Quality Today
Primaris produces QualityTODAY, the premier source of healthcare quality improvement news in Missouri. QualityTODAY is published quarterly, sent to over 5,000 healthcare professionals and leaders statewide. E-mail Matt Heger (mheger@primaris.org) to get your copy or for reprint information.
Back Issues
Spring 2008The Centers for Medicare & Medicaid Services (CMS) have announced their goals for the ninth contract with Quality Improvement Organizations. Inside this QualityTODAY, you’ll find a lighthearted look at the serious issues Primaris will address in Missouri over the next three years. |
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Inside this Issue
Every three years, the Centers for Medicare & Medicaid Services (CMS) announce new projects for Medicare Quality Improvement Organizations like Primaris. Last winter, they announced projects that will begin in the fall of 2008.
Inside this issue of QualityTODAY is a look at the new quality projects. While these previews are written with a light-hear ted movie theme, the issues we will be working on are quite serious. Accomplishing our goals will dramatically improve healthcare within our state.
Primaris will also continue our role in Beneficiary Protection, ser ving as a third-par ty reviewer of Medicare-related medical complaints.
Titles seeking studio funding
In addition to those title projects listed inside, CMS will also provide funding to a limited number of QIOs for three additional tasks. CMS is considering funding Primaris for the following titles:
- Prevention: Chronic Kidney Disease—Up to 13 Medicare Qualit y Improvement Organizations will work to slow the progression of chronic kidney disease (CKD) and to improve CKD clinical care. If funded, Primaris will accomplish this primarily through improving CKD screening and treatment in primary care and nephrology of f ices.
- Prevention: Diabetes Disparities—Up to 33 QIOs will work over the nex t three years to address disparities in diabetes care. If funded, Primaris will work to bring the community and physician of fices together to support Diabetes Self-Management Education (DSME) primarily to African-American populations in the Kansas City and St. Louis metropolitan areas.
- Patient Pathways—Up to 18 QIOs will work to improve coordination across the continuum of care. In par ticular, if funded, Primaris would work within healthcare communities to promote seamless transitions from the hospital to home, skilled nursing facilities and home health care.
For more information about the projects, ask your local Primaris contact or e-mail Matt Heger at mheger@primaris.org. Our goals are ambitious, but the results will help ensure a safer future for Missourians with Medicare.
Premiere for all projects is set for August 2008.
Attack of the Superbug
When a diabolical bacterium creeps into Missouri hospitals, impervious to traditional antibiotics, a band of heroes must discover its weaknesses and fight back. Prepare for breathtaking
system change and groundbreaking best practices in the ultimate showdown
against the malevolent MRSA.
It’s a story straight from the headlines. Between 1995 and 2005, Methicillin-resistant Staphylococcus aureus (MRSA) cases mushroomed, increasing 10-fold in the U.S. The Centers for Disease Control and Prevention (CDC) estimate that more than 94,000 people developed a serious MRSA infection in 2005. As a result approximately 18,650 people died during a hospital stay.
MRSA is four times deadlier than normal staph infections. The highest rate of MRSA hospitalization has been among the elderly with 360.8 MRSA stays per 100,000. This is three times higher than for any other age group.
Directed by the team that brought you PEPPER Reports and the 5 Million Lives Missouri Node, this project will feature a cast of hospitals dedicated to wiping MRSA from the map; destroying the rates of infection and transmission within their buildings. It all begins with reporting to the CDC.
The key to our heroes’ success? MRSA risk assessment, surveillance methodology, hand hygiene, contact precautions, and environmental and equipment decontamination. Primaris will offer the tools to help make it happen.
For information on this feature, contact Revee White at rewhite@primaris.org or 800-735-6776 ext. 187.
Relieving the pressure
They can pop up anywhere. They are pressure ulcers and they are becoming increasingly common in America’s nursing homes and hospitals. Strong enough to kill even Superman, it will take a team effort to stop them in their tracks.
From the people who brought Advancing Excellence in America’s Nursing Homes to Missouri, comes a new effort to connect hospitals and nursing homes in a common cause, reducing pressure ulcers.
Two million Americans are afflicted with pressure ulcers every year, primarily caused by a combination of immobility, poor nutrition, incontinence and/or dehydration. They start small but quickly grow to potentially fatal levels; an infected pressure ulcer ultimately killed Superman actor Christopher Reeve.
Making a compassionate stand to affect change takes a cooperative spirit. Success or failure hangs on a thread of proactive communication. Interdisciplinary teams will be the new unsung heroes.
In the past, Primaris’ pressure ulcer projects have been directed at nursing homes, but this year they will expand to hospitals. An estimated 20 percent of nursing home pressure ulcers originate outside of the home, typically within acute care hospitals. Leaders from both sides will unite, creating a collaborative model to erase these sores.
Be a part of the provocative program that saves the skin of Missourians. For information on this feature, contact Natalie Fieleke at nfieleke@primaris.org or 800-735-6776 ext. 119.
Exercising Restraint
Thirty years ago, when a younger Frank Farmer was involved in a tragic car accident, a restraint saved his life. Now living in a nursing home where he has been classified as a fall risk, Farmer finds restraints are putting him in danger.
While most commonly cited as needed to prevent falls, research says restraints can actually contribute to more falls. Worse, they can increase the risk of a host of problems including pressure ulcers, incontinence and depression. The use of unnecessary restraints not only violates residents’ rights to freedom and dignity, but has also been associated with higher rates of injury and injurious falls, precisely the condition the restraints are intended to prevent.
This August, a team of nursing homes will join Primaris in a project to provide the safest care possible to their residents. In this feature project, Primaris tackles the contentious issue of appropriate restraint use, seeking to reduce or eliminate restraint use in participating nursing homes.
The effort will be cross-cutting. Teams will track trigger events. They’ll ensure accurate MDS coding. They’ll separate the restrainers from the enablers. And, in the end, many restraints will come undone.
For information on this feature, contact Natalie Fieleke at nfieleke@primaris.org or 800-735-6776 ext. 119.
Infection 2: Revenge of the the SCIP
Don’t miss the epic sequel to the original Surgical Care Improvement Project (SCIP). Old favorites return, including antibiotic selection, temperature monitoring and glucose control.
Our story continues deep within the bowels of hospitals, close on the tail of surgical infections. Of the over 30 million major operations each year in the U.S., significant percentages result in preventable, often life-threatening complications. Thirty-day complications reduced median patient survival by 69 percent. Complications were associated with average increase in payment of $7,645 (54 percent) per patient.
Over the last three years Missouri hospitals that worked with their trusted sidekick, Primaris, made dramatic strides, reducing prolonged ineffective use of antibiotics following surgery by 34 percent. Safer methods of hair removal became more prevalent. Primaris and a select group of hospitals will team up again to reach new rates of improvement.
From the minds that brought you Show Us Your Best and Celebrating a Culture of Safety, this sequel picks up right where the last one left off: in the operating room in the competent hands of surgeons. The eternal struggle between razors and clippers shaves on but stealing the spotlight is venous thromboembolism.
Don’t SCIP this exciting sequel. For information on this feature, contact Revee White at rewhite@primaris.org or 800-735-6776 ext. 187.
The Good, the Bad, and the Preventable
In Missouri in the early 2000s, a band of four infamous killers plague the Midwest. Breast and colorectal cancer, along with pneumonia and influenza, attack the weak and strong alike, preying on the good citizens with impunity.
But there is hope; each of the killers has its own Achilles’ heel; be it early detection or immunization. Hoping to take advantage of this, a volunteer brigade of frontier doctors will align to stop them before they strike again.
From the directors of the Doctors’ Office Quality-Information Technology (DOQ-IT), comes this fast-paced, shots-blazing effort to bring down a quadruple-threat. Primaris will assist doctors in using electronic health records (EHR) for care management.
The project will ensure proper screening and immunization reminders are provided to patients, focusing on performance areas especially important to Medicare – areas that will likely affect payment when pay-for-performance (P4P) arrives.
Can the posse implement system change in time to save the good citizens of Missouri? Will doctors who participate be prepared before P4P? Will care management help save the day? Don’t miss the action!
For information on this feature, contact Dr. Sharon Hoffarth at shoffarth@primaris.org.