QIOs in Action

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Oregon Nursing Homes Address Readmissions with In-house Primary Care

Acumentra Health, the QIO for Oregon, helped inspire the adaptation of a system of in-house primary care that greatly reduced readmission rates at three Pinnacle Healthcare, Inc. nursing homes. The new system allows the nursing homes to better coordinate care and address many issues without having to transfer a resident to a hospital, while providing peace of mind to residents and their families. Acumentra Health convened a regional network to support evidence-based approaches for reducing readmissions across health care settings at the community level. The QIO brought together health care leaders in four regions, identified through claims data indicating a potential for improvement. The QIO reported that the average 30-day all-cause readmission rate for the first quarter of 2012 was 23 percent for one of Pinnacle’s nursing facilities. Since primary care services began, the average readmission rate dropped to 14 percent. The rate is dramatically lower than similar rates in the community, with skilled nursing facilities at 20 percent, Oregon facilities at 22 percent overall, and national facilities at 24 percent overall.

Texas QIO Collaborates with Community Partners to Promote New Diabetes Prevention Program

The Area Agency on Aging of East Texas and TMF Health Quality Institute, the QIO for Texas, have partnered with Wellness Pointe of Longview to promote a new program on the importance of preventing and controlling diabetes. The goal of the partnership is to increase access to diabetes self-management education among underserved populations with diabetes. The Diabetes Education Empowerment Program (DEEP) is a free, six-week course that offers tools and resources, webinars, and recorded events that can help educators and physicians practice better care for patients with diabetes. The program’s curriculum teaches the importance of controlling diabetes by empowering the participant to check blood glucose levels daily, eat right, exercise, and keep regular doctor visits. 

Becky Roberson Named Mississippi QIO Chief Executive Officer

Information & Quality Healthcare (IQH), the QIO for Mississippi, has named Becky Roberson Chief Executive Officer (CEO). Roberson has been with IQH for 26 years, most recently serving as Senior Vice President. Roberson is a member of the Mississippi Society of Certified Public Accountants and the North American Quitline Consortium. She has also chaired the American Health Quality Association's finance and human resources network. Roberson follows Dr. James S. McIlwain as CEO, who is now assuming the duties of the IQH President of Medical Affairs. 

Michigan QIO Initiative Aims to Reduce Behavioral Health Readmissions

Taking care of recently discharged patients with chronic conditions who also have behavioral health conditions is one of the more vexing problems in health care, said Bob Yellan, Chief Executive Officer of MPRO, the QIO for Michigan. The QIO and more than two dozen hospitals, community mental health organizations, area agencies on aging, home health agencies and health plans are addressing the issue in southeast Michigan. MPRO reported that 25 percent of beneficiaries admitted to hospitals have a behavioral health diagnosis. In September 2013, the QIO began an initiative that identifies senior patients recently discharged from hospitals who have a high risk of patient readmissions within 30 days. The goal is to reduce readmissions by six percent. According to Yellan, the QIO has been focusing on reducing readmissions for patients with heart failure and pneumonia; however, some of the most difficult patients to deal with have these types of chronic health conditions as well as behavioral health conditions.

Qualidigm Announces First Home Health Experts to Achieve Consultant Certification

Qualidigm, the QIO for Connecticut, announced that Consulting Director Kathy Roby and Project Manager Rita Grimes have earned the Consultant Certification from the Community Health Accreditation Program (CHAP). The CHAP Consultant Certification is a distinction that highlights individuals as experts who work with home health and hospice providers. The certification is based on the goals of the CHAP Standards of Excellence which are: to help all community-based health care organizations strengthen internal operations; promote continuous quality improvement, safety and cost-effectiveness; affirm public trust; and to maintain the viability of community health practice. More and more, consumers and health care providers alike look with discernment for a national accreditation as a validating seal of approval and a standard of excellence. I am proud of Kathy and Rita for achieving this professional distinction and for being the state’s first CHAP Certified Consultants,” said Tim Elwell, Qualidigm President and CEO. With more than 50 years of collective experience, this certification exemplifies their commitment to help community-based home care and hospice providers consistently provide a high level of care to their patients.”