Professionals

Patient Safety

Overview

As part of the Medicare 9th SOW, Qualidigm is collaborating with hospitals and nursing homes to implement programs to improve patient safety. Qualidigm’s activities focus on six topics:

Qualidigm Activities

These Patient Safety activities are designed to address areas of patient harm for which there is evidence to demonstrate that safety can be improved by improving health care processes and systems. Qualidigm has worked on the majority of these topics previously (surgical care, heart failure, pressure ulcers and physical restraints in nursing homes and drug safety), so we will build on the progress we have made with our health care provider collaborators over the past six years.

Qualidigm will offer the following services to hospitals and nursing homes that choose to participate in any of the six focus areas:

  • Technical assistance in quality improvement techniques, including on-site assessment and planning
  • Technical assistance with implementation of the Centers for Disease Control and Prevention National Healthcare Safety Network Multidrug-resistant Organism Module (related to the MRSA topic)
  • Assistance with quality measurement, analysis, and benchmarking
  • Assistance with collaborating and sharing data across settings
  • Training in Team STEPPS to improve teamwork and communication among the clinical staff
  • Conducting educational workshops and seminars in quality improvement techniques such as Root Cause Analysis, Failure Mode Effects Analysis, rapid cycle change, and LEAN methodology
  • Access to proven tools, resources, and interventions that improve quality of care
  • A venue to share lessons learned, challenges, and best practices among facilities

Overview | Qualidigm Activities | Links, Tools & Resources | Team Members

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Links, Tools and Resources

Overview | Qualidigm Activities | Links, Tools & Resources | Team Members

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Team Members

Project Manager Consulting Services Hospital Setting
Carol Dietz
(860) 632-3737
cdietz@qualidigm.org

Project Manager Consulting Services Long Term Care Setting
Michelle Pandolfi
(860) 632-3735
mpandolfi@qualidigm.org

Administrative Assistant
Doreen Ostapchuk

Chief Medical Officer
Thomas P. Meahan

Director of Analysis Services
Shih-Yieh Ho

Director of Consulting Services
Anne Elwell

Clinical Advisor Long Term Care
Ann Spenard

Overview | Qualidigm Activities | Links, Tools & Resources | Team Members

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Reducing the Incidence of MRSA Infections

MRSA is the most common hospital acquired infection in the United States according to the Association for Professionals in Infection Control and Epidemiology (APIC).  It increases patient morbidity, mortality, and the cost of hospital care. As a result, reducing MRSA infections has become the goal of many interested parties:  hospitals, payers, and consumer groups.

Qualidigm will work with hospitals in Connecticut to reduce the rate of health care associated MRSA infections over the next three years. This collaboration will utilize the Institute of Healthcare Improvement (IHI) recommended components of care as its basic quality improvement intervention.  These components include hand hygiene, decontamination of the environment and equipment, active surveillance, contact precautions for infected and colonized patients, and device bundles (central line and ventilator).

In addition to the IHI intervention, Qualidigm will provide Team STEPPS training to the participating hospitals. Utilizing Team STEPPS improves communication among an organization’s staff to improve patient safety and patient satisfaction with the care experience.

And, finally, Qualidigm will encourage hospitals to track their progress toward improvement through submitting data to the United States Centers for Disease Control (CDC).  One of the modules in the CDC database is being designed specifically for the purpose of tracking MRSA infection rates. 

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Surgical Safety and Heart Failure Treatment

More than 20 million surgical procedures are performed in the United States each year. Depending on the procedure, up to one-half of these procedures have postoperative complications associated with them. These complications take a significant toll on the patients who experience these complications. They also raise the overall cost of health care and increase the patient’s length of stay in the hospital.

The Surgical Care Improvement Project (SCIP), initiated by Medicare several years ago, is a national partnership of organizations committed to improving the safety of surgical care through the reduction of post-operative complications. SCIP’s goal is to reduce surgical complications for selected procedures by 25 percent nationally by the year 2010.

Qualidigm will offer the following services to participating hospitals:

  • Assistance to improve the SCIP quality measures
  • Technical and educational assistance on quality improvement
  • Sharing “best practices” with hospitals to improve the care they deliver to heart failure patients

Heart failure is a condition that affects nearly five million Americans of all ages and is responsible for more hospitalizations than all forms of cancer combined. Over 400,000 new cases of heart failure will be diagnosed in the next year.

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Reducing the Incidence of Pressure Ulcers in Hospitals and Nursing Homes

The quality initiatives of the Joint Commission, the Institute for Healthcare Improvement’s 5 million Lives Campaign, and the Advancing Excellence in America’s Nursing Home Campaign all include decreasing the incidence of pressure ulcers and improving the treatment of them.

Although CMS has focused on preventing and treating pressure ulcers in the nursing home setting in the past, it is now including hospitals in the initiative.  The CMS expectation is that nursing homes and hospitals will work together on this. As part of the federal Deficit Reduction Act of 2005, beginning on October 1, 2008, hospitals will no longer receive additional reimbursement from Medicare to care for a patient who has acquired a pressure ulcer during the hospital stay.

Qualidigm will be offering the following services to hospitals and nursing homes participating in this initiative:

  • Technical and educational assistance related to quality improvement techniques
  • Assistance with performing and documenting admission and daily assessments of patients, as well as prevention and treatment interventions
  • Developing cross-setting collaboration bringing together hospitals and nursing homes that share patients to work on this common challenge
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Decreasing the Use of Physical Restraints in Nursing Homes

A physical restraint is defined as any device, material or equipment that keeps a resident from moving freely. Many believe that physical restraints can help to protect residents with limited mobility. Restraints can, in fact, cause more harm than good. Physical restraints should only be used to treat the resident’s medical symptoms upon the written order of a physician, except in the case of emergencies.

In this initiative, Qualidigm will be offering the following services to participating nursing homes:

  • Technical assistance with decreasing the use of  physical restraints and advice about better ways to protect residents who may have poor safety awareness or are at risk of falling 
  • Technical and educational assistance on quality improvement techniques
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Drug Safety

Qualidigm will work with physicians, Prescription Drug Plans and Medicare Advantage plans to reduce the number of prescriptions with potential drug-on-drug interactions (DDI) and to decrease the number of potentially inappropriate medications (PIM) prescriptions for beneficiaries. 

Qualidigm is partnering with the Connecticut State Medical Society - IPA and the Connecticut Pharmacists Association to provide information on a potential drug-to-drug interaction and the use of potentially inappropriate medications for seniors.  For more information go to: www.csms-ipa.com

pillsNew information on evaluation of the risk of adverse events (AEs) and the healthcare costs for elderly patients receiving specific potentially inappropriate medications (PIMs) is available on AJMC website.

For your convenience, we are providing this link to this report: Clinical and Economic Outcomes Associated With Potentially Inappropriate Prescribing in the Elderly potentially inappropriate medication

attention  In July the FDA responded to Public Citizen's petition for propoxyphene withdrawal by taking several actions, including a strengthened Black Box Warning, further studies on cardiotoxicity, hip fractures, etc., and development of a patient information sheet by the manufacturers.

For your convenience, we are providing this link to a summary of their response: Propoxyphene Questions and Answers

 

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