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Entries in Clinical & Quality (54)

Friday
Apr192019

Five Sterile Processing Questions for Stephen Cuthbertson, College Medical Center and Jeremy Gibson-Roark, DNV GL Healthcare: Post-Webinar Interview

By Claire Thayer, April 18, 2019

Improvement, Regulatory Compliance & Case Management of College Medical Center in Long Beach California, and Jeremy Gibson-Roark, a lead clinical and certification surveyor with DNV GL Healthcare, participated in a Healthcare Web Summit discussion on sterile processing.

If you missed this informative webinar, Is Your Sterile Processing Department Safe? Risks and Opportunities in Sterile Processing, watch the On-Demand version here. After the webinar, we interviewed Stephen and Jeremy on five key takeaways from the webinar: 

1. What are a few of the opportunities you've identified in sterile processing departments for quality improvement? 

Jeremy Gibson-Roark: 

  • IUSS use
  • Tray Completion – All instruments accounted for and delivered
  • Instrument Quality
  • Instrument/Set Availability
  • Tray Management – Removing and repurposing of trays not being utilized
  • Tray Management – Condensing of trays to reduce volume of processing  

2. How does the certification in sterile processing benefit the patient? 

Jeremy Gibson-Roark: It allows an organization to ensure that a Quality Management System (QMS) is in place in the sterile processing department.  This system should be designed to achieve continual improvement in the department.  The benefit to the patient is the assurance that the organization has dedicated the resources and leadership to the processing of surgical/medical instrumentation. 

3. Why were you interested in obtaining Sterile Processing Program Certification for your hospital? 

Stephen Cuthbertson: We wanted a certification to set us apart from our local area hospitals. After review of the SPPC standards, we felt confident we could achieve the certification. We don’t have the volume for attempting, stroke, VAD, or hip and knee, etc… 

4. What are some of the key steps involved in the certification process? 

Stephen Cuthbertson: I think the biggest key steps are first understanding that the standards speak to and expect to see data, policies, QMS, etc.., specific to the SPD. The document review is extensive and the tour of the various departments affected by SPD are the other big steps. It’s also important to realize that the nonconformities aren’t a bad thing, they assist the organization in improving their patient safety related to SPD. 

5. Is certification only available for Hospital? 

Jeremy Gibson-Roark: This is the only certification available for the Sterile Processing Department in the United States. While individual certification is available through other organizations, DNV GL is the only organization that will certify a hospitals SPD.

Thursday
May172018

Medication Nonadherence: Data and Analytics Can Make an Impact

By Claire Thayer, May 16, 2018

Over two-thirds of hospital readmissions are directly due to medication nonadherence.  Many factors contribute to patients not taking their medications, including fear of side effects, out-of-pocket costs, and misunderstanding intended use.  Interventions targeted at understanding the underlying causes on nonadherence are critical to improving chronic disease outcomes.  Successful interventions include: educating patients on purpose and benefits of treatment regimen, reducing barriers to obtain medication, as well as use of health IT tools to improve decision making and communication during and after office visits. 

This weeks’ edition of the MCOL infoGraphoid, co-sponsored by DST Health, explores how data and analytics can provide insight to drive behavior change to improve adherence.

MCOL’s weekly infoGraphoid is a benefit for MCOL Basic members and released each Wednesday as part of the MCOL Daily Factoid e-newsletter distribution service – find out more here.

Friday
May042018

Welcome to Lifestyle Medicine

By Clive Riddle, May 4, 2018 

The May issue of Circulation includes the research article: Impact of Healthy Lifestyle Factors on Life Expectancies in the US Population, which presented findings from a study that aimed “to estimate the impact of lifestyle factors on premature mortality and life expectancy in the US population.” 

Using data from previous studies they defined five low-risk lifestyle factors

  1. never smoking
  2. ≥30 min/d of moderate to vigorous physical activity
  3. moderate alcohol intake
  4. a high diet quality score (upper 40%)

The study “estimated hazard ratios for the association of total lifestyle score (0-5 scale) with mortality,” and used available national public databases to estimate life expectancy by levels of the lifestyle score, examining mortality of 42,167 adults. 

They found the females who adopted all five of these low risk factors would at age 50 live 14.0 more years that those who adopted zero of the five; and that men at age 50 who adopted all five would live 12.2 years longer than those who adopted zero. They “estimated that the life expectancy at age 50 years was 29.0 years for women and 25.5 years for men who adopted zero low-risk lifestyle factors. In contrast, for those who adopted all 5 low-risk factors, we projected a life expectancy at age 50 years of 43.1 years for women and 37.6 years for men.” 

With these findings in mind, let’s stop by the American College of Lifestyle Medicine (ACLM), established several years ago as “the professional medical association for those dedicated to the advancement and clinical practice of Lifestyle Medicine as the foundation of a transformed and sustainable healthcare system.” They tell us that “Lifestyle Medicine involves the use of evidence-based lifestyle therapeutic approaches.” 

ACLM and Blue Shield of California have just announced a collaboration “to provide Lifestyle Medicine continuing medical education and other training tools to the nonprofit health plan’s in-network healthcare providers.” They tell us that “with this new collaboration, Blue Shield becomes the first health plan to offer its in-network healthcare professionals access to discounted ACLM courses, membership, conference registration, board certification review coursework and registration for the American Board of Lifestyle Medicine exam.” 

In November last year, ACLM announced the first physicians and health professionals to be board-certified in the field. They also have developed True Health Initiative (THI), “a coalition of world-renowned health experts committed to cutting through the noise and educating on only the evidence-based, time-honored, proven principles about lifestyle as medicine. The ultimate mission of the THI is to eliminate as much as 80% of all lifestyle-related chronic disease through lifestyle as medicine.”

 

Friday
Apr272018

Nine Things to Know Jump Out of Leapfrog Hospital Safety Grade Report

Nine Things to Know Jump Out of Leapfrog Hospital Safety Grade Report
 

By Clive Riddle, April 27, 2018

 

In May talk of frogs would lead one to the annual Calaveras Jumping Frog Jubilee (check out www.frogtown.com). But in April, talk of frogs leads one to The Leapfrog Group, who just released the spring 2018 edition of the Leapfrog biannual  Hospital Safety Grades. Leapfrog tells us their “grading assigns “A,” “B,” “C,” “D” and “F” letter grades to general acute-care hospitals in the U.S., and is the nation’s only rating focused entirely on errors, accidents, injuries and infections that collectively are the third leading cause of death in the United States.”

 

Here’s nine things to know from the Leapfrog report card results they have shared:

1.     Five “A” hospitals receiving this grade for the very first time this spring had an “F” grade in the past

2.     46 hospitals have achieved an “A” for the first time since the Leapfrog Hospital Safety Grade began six years ago

3.     89 hospitals receiving an “A” at one point had received a “D” or “F”

4.     Of the approximately 2,500 hospitals graded, 30 percent earned an “A,” 28 percent earned a “B,” 35 percent a “C,” six percent a “D” and one percent an “F”

5.     The five states with the highest percentage of “A” hospitals this spring are Hawaii, Idaho, Rhode Island, Massachusetts and Virginia

6.     Rhode Island, Hawaii, Wisconsin, and Idaho once ranked near the bottom of the state rankings of percentage of “A” hospitals but now rank in the top ten

7.     Hospitals with “F” grades are located in California, Washington, D.C., Florida, Iowa, Illinois, Maryland, Michigan, Mississippi, New Jersey and New York

8.     There are no “A” hospitals in Alaska, Delaware or North Dakota

9.     Impressively, 49 hospitals nationwide have achieved an “A” in every grading update since the launch of the Safety Grade in spring 2012

 

In addition to staterankings, you can search for specific hospital safety results at their webaite: http://www.hospitalsafetygrade.org

 
Wednesday
Apr252018

Five Questions for Erin Benson and Rich Morino with LexisNexis Health Care: Post-Webinar Interview

Five Questions for Erin Benson and Rich Morino with LexisNexis Health Care: Post-Webinar Interview
 

Last week, Erin Benson, Director Marketing Planning and Rich Morino, Director, Strategic Solutions, LexisNexis Health Care, participated in a Healthcare Web Summit webinar discussion on opportunities for health plans to leverage social determinants of health data to attain quality goals while managing cost and enhancing member experience.  If you missed this engaging webinar presentation, watch the On-Demand version here. After the webinar, we interviewed Erin and Rich on five key takeaways from the webinar:

 

1. What are some of the ways that member health is impacted on a daily basis by social, economic and environmental factors?

 

Erin Benson and Rich Morino: The environment in which a person lives impacts their likelihood to develop health conditions as well as their likelihood to effectively manage those conditions. Care recommendations need to be a good fit for a member’s environment, not just their medical condition. If recommendations won’t work within the person’s physical environment, aren’t affordable or conveniently located, and are provided in a way that is hard for the member to understand, they won’t be effective at improving health. Studies support this fact. For example, 75-90% of primary care visits are the result of stress-related factors (JAOA Evaluating the Impact of Stress on Systemic Disease: The MOST Protocol in Primary Care). Money, work and family responsibilities – all reflective of social determinants of health -- are cited as the top three causes of stress (APA 2015).

 

2. We've heard reference to aggregating data at the zip code level for use in personalizing care for members. However, this is one of your top five myths about socio determinants of health. Can you tell us more?

 

Erin Benson and Rich Morino: While aggregate data can be useful in certain capacities, it isn’t recommended as a best practice for personalizing care. Within a single zip code, it is not unusual to see variance in income levels, crime rates and other factors impacting an individual’s neighborhood and built environment, so we recommend looking at an individual’s neighborhood from the perspective of their specific address. Focusing on zip code alone also ignores the influences of education, economic stability and social and community context so we recommend incorporating these other social determinants of health into decision-making in order to view the member holistically and create a more comprehensive plan of care outreach.  

 

3. Can you briefly explain why previous generations of SDOH have failed to improve health outcomes?

 

Erin Benson and Rich Morino: There are two primary reasons why previous generations of SDOH have failed to improve health outcomes, data and workflow.   In order to get sufficient value, the data needs to address all 5 categories of SDOH to properly draw useful insights.  The data should also be at the member level, and address who the member’s family and close associations.  Without that information, we cannot tell if someone is socially isolated or living with caregivers, for instance.

 

The second reason why previous generations of SDOH have failed is how they are deployed in the workflow.  An example would be a plan simply adding them to an existing claims-based model to achieve an increase in lift.  The lift is nice, but no changes in process are filtering down to the Care Management team interacting with the members.   In this scenario, a lot of value was ignored.

 

A better method would be if the plan also built models identifying members with barriers to improved health outcomes.  If you now apply this to your chronic or at-risk population you can determine not just who is sick and in need of help, but how to most likely achieve success in an intervention program.  Care Managers would immediately know the challenges to success, and what type of intervention program the member should be in enrolled in from the start.

 

4. One of the SDOH models to uncover health barriers referenced during your webinar was social isolation. Can you provide more context for us here?

 

Erin Benson and Rich Morino: Studies have shown that social isolation can increase risk of heart disease by 29% and stroke by 32% (New York Times How Social Isolation Is Killing Us). By understanding factors about an individual such as who else is living in the household with them, their predicted marital status, and how close their nearest relatives and associates live to them, healthcare organizations can identify who may be socially isolated. This allows care providers to ask the right questions to determine if that person needs access to social support systems such as support groups or community resources to improve their health outcomes.

 

5. What are some ways social determinants can help health plans enhance predictions and improve care management?

 

Erin Benson and Rich Morino: The most common way of utilizing SDOH data so far has been to incorporate it into existing claims-based predictive models to improve predictive accuracy or to use it to create new predictive models. The second use is for care management purposes and this is where social determinants of health can be truly transformational. We recommend as a best practice to use social determinants of health insights to also build models that identify health barriers. The combination of models allows healthcare organizations to better stratify the risk of their members and then better tailor care to their medical and social needs.