of vaccine confidence and hesitancy among residents as well as concerns about the safety and efficacy of the vaccine; 2) Some residents having received only one of the two required doses of the primary series making them ineligible to receive the bivalent booster; 3) Lack of understanding among staff about NHSN data entry leading to inaccurate reporting; and 4) An email firewall which was blocking messages from Alliant team members.</p> <p>Alliant quickly resolved the firewall issue through real-time communication with one of the facility’s two infection preventionists (IPs) to ensure nursing home staff had access to Alliant’s resources and education. The QIN-QIO also worked with the IPs to clarify the correct NHSN data entry format and definitions, provided NHSN reference documents such as <a href="https://www.cdc.gov/nhsn/pdfs/hps/covidvax/UpToDateGuidance-508.pdf">key terms related to COVID-19 vaccination</a> and the <a href="https://www.cdc.gov/nhsn/pdfs/ltc/covidvax/ltc-vaccination-surveillance-definition-sept-2022-508.pdf">up to date vaccination status definition</a> and followed up if data entry issues persisted.</p> <p><strong>Addressing Vaccine Ineligibility</strong><br /> To help the facility ensure residents who were ineligible for the bivalent vaccine completed their primary series, Alliant provided <a href="https://www.cdc.gov/nhsn/pdfs/hps/covidvax/UpToDateGuidance-508.pdf">guidance from NHSN</a> that included flow charts on how to get up-to-date. The guidance included a timeline on how soon the bivalent booster could be given following the second dose in the primary series. The QIN-QIO also met with the facility monthly to discuss the number of residents who remained ineligible to help address any concerns or challenges.</p> <p><strong>Coaching Infection Preventionists to Boost Residents Confidence and Reduce Hesitancy </strong><br /> Hesitancy among residents stemmed from concerns about 1) Receiving too many vaccines; and 2) The vaccine’s safety following the administration of a bivalent booster to a resident who then developed chest pains. Despite confirmation from a physician that these pains were unrelated to the vaccine, no additional side effects were documented and there was no need for a higher level of care, these concerns persisted. To help nursing home staff address residents’ hesitancy, Alliant provided coaching to the facility’s IPs using Motivational Interviewing (MI) techniques and provided MI resources. These included the Centers for Disease Control and Prevention’s (CDC)<a href="https://www.cdc.gov/vaccines/covid-19/hcp/engaging-patients.html"> Talking with Patients about COVID-19 Vaccination</a> and Alliant’s <a href="https://quality.allianthealth.org/wp-content/uploads/2022/03/Using-Motivational-Interviewing_3.24.22.pdf">Using Motivational Interviewing to Increase COVID-19 Vaccinations</a>. In addition, the QIN-QIO offered its <a href="https://youtube.com/playlist?list=PLXWmxni-xNHsP-DXT1IF9C7buXIZDoX1m&amp;si=rNNEK0rYYbucvnAR">Take 5 Videos</a>, including <a href="https://youtu.be/i0yVhc-9xc0">Take 5: Overcoming Refusals</a>, a five-minute video highlighting strategies to mitigate vaccine refusals. </p> <p><strong>Targeted Resources Help IPs Educate Residents</strong><br /> Alliant also provided several resources to help address residents’ concerns about safety. These included <a href="https://wecandothis.hhs.gov/resource/frequently-asked-questions-about-covid-19-vaccine-boosters">Frequently Asked Questions About Updated COVID-19 Vaccines</a>, the CDC’s <a href="https://www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html">Myths and Facts about COVID-19 Vaccines</a>, Alliant’s <a href="https://quality.allianthealth.org/wp-content/uploads/2023/01/Bivalent-Myths-and-Facts-FINAL-v2_508.pdf">Bivalent Myths and Facts</a> and Alliant’s <a href="https://youtu.be/SuLlANKVsvs?si=QbESdkvmPu1sJWOI">Bite Sized Learning on COVID-19 Vaccination</a>. The combination of coaching and resources provided to the facility was intended to empower the IPs to speak confidently about the vaccine and answer any questions from residents.</p> <p>Due to staffing challenges at the facility, the IPs were assigned to patient care. This offers an opportunity for the IPs to educate residents one-on-one in addition to their regular responsibility of offering and administering the bivalent vaccine to residents. To help staff take advantage of this opportunity, Alliant provided an <a href="https://quality.allianthealth.org/wp-content/uploads/2023/01/Immunization-Trivia-Kit-FINAL.pdf">Immunization Trivia Kit for Seniors</a>. The kit is intended to engage residents, provide education and dispel misinformation about the vaccine through interactive activities such as team trivia, daily trivia and newsletter trivia. Although the content is focused primarily on COVID vaccines, there also are questions about other vaccines in the recommended schedule for this age group including shingles, pneumonia and flu.</p> <img alt="Alliant Keys to Success infographic" data-entity-type="file" data-entity-uuid="4ffdb64c-e693-43a9-abc1-d741f8286a2e" src="/sites/default/files/inline-images/MicrosoftTeams-image%20%284%29_0.png" class="align-center" /> <p><strong>Keys to Success</strong><br /> Alliant’s success can be replicated by taking the following steps:</p> <ol> <li>Use root cause analysis to quickly identify barriers and challenges.</li> <li>Quickly address small barriers to allow time for tackling more difficult challenges.</li> <li>Provide customized resources and education based on identified barriers and challenges.</li> </ol> <p><strong>Regional Impact of Alliant’s Assistance</strong><br /> Per the NHSN weekly report dated September 3, 2023, the percentage of residents who are up to date in nursing homes that received assistance from Alliant increased by 7.7 percent as compared to the average change in resident vaccination across all nursing homes in Alliant’s region.</p> <p> </p> <p> </p> <p> </p> <p><em>This material was prepared by The Bizzell Group (Bizzell), the Data Validation and Administrative (DVA) contractor, under contract with the Centers for Medicare &amp; Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. 12SOW/Bizzell/DVA-1195-09/18/2023.</em></p> </div> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--text-with-summary.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--uid--blog-post.html.twig x field--node--uid.html.twig * field--node--blog-post.html.twig * field--uid.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--uid.html.twig' --> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'username' --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/user/username.html.twig' --> <span lang="" about="/user/846" typeof="schema:Person" property="schema:name" datatype="">lchatman</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/user/username.html.twig' --> </span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--uid.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--created--blog-post.html.twig x field--node--created.html.twig * field--node--blog-post.html.twig * field--created.html.twig * field--created.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--created.html.twig' --> <span class="field field--name-created field--type-created field--label-hidden">Thu, 10/19/2023 - 09:14 AM</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--created.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--field-tags--blog-post.html.twig x field--node--field-tags.html.twig * field--node--blog-post.html.twig * field--field-tags.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--field-tags.html.twig' --> <div class="field field--name-field-tags field--type-entity-reference field--label-hidden clearfix"> <ul class='links field__items'> <li>QIN-QIO</li> <li>CMS</li> <li>COVID-19 and Infection Control</li> <li>Long-term Care - Nursing Homes</li> <li>Patient Safety</li> </ul> </div> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--field-tags.html.twig' --> Thu, 19 Oct 2023 13:14:14 +0000 lchatman 3435 at https://qioprogram.org Alliant Health Solutions’ Beneficiary & Family Advisory Council Empowers People with Medicare and Their Caregivers Through Informed Healthcare Decision-Making https://qioprogram.org/quality-in-action-blog-series/alliant-health-solutions-beneficiary-family-advisory-council-empowers <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--title--blog-post.html.twig x field--node--title.html.twig * field--node--blog-post.html.twig * field--title.html.twig * field--string.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--title.html.twig' --> <span class="field field--name-title field--type-string field--label-hidden">Alliant Health Solutions’ Beneficiary &amp; Family Advisory Council Empowers People with Medicare and Their Caregivers Through Informed Healthcare Decision-Making</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--title.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--body--blog-post.html.twig * field--node--body.html.twig * field--node--blog-post.html.twig * field--body.html.twig x field--text-with-summary.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--text-with-summary.html.twig' --> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>In the decade since its founding, Alliant Health Solutions' (Alliant) Beneficiary &amp; Family Advisory Council (BFAC) has played a significant role in the organization's mission to make health care better. The council consists of 11 volunteers over the age of 55 from across the Southeast whose primary objective is to ensure people with Medicare and their caregivers have the necessary tools and resources to make well-informed health decisions. Council members are part of the targeted age group for many of Alliant's resources and some even reside in long-term care facilities.</p> <p>As a Centers for Medicare &amp; Medicaid Services (CMS) Quality Innovation Network-Quality Improvement Organization (QIN-QIO), Alliant develops patient-facing tools, <a href="https://quality.allianthealth.org/topic/chronic-disease-self-conditions/">resources and videos</a> for nursing homes and partnerships for community health in Alabama, Florida, Georgia, Kentucky, Louisiana, North Carolina and Tennessee. These resources are carefully reviewed by the BFAC to ensure they are beneficial, relevant and informative for their intended audience.</p> <p>While some of the BFAC members have a background in health care, their assessment of Alliant's materials is based on their personal experiences caring for a loved one or being a patient.</p> <p>"When my dad died in 2001, I was only 35 years old and became a full-time caretaker for my mom, who had Lewy body dementia and palsy," said BFAC member Kim McRae.</p> <p>That experience led McRae, now 57, to become a champion for improving the quality of life for seniors and caregivers.</p> <p>"I don't have a clinical background and I've never worked in a nursing home or long-term care facility, but I've always been a champion for the consumers and residents and care partners. I try to help the professionals remember what it's like for them," she said.</p> <p>Alliant hosts monthly Zoom meetings during which the BFAC reviews draft projects and provides feedback to staff. According to BFAC member Peggy Haddock, 76, the council's insight is honest and straightforward.</p> <p>"Nobody spares their words," she said. "Many of us on the council have been through things or cared for someone, so we'll let (Alliant staff) know if anyone is going to use a resource."</p> <p>Rhonda Allison, 63, who has served on the council for eight years, said she enjoys volunteering with the BFAC because it aligns with her passion for advocacy. In addition to the BFAC, she also volunteers with a long-term care ombudsman program.</p> <p>"Because I'm out advocating for (nursing home) residents, I like to know what's going on with Medicare and bring some of the tools to the bedside," she said.</p> <p>Allison said one project she enjoyed working on was creating resources on the importance of the flu shot.</p> <p>"The first time I ever got a flu shot was when I worked on the flu project," she said. "It's nice when you get to work on a special project. It gives me a chance to connect with the (Alliant) staff."</p> <p>In addition to collaborating with Alliant staff, BFAC members bring fresh ideas and occasionally lend their talent to voiceover work on Alliant's educational videos. Their voices can be heard on Alliant's <a href="https://youtu.be/_VRBpjljdeI">cardiac rehab</a>, <a href="https://youtu.be/kp6UNu8lDyw">smoking cessation</a> and <a href="https://youtu.be/SuLlANKVsvs?si=PRz5R1nJUfHB9LOA">COVID-19</a> videos, to name a few.</p> <p>"It's fun doing the videos," said 75-year-old BFAC member Charlotte Ingram. "I did a lot of theater in college, so I got to use my old experiences."</p> <p>BFAC member Jeana Partington, 62, said she believes the BFAC is crucial to improving health care outcomes for patients.</p> <p>"As an advocate for patients and care partners, it's important to ensure the information is valuable to them and can be understood," she said. "We ensure the materials that Alliant creates are the best resources for patients."</p> <p><img alt="An image from the August 2023 meeting of the Alliant Beneficiary &amp; Family Advisory Council. " data-entity-type="file" data-entity-uuid="f4f66136-3ab4-4396-9c58-175d32f9c9d2" src="/sites/default/files/inline-images/image005_0.jpg" /></p> <p><em>An image from the August 2023 meeting of the Alliant Beneficiary &amp; Family Advisory Council (BFAC).</em></p> <p><em>First row, from left: Melody Brown, Alliant Georgia State Manager and BFAC organizer; Tracie Troha, Alliant Communications Editorial Assistant; Jeana Partington, BFAC member; Amy Ward, Alliant Patient Safety Manager.</em></p> <p><em>Second row, from left: Peggy Haddock, BFAC member; Carolyn Kazdan, IPRO Senior Director, Health Care Quality Improvement; Kim McRae, BFAC member; JoVonn Givens, Alliant Task Order Director.</em></p> <p><em>Third row, from left: Natasha Avery, Alliant Sr. Executive Director, State &amp; Federal Programs.&nbsp;</em></p> <p><em>Not pictured: Jen Hurley, Alliant contractor and BFAC members Joyce Horn and Renee DelMonico.</em></p> <p>Submitted by: Alliant Health Solutions</p> <p>&nbsp;</p> <p><em>This material was prepared by The Bizzell Group (Bizzell), the Data Validation and Administrative (DVA) contractor, under contract with the Centers for Medicare &amp; Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. 12SOW/Bizzell/DVA-1198-09/26/2023.</em></p> </div> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--text-with-summary.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--uid--blog-post.html.twig x field--node--uid.html.twig * field--node--blog-post.html.twig * field--uid.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--uid.html.twig' --> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'username' --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/user/username.html.twig' --> <span lang="" about="/user/219" typeof="schema:Person" property="schema:name" datatype="">asteinmann</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/user/username.html.twig' --> </span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--uid.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--created--blog-post.html.twig x field--node--created.html.twig * field--node--blog-post.html.twig * field--created.html.twig * field--created.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--created.html.twig' --> <span class="field field--name-created field--type-created field--label-hidden">Mon, 09/25/2023 - 10:03 AM</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--created.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--field-tags--blog-post.html.twig x field--node--field-tags.html.twig * field--node--blog-post.html.twig * field--field-tags.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--field-tags.html.twig' --> <div class="field field--name-field-tags field--type-entity-reference field--label-hidden clearfix"> <ul class='links field__items'> <li>Patient and Family Engagement</li> <li>Quality Improvement Initiatives (QII)</li> <li>QIN-QIO</li> </ul> </div> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--field-tags.html.twig' --> Mon, 25 Sep 2023 14:03:58 +0000 asteinmann 3387 at https://qioprogram.org Alliant Health Solutions Helps Georgia Hospital Improve Its CLABSI Rate and Achieve a Cost Savings of More Than $165,000 https://qioprogram.org/quality-in-action-blog-series/alliant-health-solutions-helps-georgia-hospital-improve-its-clabsi <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--title--blog-post.html.twig x field--node--title.html.twig * field--node--blog-post.html.twig * field--title.html.twig * field--string.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--title.html.twig' --> <span class="field field--name-title field--type-string field--label-hidden">Alliant Health Solutions Helps Georgia Hospital Improve Its CLABSI Rate and Achieve a Cost Savings of More Than $165,000</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--title.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--body--blog-post.html.twig * field--node--body.html.twig * field--node--blog-post.html.twig * field--body.html.twig x field--text-with-summary.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--text-with-summary.html.twig' --> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>The Centers for Medicare &amp; Medicaid Services (CMS) Quality Improvement Organization (QIO) Program is dedicated to improving the quality of health care at the community level. Hospital Quality Improvement Contractors (HQICs) are strategic partners of the QIO Program that support this mission within hospitals by helping clinical teams increase patient safety, particularly preventing hospital-acquired infections (HAIs). Alliant Health Solutions (Alliant) is an HQIC that focuses on helping the 147 enrolled hospitals in their multistate region improve the quality of care and outcomes for patients. Alliant’s goal is to help hospitals reach and maintain zero cases of Central Line-associated Bloodstream Infections (CLABSI).</p> <p>A large rural hospital in Georgia began working with Alliant to reduce its CLABSI rate in June of 2022. In conjunction with a Georgia Hospital Association (GHA) quality improvement coach and the hospital, Alliant conducted a root-cause analysis. The analysis revealed that a large group of physicians and nurses participated in the insertion, maintenance, and removal of Central Venous Catheters (CVCs) and Peripherally Inserted Center Catheters (PICCs). Inconsistencies with insertion may have contributed to an increase in infections. To address these inconsistencies, the hospital developed a Central Line Infusion team.</p> <p>When Alliant began working with the hospital, it had a baseline of five CLABSI cases (October 2020 – September 2021). With the assistance of the quality improvement coach, Alliant’s resources, and the Central Line Infusion team, the hospital achieved a Standard Infection Ratio (SIR) of 0.67 and a 71.43 percent relative improvement rate (RIR) as of October 2022. There were three CLABSIs avoided, and a methodology recommended by CMS, based on the White Paper, Draft Final Report Estimating the Additional Hospital Inpatient Cost and Mortality Associated with Selected Hospital Acquired Conditions<a href="#_ftn1" title="">[1]</a>, estimated a cost savings of $165,398. As of April 2023, the hospital is maintaining a 0.00 percent SIR with a 100 percent RIR.</p> <p><strong>Forming a Central Line Infusion Team and Implementing Recommended CLABSI Interventions</strong></p> <p>The hospital’s Central Line Infusion team, led by a physician champion, is comprised of nurses and physicians who insert CVCs and PICCs with the goal of reducing the number of CLABSI infections. The GHA quality improvement coach provided education and training to the hospital’s infection preventionist via coaching calls who then trained the infusion team through group and one-on-one learning on the following:</p> <p>    •    Use of sterile barrier precautions for CVCs and PICCs<br />     •    Insertion, maintenance and indications for intravascular catheter use<br />     •    Avoiding the use of the femoral vein for central venous access in adult patients<br />     •    Proper removal of any intravascular catheter that is no longer essential</p> <p>The intent of these efforts was to ensure strict adherence to evidence-based best practices by limiting the placement, maintenance and removal of CVCs and PICCs to a highly trained team of experts.</p> <p>Interventions were supported by Alliant’s Making Health Care Better Together <a href="https://quality.allianthealth.org/wp-content/uploads/2023/04/2023-Coaching-Package-CLABSI_508.pdf">CLABSI Coaching Package</a> which includes evidence-based best practices and resources to create quality improvement action plans. Education, training and staffing, selection of catheters and sites and maximal sterile barrier precautions are a few examples of the resources in the coaching package. </p> <p>Compliance with these protocols were monitored by nursing staff and audited through direct observation by the physician champion. Direct observation of insertions on the unit allowed just-in-time staff education and additional training if needed. Ongoing skills education and resources were provided by Alliant and annual competencies were completed by the hospital infection preventionist to assess the knowledge and capability of the infusion team. A concurrent and retrospective review of the hospital’s catheter utilization data was completed by the Central Line Infusion team. Discussions about removing central lines, successes and other related updates were shared during daily huddles, direct observations, team meetings and quality/medical staff and board meetings.</p> <p><strong>Participating in Ongoing CLABSI Education</strong></p> <p>In addition to the training and education provided to the infection preventionist and the Central Line Infusion team, the hospital’s quality manager and director of quality attended one-on-one monthly coaching sessions with the GHA quality improvement coach to review best practice interventions and the CLABSI Coaching Package. They also attended Alliant’s Office Hours/Infection Prevention Chats led by Alliant’s infection preventionists. These events are intended to provide networking opportunities for participants to build knowledge, share experiences and find support. Additionally, they participated in Alliant’s <a href="https://quality.allianthealth.org/conference/catheter-associated-urinary-tract-infection-prevention-in-action-strategies-from-the-field-oct-27-2022/">Catheter-Associated Urinary Tract Infection Prevention in Action: Strategies from the Field</a> event that featured real-world examples of effective CAUTI prevention strategies shared by infection prevention leaders.</p> <p><strong>Keys to Success </strong></p> <p>Alliant’s success can be replicated by taking the following steps:</p> <img alt="Alliant Keys to Success infographic" data-entity-type="file" data-entity-uuid="cedb8e96-186c-4fec-a4ac-353bc10e2b5e" src="/sites/default/files/inline-images/Alliant_Keys_To_Success.png" class="align-center" /> <p>For more information, visit <a href="https://quality.allianthealth.org/nqiic/hqic/">Alliant HQIC</a>.</p> <p><em>This material was prepared by The Bizzell Group (Bizzell), the Data Validation and Administrative (DVA) contractor, under contract with the Centers for Medicare &amp; Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. 12SOW/Bizzell/DVA-1173-08/15/23</em></p> <div>  <div> <p><a href="#_ftnref1" title="">[1]</a> Bysshe, T., et al. "<a href="https://www.ahrq.gov/sites/default/files/publications2/files/hac-cost-report2017.pdf">Estimating the additional hospital inpatient cost and mortality associated with selected hospital‐acquired conditions</a>." (2018).</p> </div> </div></div> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--text-with-summary.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--uid--blog-post.html.twig x field--node--uid.html.twig * field--node--blog-post.html.twig * field--uid.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--uid.html.twig' --> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'username' --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/user/username.html.twig' --> <span lang="" about="/user/846" typeof="schema:Person" property="schema:name" datatype="">lchatman</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/user/username.html.twig' --> </span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--uid.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--created--blog-post.html.twig x field--node--created.html.twig * field--node--blog-post.html.twig * field--created.html.twig * field--created.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--created.html.twig' --> <span class="field field--name-created field--type-created field--label-hidden">Fri, 09/22/2023 - 11:43 AM</span> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--created.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--node--field-tags--blog-post.html.twig x field--node--field-tags.html.twig * field--node--blog-post.html.twig * field--field-tags.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--field-tags.html.twig' --> <div class="field field--name-field-tags field--type-entity-reference field--label-hidden clearfix"> <ul class='links field__items'> <li>Patient Safety</li> <li>Quality Improvement Initiatives (QII)</li> <li>HQIC</li> <li>QIN-QIO</li> <li>Care Coordination</li> </ul> </div> <!-- END OUTPUT from 'themes/bootstrap_barrio/templates/field/field--node--field-tags.html.twig' --> Fri, 22 Sep 2023 15:43:28 +0000 lchatman 3381 at https://qioprogram.org