FROM THE PRESIDENT’S DESK

Where has the year gone? What a great conference we had in Nashville with NAHQ! The meeting was packed with information and held many highlights for all who attended. NAHQ leadership announced the 2014 conference attendance was the highest ever with 1,000 attendees!

In case you have not heard, NAHQ will not have an educational conference next fall. Instead there will be a two-day Quality Summit held April 23-24 in Philadelphia. The title of the summit is “Leading Care Transitions: Improving Quality & Safety Across the Healthcare Continuum”. The speaker will be Eric Coleman, MD, MPH, director of the Care Transitions Program at the University of Colorado and developer of the Coleman Model of Transitions. NAHQ plans on holding summits the next two years and then will return to the educational conferences the following year. The plan is to reinvigorate and expand the conferences in the future.

October 19 – 25 is National Healthcare Quality Week. Please let the board know how you and your facility will be celebrating. Gov. Mike Beebe has once again recognized the week in Arkansas with a proclamation from his office! We appreciate his support of the week.

We are in final phases of preparations for our fall conference, which will be November 14 at Gilbreath Center at Baptist Health in Little Rock. We have put together an exciting agenda on a topic of interest shared by our members. We are looking forward to having a record turnout!

We recently sent out membership cards that are good until the end of the year (our membership runs from January through December). We are evaluating different vendors and will be picking out a different version for the new year once membership dues are paid to ensure we do not miss anyone. This was again an item members expressed as an interest to us.

Our organization continues to be financially sound. AAHQ was able to sponsor both members who applied for grants to attend the NAHQ conference this year. You will see articles written by both Devin Terry and Debbie Hare in this special edition newsletter. They have both committed to becoming team members for the organization.

If you are interested in working on a team or short-term project, please let any member of the board know. Volunteering is a great way to become more involved with the organization. As president of the organization, I am asking you to become active in the organization so that we can sustain the legacy of those who have gone before us. Please let any member of the board know if you have an interest or want more information.

Sincerely,

Sandra J. “Sandy” Grinder, AAHQ President

39th Annual Educational Conference Creating a High Reliability Organizational Culture John Toussaint, MD

By Debbie Hare, BSN, RN, CPHQ

Director Quality/Risk Management & Regulatory Compliance

White County Medical Center

John Toussaint, M.D., CEO of Thedacare Center for Healthcare Value, presented at one of the general sessions on the topic, “A Management and Leadership Road Map to Transforming Care for Patients”. As I listened to this presentation, I thought of all the transitions in quality that I have witnessed in my years in the profession, especially when I noticed the statement on his slide deck, “Targeting Value, Spreading Change”.

I am sure many of you remember the JCAHO 10-step QA process. This process was very focused at the department level and aspects of care, and you completed all steps and communicated relevant findings to the overall organization’s program. Basically each department did their own thing and completing the steps in the process met the regulatory requirements.

Another key transition was rapid cycle improvement. This was promoted and supported by the Quality Improvement Organizations from Medicare and Medicaid. This model promoted using the traditional tools, but involving other areas to accelerate change in the process. It involved looking at what models were used in other industries and not just focus on the traditional health care model. This model started with asking three questions: 1) What do we want to accomplish? 2) What changes can we make to result in an improvement? 3) How will we know an improvement has been made? After answering these questions, then you start the PDSA Cycle. A Plan-Do- Study- Act cycle would help you execute and test the change. After an improvement cycle was complete, you moved on to the next and improved again. Spread the change.

Dr. Toussaint shared how high-reliability organizations use Lean principles to transform patient care. The focus is on important business processes. The goals are to redesign care to improve value, develop payment systems that reward value, and publicly report health outcomes.

The following are highlights from his presentation:

Transformation Questions:

• What is our purpose or what problem are we trying to solve, what value to create?
• How do we improve the actual work?
• How do we develop the people?
• What role must leadership take and how does the management system support the new way of working?
• What basic thinking or assumptions underlie this transformation?

Model Cell approach to create a new standard of care:

• An inch wide, mile deep experiment
• Focused on important business problems
• Creates a new system with standard work
• Ties to key organizational performance
• Involves and is supported by senior leadership
• Once complete requires spread

Standard work for senior leaders:

• True North – Do you know where the true North is for your business?
• Strategy Deployment – Have you defined the top issues to address?
• Visual Management – Transparency
• Gemba (“the real place” in Japanese) to see waste and remove barriers
• A3 thinking – Unity of purpose – What are you talking about?
• Management system

The purpose of going to gemba is to see waste and eliminate waste:

• Waiting
• Defects
• Transportation
• Overproduction
• Motion
• Unused human talent
• Overprocessing
• Inventory

“Most of what we call management consists of making it difficult for people to get their work done.” –Peter Drucker

Management by process:

 

• Andon- pulling the cord and stopping the work to prevent another event.
• A3 thinking
• Daily patient and business status sheet
• Daily performance-and-defect review huddle
• Unit-based leadership teams focused on achieving results
• Standard work audits
• Visual progress tracking

Management by objective:

“It nourishes short term performance, annihilates long term planning, builds fear, and demolishes teamwork it leaves people bitter, crushed , bruised, battered, desolate and despondent.“ –W. Edwards Deming

Failure is the only way to create high reliability. We need to stop looking at red as bad. Unleash the creativity of front-line teams to solve the problems.

A book was recommended in his presentation: Beyond Heroes: A Lean Management System for Healthcare. Dr. Toussaint’s article, “Improving Organizational Performance: Road Maps for the Journey to Excellence”, can be found at www.createvalue.org. Good luck to you on your journey to excellence!

Share your best insights: AAHQ Fall Educational Conference call for poster presentations

Are you ready to share your best strategies for improving health care quality with your peers? We’re seeking poster presentations from AAHQ members for the annual Spring Educational Conference, scheduled for Nov. 14 at the Baptist Health Medical Center – Gilbreath Conference Center in Little Rock. We’re looking for interesting, exciting and informative poster presentations on health care quality improvement projects in your facility.

The call for poster presentations runs through Nov. 1. For complete submission details, contact a Terry Anderson, AAHQ professional development team leader, at Terry.Anderson3@va.gov.

NAHQ – Quality in Harmony across the Continuum

By Devin K. Terry, RN

September 7, 2014, began the 39th annual Education Conference through the National Association for Health Care Quality (NAHQ). Even if you do not work in your facility’s Quality Management Department, all of our roles play a huge part in the quality outcomes of our patients. In a time where more and more health care institutions are moving towards electronic health records (EHR), internal and external parties are demanding more and more proof that reflects these quality patient outcomes. The questions for the health care team become how do we help build a system where documentation is entered in a fashion that it can be data mined, how do we report this information, and how do we share it with the interested internal and external parties efficiently and in a fashion where it is easily understood?

“Quality in Harmony across the Continuum” addressed many of these questions for us. The conference opened with guest speaker Dr. Marty Makary, MD, MPH, who challenged us to a culture of transparency for greater change in our facilities. He spoke about of breaking down barriers between the health care teams of today and creating a safe environment where physicians, nurses, therapists, and more can approach one another and ask questions and build a high-reliable system. High Reliability is a hot topic at the moment which guides systems towards providing complex care in an environment that is developed as “fail proof”. National benchmarks such as CAUTI, CLABSI, and many others should be reviewed with processes and procedures in mind and differences of delivery amongst the health care team. Dr. Makary submitted that it is these differences that lower our systems’ high reliability. To read more views on this topic by Dr. Makary, you can find him on CNN, FOXNews, The New York Times, and his newest publication: Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Health Care.

Next we heard about physician reporting in the ambulatory world. Shelly van’t Riet from VCU Medical Center, Richmond, VA, spoke about using PQRS data in your Ambulatory Quality Program. Many of you may be thinking the same thing I did, what program – at best, it is one person! It is my belief that gathering data such as what Ms. Van’t Riet shared with the group is the beginning of our push for better data in ambulatory areas. VCU started their Ambulatory Quality Program with the Centers for Medicare & Medicaid Services’ Better Health model. After analyzing this model and the payment methods, it was proven that reimbursement was gained by decreasing cost and increasing quality measures. They then developed a more system-based model which includes PQRS modifiers, financial impact, clinical projects, private payer programs, Meaningful Use and HEDIS to help guide their data collection process.

Discussions moved next towards primary care practices and what it takes to transition towards the Patient-Centered Medical Home model. This topic was presented by Rebecca Hightower from Missouri. Trends in healthcare were discussed during the introduction with a focus on value with better outcomes and cost savings. The goals of this medical home were to: reduce re-admissions for participants with chronic illness, improve transitions of care, increase quality of health care to patients with chronic illness, demonstrate cost-effectiveness and sustainability, as well as develop a system that supports the primary care sites by increasing availability of resources, coordination, and patient outcomes.

Many more topics were presented such as: Lean and Six Sigma, Ambulatory Quality Institutes, Care Coordination and the positive outcomes this brings to a practice, utilizing Lean to analyze clinic flow and better the patient experience, the utilization of lay members of the health care team to become “Care Guides”, and many more topics. Overall there were many great sessions to attend and the conference was one that I would attend again. The ability to network and problem-solve with people from across the country was a great benefit to the educational experience that occurred within the breakout sessions.

I would like to thank the Arkansas Association for Healthcare Quality for sponsoring me in attending the NAHQ annual Education Conference through their grant program.

Contacts

Martin A. Makary mmakary1@jhmi.edu. Professor of Surgery at John Hopkins University School of Medicine. Baltimore, MD.

Shelly van’t Riet. Performance Improvement Project Manager. VCU Medical Center Richmand, Virginia. svantriet@mcvh-vcu.edu 804-628-2585.

Diane Lecerf, MBA. Meridian Health Plan. Director of Quality Improvement. Diane.lecerf@mhplan.com

Kim Radel, MHA. Care Copilot Institute, Allina Health. Kimberly.radel@allina.com

Cynthia Zells, MD, MBA. Vice President Clinical Integration University Hospital Cleveland. Medical Director, System Quality Physician Offices. Cindy. zells@uhhospitals.org

Centers for Medicare & Medicaid Services. http://cms.hhs.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityInitiativesGenInfo/Downloads/QualityMeasurementRoadmap_OEA1-16_508.pdf

Arkansas Association for Healthcare Quality. http://www.arkahq.org/

National Association for Healthcare Quality. http://www.nahq.org/

 

Our sponsors

ARKANSAS FOUNDATION FOR MEDICAL CARE

 

 

 

Julie Kettlewell, RNP, AVP of Quality Programs 1020 West 4th Street, Suite 300
Little Rock, AR 72201 Phone 501-212-8740
E-Mail jkettlewell@afmc.org Website www.afmc.org

The Arkansas Foundation for Medical Care (AFMC) was incorporated in 1972 as a private, nonprofit educational organization dedicated to the evaluation and improvement of health care. We are the federally designated quality improvement organization (QIO) for Arkansas. Our staff includes physicians, nurses, statisticians, educators, communicators – professionals with widely varied expertise, at various stages of life and career, who have been on both sides of the health care system. We work with staff in every health care setting and offer free tools and resources, such as educational materials for patients and providers and help with Medicare and Medicaid issues. We review certain types of health care paid for by Medicare and Medicaid to ensure high-quality, cost-effective care and to resolve beneficiary concerns. We help find evidence-based ways to improve preventive care as well as treatment and management of specific illnesses and conditions. We are also a health information technology regional extension center (HITREC), federally funded to provide technical assistance to health care providers as they make the transition to electronic health records. Our roles and responsibilities are constantly evolving, but they all serve the purpose of building support systems and partnerships, and helping focus the efforts of the health care community, agencies and organizations toward common goals. Together, we’re working to make health care safer, more effective and more efficient.

BANCORPSOUTH INSURANCE SERVICES, INC.
Tom Hesselbein, CPCU, Executive VP, Healthcare (Ramsey, Krug, Farrell & Lensing)
8315 Cantrell Road, Suite 300 Little Rock, AR 72227 Phone 501-614-1134
Email Tom_Hesselbein@rkfl.com

AMERICAN DATA NETWORK
Jamie Walden, Public Relations Manager
10809 Executive Center Dr., Searcy Building Suite 300 Little Rock, AR 72211 Phone 501-225-5533
Email jwalden@americandatanetwork.com Website www.americandatanetwork.com

Founded in 1994, American Data Network provides clinical, quality, safety and financial data applications and services to healthcare executives, allowing them to better manage costs and care quality, influence physician practice patterns and meet demands for public accountability and disclosure.

 

2014 Board of Directors

President
Sandra Grinder
501-257-6187
501-257-6179 fax
sandra.grinder@va.gov

President- Elect
Connie Taylor
501-380-3291
501-380-2342 fax
cstaylor@wcmc.org

Secretary
Gina Reves
870-262-1925
870-262-1050 fax
greves@wrmc.com

Past- President
Susan Hapner
501-202-4999
501-202-6469 fax
susan.hapner@baptist-health.org

Action Team Leaders

Protocol
Vacant

Professional Dev.
Terry Anderson
501-257-6166
501-257-6179 fax
terry.anderson3@med.va.gov

Membership Srv.
Karen Donaldson
870-382-7657
870-460-3597 fax
kdonaldson@deltamem.net

Finance
Louise Hickman
870-541-7773
870-541-7204 fax
hickmanl@jrmc.org

Communication

Janie Ginocchio
501-212-8644
501-374-2826 fax
jginocchio@afmc.org

AHA Liaison

Cindy Harris Cook
501-224-7878
501-224-0519 fax
charris@arkhospitals.org

Editor: Janie Ginocchio
Arkansas Foundation for Medical Care Little Rock, Arkansas

NAHQ Award for Association Excellence

 

2001 Bronze Level Award Winner

2002 Silver Level Award Winner

2003 Gold Level Award Winner

2007 Gold Level Award Winner

2006 NAHQ Award for Support of CPHQ Certification