Hospital Quality: A Board Responsibility

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Hospital Quality A Board Responsibility

• Nancy Foster
• Vice President

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Community Perspective on Hospital

• Be there when my family and I need you
• Protect us from harm
• Provide the care most likely to lead to the best
  outcome for us
• Treat us with kindness and respect
• Engage us in our own care

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Reform Harder than it looks
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Three House Committees Report Bills
House Three Committees Report Bills

• Education and Labor Committee
• Ways and Means Committee
• Energy and Commerce Committee

Senate Two Committees Report Bills

• Health, Education, Labor, and
• Pensions Committee
• Finance Committee

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Main Messages for Hospitals

• More is Needed
• More Integration
• Delivery system reform
• Patient-centered care
• More Improvement
• Reduce infections
• Reduce hospital acquired conditions
• Reduce avoidable readmissions
• More Transparency
• More measures
• Better communication

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Aligning Our Efforts
Practice Drives Policy
Policy Drives Practice
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Why Focus on Performance?
or
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Main Messages for Hospitals

• More is Needed
• More Integration
• Delivery system reform
• Patient-centered care
• More Improvement
• Reduce infections
• Reduce hospital acquired conditions
• Reduce avoidable readmissions
• More Transparency
• More measures
• Better communication

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More Integration.

• Stop unwarranted shuffling of patients
• Better transition patients and their families
  pre- and post-discharge
• Link information systems to reduce chance of
  error, improve decision-making
• Align with physicians, post acute care
  settings for bundled payments
• Align to be accountable care organizations

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Main Messages for Hospitals

• More is Needed
• More Integration
• Delivery system reform
• Patient-centered care
• More Improvement
• Reduce infections
• Reduce hospital acquired conditions
• Reduce avoidable readmissions
• More Transparency
• More measures
• Better communication

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Safer Care

• Preventable medical errors
• 44,000 to 98,000 Americans die each year
• Eighth leading cause of death in the United
  States
• Annual cost as much as 29 billion annually
• IOM conclusion the majority of these problems
  are systemic, not the fault of individual
  providers

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Sensation in the Popular Press
Not being above the fold priceless.
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As Board Members
Are you investing resources for safety?
Is safety embedded in daily work?
How strong is your a safety culture?
What projects do you have underway are they
making a difference?
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30 Day Medicare Readmission Rates
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Main Messages for Hospitals

• More is Needed
• More Integration
• Delivery system reform
• Patient-centered care
• More Improvement
• Reduce infections
• Reduce hospital acquired conditions
• Reduce avoidable readmissions
• More Transparency
• More measures
• Better communication

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More Transparency

• Inpatient and Outpatient Quality Data
• Physician Quality Data
• Ambulatory Surgical Center Data
• Pricing
• Adverse Events
• Executive Compensation
• Outcomes
• Patient Perceptions
• Information Technology implementation

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Five Simple Rules for Trustees

• Recognize improvement is a journey
• Dont make the journey alone
• Keep track and know what has been accomplished
• Dont forget your patients
• Recognize the power of your interest

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1. Recognize Improvement is a Journey
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2. Dont Make the Journey Alone

• Coalitions and collaborations
• AHAs and NHHA activities
• Infections
• Readmissions
• Safety
• IHI, Premier, VHA, professional societies, others

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3. Keep Track

• Public data
• Internal improvement data - Expect reports
• GOOGLE and Blogs

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4. Dont Forget Your Patients
Make them partners in the work
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5. Recognize The Power of Your Interest

• Hawthorne Effect
• Ask your questions
• The Porter Question
• Tell YOUR Story
• Data must be set in context to become information

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THE COMING ERA
What Will Be Expected of Healthcare Organizations?
More Integrated Care Delivery
Better stewardship of Care,
More Transparency on Performance
More Risk Assumed