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Quality &Safety Report 2017

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Quality &Safety Report 2017 Quality & Safety Report 2017 The right care in the right place at the right time. e Christiana Care Way We serve our neighbors as respectful, expert, caring partners in their health. We do this by creating innovative, effective, affordable systems of care that our neighbors value. IN THIS REPORT 2 Carelink CareNow 9 Clinical Pathways 15 Preventable Harm ON THE COVER: Albert White, with his faithful canine 25 Project Highlights companion, Chi Chi, is a glowing example of how our nationally recognized Carelink CareNow service is 33 Patient Experience helping neighbors overcome barriers to optimal health 35 Awards & Recognition by linking them with needed support throughout our community. See page 6 to learn how his Carelink CareNow team (pictured above) is traveling the journey with him on the road to good health. We serve together At Christiana Care, our mission is simple, yet profound: For neighbors like Albert White, featured on our cover for We take care of people. Our approach to quality and safety the life-changing progress he has achieved with the support is to put our patients and their families at the center of all of his Carelink CareNow team, this innovative approach to we do. We serve our community together as one team, care — evidence-based and individualized for success — guided by our values, excellence and love. is changing lives. Providing safe, highly reliable care, an exceptional experience So is our multidisciplinary collaboration toward prevention for every patient and reducing the cost of care to deliver of harm, including infection control and medication safety. excellent value means not only treating people when they Collaboration is paramount in our Journey to Zero to eliminate are sick, but helping them to stay well. The missing link to cases of preventable harm and in our efforts to manage and optimal health, we know, is addressing the gaps in between. learn from events with transparency and compassion through our CANDOR program. This year, we earned the John M. Eisenberg Patient Safety and Quality Award, the nation’s preeminent acknowledgment In our continuous endeavor to provide care of the highest of quality and safety in health care, for our patient-centered quality and safety, our move from a department-based care coordination service Carelink CareNow. Through Carelink clinical structure to a service line structure more closely CareNow, we are meeting patients’ social and behavioral matches how patients experience us when they come for health needs in addition to their medical needs. We are care. This transformation is achieving measureable and ensuring the right care in the right place at the right time. meaningful results for those we serve. Clinical pathways This is the road map to better health at lower cost — quality, within each service line enable us to reduce variation in safety and value. care and provide care that is evidence-based — decreasing readmissions, reducing length of stay and making a positive impact that reverberates through our health system and our community. Our neighbors count on us to anticipate their needs and help with compassion and generosity. We are committed to being exceptional today and even better tomorrow. Our consistent, rapid gains in quality and safety speak to the extraordinary people in our health care workforce who understand what our patients and our community value. JANICE E. NEVIN, M.D., MPH PRESIDENT AND CHIEF EXECUTIVE OFFICER CHRISTIANA CARE HEALTH SYSTEM ChristianaCare.org | Quality & Safety Report 1 Carelink CareNow care coordination service earns Eisenberg Patient Safety and Quality Award Preeminent recognition for quality and safety in health care honors innovative approach to helping patients manage chronic conditions hristiana Care Health System’s patient-centered A well-connected multidisciplinary network of Carelink CareNow care coordination service Carelink CareNow team members supports patients across the continuum of care was recognized with a 2017 John M. Eisenberg from hospital to skilled nursing facilities to community-based Patient Safety and Quality Award in the Local Level providers to home care through the Christiana Care Visiting Innovation in Patient Safety and Quality category. Nurse Association. Outpatient outreach starts as soon as CPresented by the Joint Commission and the National Quality patients return home, with a focus on symptom management, Forum, the Eisenberg Award recognizes innovation and follow-up appointments and access to medications after effectiveness in helping patients to manage their health while discharge, all while supporting primary care and sub-specialty achieving higher quality health care at lower costs. physicians in the care of their patients. Through Carelink CareNow, Christiana Care partners with Real-time admission alerts on patients from all emergency about 300 primary care physicians to transform the way care is departments and hospitals through the regional health delivered to nearly 75,000 Medicare beneficiaries and health information exchanges, along with other health information and plan members. It accelerates the health system’s journey to claims data, allow the team to interact with hospital clinical achieve better quality and better experience at reduced costs. and care management teams, helping to avoid unnecessary hospitalizations and ensuring appropriate follow-through A robust information technology-enabled network of care on clinical plans. The service educates patients on the coordination support services features a prediction analytics appropriate sites to access acute care and minimize engine that integrates real-time information from the Delaware unnecessary use of the emergency department or hospital. Health Information Network, along with other health information The intensity of outreach is customized to each patient. — admission and emergency department visit information, physician visits, lab results, radiologic reports, pharmaceutical use and claims data, to proactively identify populations most at risk or in need of attention before issues escalate. Carelink CareNow’s unprecedented predictive analytic capabilities and innovative“ work in care coordination improve health care safety, quality, value and access to care for all throughout our state and region.” SHARON L. ANDERSON, MS, BSN, RN, FACHE CHIEF POPULATION HEALTH OFFICER, SENIOR VICE PRESIDENT OF QUALITY AND PATIENT SAFETY PRESIDENT OF CARELINK CARENOW 2 Quality & Safety Report | ChristianaCare.org Carelink CareNow supports bundled care Carelink CareNow supports more than 8,600 patients through participation in the Centers for Medicare & Medicaid Services’ Bundled Payment for Care Improvement project. The patients represent several surgical and medical populations, including total hip and knee replacement surgery, cervical spine surgery and congestive heart failure. Through bundles, Christiana Care takes responsibility for the financial and clinical outcomes of Medicare patients in episodes of care, including acute inpatient stays, post-acute care and all related services up to 90 days after hospital discharge. f Elective joint replacement Bundled care increased the number of patients having elective joint replacement who were discharged to their homes with self-care or with home health care by 30 percent. It reduced the number of patients transferred to skilled nursing facilities after total joint replacement surgery by more than 62 percent and created a 30 percent reduction in readmissions after 90 days. Community Discharge Rate for Patients with Total Joint (Hip or Knee) Replacement July 2011 – February 2017 Percent fo patients discharged to home with self care or home health care Upper Control Limit Mean Lower Control Limit Upper Control Limit Mean Lower Control Limit ChristianaCare.org | Quality & Safety Report 3 Carelink CareNow f Congestive heart failure For patients admitted to the hospital with congestive heart failure, the average length of stay decreased by more than 11 percent. The volume of patients discharged to home with self-care or with home health care increased by nearly 12 percent, with a concurrent reduction in the number of patients transferred to skilled nursing facilities by more than 10 percent. The readmission rate to the hospital decreased by almost 14 percent. Upper Control Limit Mean Lower Control Limit Upper Control Limit Mean Lower Control Limit 4 Quality & Safety Report | ChristianaCare.org f Skilled nursing facilities To reduce unnecessary hospital utilization and improve quality of care for patients in skilled nursing facilities, Carelink CareNow teamed with the staff from local and regional facilities. Strategies included weekly interdisciplinary conference-call patient rounds, medication review and reconciliation and social work support. This effort reduced average length of stay by 17 percent, saving an estimated $821,000, and reduced hospital readmission rates by almost 8 percent. 30-Day Readmission Rate Total Hospital Returns Unplanned Inpatient Admissions Unplanned Inpatient, ED, Obs Visits 25.0% 25.0% -17.0% 20.0% 20.0% -7.6% 15.0% 15.0% 10.0% 10.0% 20.0% 16.6% Percentage of patients Percentage 5.0% 10.7% 9.9% of patients Percentage 5.0% 0.0% 0.0% Jul-Dec 2015 Jul-Dec 2016 Jul-Dec 2015 Jul-Dec 2016 Christiana Care wins Stand Up for Patient Safety Management Award The National Patient Safety Foundation presented Christiana Care Health System with a Stand Up for Patient Safety Management Award for the successful implementation of Carelink CareNow. The annual award recognizes
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