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Transparency in Healthcare Quality Reporting East Midlands, National Health Service Alide Chase, SVP Medicare Clinical Operations and Population CareNovember,

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Presentation on theme: "Transparency in Healthcare Quality Reporting East Midlands, National Health Service Alide Chase, SVP Medicare Clinical Operations and Population CareNovember,"— Presentation transcript:

1 Transparency in Healthcare Quality Reporting East Midlands, National Health Service Alide Chase, SVP Medicare Clinical Operations and Population CareNovember, 2013

2 Objective  Develop an understanding about the importance of transparency in Quality Reporting in a Healthcare System. 2

3 KP by the Numbers  7 regions serving 8 states and the District of Columbia  More than 9 million members  More than 16,000 physicians and 174,000 employees (including 49,000 nurses)  38 hospitals (co-located with medical offices)  Almost 600 medical offices and other outpatient facilities  68 years of providing care

4 Our Markets and Membership (2012) Mid-Atlantic Region  Washington, DC  Maryland  Virginia 482,000 members Georgia Region 234,000 members Colorado Region 540,000 members Northern California Region 3.4 million members Hawaii Region 225,000 members Northwest Region  Portland, OR  Vancouver, WA 484,000 members Southern California Region 3.6 million members 4

5 5 Our Aspiration Kaiser Permanente’s Strategic Vision is to be a Leader in Total Health by making lives better. Total Health is a state of complete physical, mental and social well-being for all people. 5

6 Transparency with Performance… A Challenging Uphill Climb 6 Health Care Reporting Patients The Press Gov’t Regulations

7 Consumer Report Websites – (can be scary) More informal sites can publish misinformation. For example, Dead by Mistake ie’s 7

8 8 2005

9 Mid Staffordshire NHS trust inquiry report published Causing death or harm to a patient 'should be offence' 'Duty of candour' should be imposed on NHS staff Senior staff who breach code of conduct 'should be disqualified' No sacking of 'scapegoats' or reorganising the NHS Cameron creates new post of chief inspector of hospitals PM apologises for care scandal at Stafford hospital Read the key points Read the main news story: Report calls for sweeping changes Read more: Mid Staffs hospital scandal: explainer Read the full report Read all our Mid Staffs coverageRead the key pointsReport calls for sweeping changesMid Staffs hospital scandal: explainerRead the full reportRead all our Mid Staffs coverage 2013 9

10 Is Transparency a Game Changer? Agree or Disagree?  Serious improvement begins with understanding reality. Transparency and honesty are not just assets for better health care, they are preconditions (Don Berwick, MD 2009). 10

11 The Benefits of Transparency  Allows demonstration of “Best”  Motivates improvement  Raises the bar on accountability  Enables learning  Increases recognition of risk in the microsystem  Provides information for decision-making  Builds trust  Others? Gains from Transparency 11

12 Risks of Transparency  Personal liability and reputation  Organizational liability and reputation Inability to close gaps Managed care liability and medical malpractice Brand management Regulatory-related issues  Patients making poor decisions  Others? 12

13 KP’s Transparency Journey AudiencePastPresent Future Opportunity Patient-Doctor Communications Organization-Patient Communications Organization-Staff Communications Organization-Public Communications 13

14 Patient-physician Communications AudiencePastPresent Future Opportunity 14

15 KP Guiding Principle re: Communicating about Adverse Outcomes “Patient safety and clinician welfare will be best served if we are honest about unanticipated adverse outcomes with our patients and open with our colleagues and ourselves and that we handle such occurrences with sympathy and empathy for our patients and our colleagues." 15 Policy Development Training Modules/ Simulation Leadership Endorsement MD Staff Go Thru Training (Track # Trained) Event Documentation Track Conversation (Loop Closed)

16 Organization-Patient Communications AudiencePastPresent Future Opportunity 16

17 Surveys, focus groups … Story telling, video ethnography, shadowing, touchpoint mapping … Advisory councils, members on committees, grand rounds, subject matter experts … Co-designers and partners in creating value and improving quality … Co-Creating & Co-Designing Advising & Consulting Diving Deeper Gathering Feedback KP’s Evolution in Integrating Patients and Families We leverage all these approaches today as we strive to actively listen and partner with our members and their families at every touchpoint in their journey and across all our quality improvement and innovation efforts.

18 Organization-staff Communications AudiencePastPresent Future Opportunity 18

19 Organization-staff Communications  Unblinded medical center level data shared with small audiences  Near real-time sharing of event-related information, e.g., “days since last…” 19

20 Inpatient Mortality: All KFH HSMR continues below US Medicare benchmark. HEDIS: KP performance continues to trend above the national 90th Percentile Safety: Opportunities exist for SRAE verification incidents, infections, HAPUs, and falls Service-METEOR: Health Care Rating showed a significant improvement of 3.7 points from the previous year. Big Q Performance Metrics Top Level or Program View – August 15, 2013 Resource Stewardship: No threshold has been established for this top level metric, commercial HMO risk adjusted selected services cost PMPM. Equitable Care: The gap between the Black or African American and White rates for 2012 Q4 was 29 points; the disparity has decreased 28% since 2010 Q4.. T JC: The combined TJC composite for all KFH hospitals continues to be less than one point from 100% - the national 90 th percentile Privileged and Confidential 20 Service-HCAHPS: Overall Rating demonstrated a significant 1.2 point increase from the previous year.. Nurse Communication also showed a significant improvement of.8 points from previous year. Confidential

21 Diving a Little Deeper 21 Patient Safety Building Blocks Pressure Ulcers Surgical Care Improvement Program HSMR All Regions TJC National Average Falls SRAE Composite Adult ICU Central Line Associated BSI All Cause 30-Day Readmissions Worker Injuries May 2013

22 Hospital Accreditation 22 We Report on KP’s Website as Well Orange County - Mortality

23 We Report on KP’s Website as Well Orange County: The Leapfrog Group - Quality and Patient Safety 23

24 We Report on KP’s Website as Well Orange County – Infections 24 Orange County – HAPUs

25 We Report on KP’s Website as Well Orange County - Service 25

26 In Quality, Quality Improvement and Patient Safety, we’ve come a long way, but there’s a long way to go! 26

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