1. Shifting Your Quality Improvement into High Gear: Using Rapid Cycle Improvement to Impact Quality Outcomes Cindy Sun, MSN, RN, COS-C

2. Objectives After today’s session, the participant will be able to:  Explain rapid-cycle improvement and describe how it aligns with current HHA goals  List steps towards implementing PDSA in own HHA  Access the HHQI tools and resources for reference and to support individual PDSA cycle

3. Connection to Quality Quality HH Star CoP

4. Quality of Patient Care Star Ratings Summary of Current Performance Measures Process MeasuresOutcome Measures Improvement of: Timely Initiation of CareAmbulation Drug Education on all MedsBed Transferring Influenza ImmunizationBathing Pain Interfering with Activity Shortness of Breath Acute Care Hospitalization (ACH)

5. Conditions of Participation (CoP)  Data-driven quality assessment and performance improvement (QAPI) program  Start Now and achieve sustainability by the time the CoP is released

6. Data-Driven Quality Improvement HHQI Data Reports HH Compare CASPER

7. Model for Improvement What? What are we trying to improve? When? How will we know the improvement has occurred? Changes? What changes can we make that will REALLY result in improvement? Pave Your Path Webinar Series: http://www.homehealthquality.org/Webinars/Pave-Your-Path-Webinars.aspx http://www.homehealthquality.org/Webinars/Pave-Your-Path-Webinars.aspx

8. Rapid Cycle-Improvement: PDSA

9. “The Domestic Lean Goddess”  Short video demonstrating the use of the PDSA Cycle related to getting the family out the door on time in the morning  Available on the HHQI website at: www.HomeHealthQuality.org/Webinars/Pave-Your- Path-Webinar-Series www.HomeHealthQuality.org/Webinars/Pave-Your- Path-Webinar-Series

10. Sustainability and Spread  Organizational Culture  Community Partners  Resources

11. Home Health Quality Improvement (HHQI) National Campaign Goal: Improve the quality of care home health patients receive Special Project funded by Centers for Medicare & Medicaid Services Free evidence-based tools and resource Many networking opportunities with 12,000+ participants

12. www.HomeHealthQuality.org

13. HHQI Rapid Cycle Improvement Resources  Pave Your Path Webinar Series: Designing a Systematic Approach to Quality Improvement – Institute of Healthcare Improvement – 4-part series focusing on IHI’s Model for Improvement Includes PDSA (Rapid Cycle Improvement)

14. Self-Management PDSA Checklist The model for improvement, with Plan-Do-Study-Act (PDSA) cycles, provides a framework for testing changes to improve patient self- management. Learn about the PDSA model: CHAMP presentation, handouts, and worksheetpresentationhandoutsworksheet

15. Medication Management

16. Underserved Population Templates  Health Literacy  Small HHA hospitalization

17. Interpretation of HHQI Data Reports

18. HHQI Data Access  Individualized reports: – Acute Care Hospitalization – Oral Medication Management – Immunizations – Cardiovascular  OASIS-based (raw & risk- adjusted)  Securely delivered online  Updated monthly  Historical trends

19. Best Practice Intervention Packages (BPIPs)  T opics – Cardiovascular Health – Immunization – Underserved Population – Acute Care Hospitalization – Oral Medication Management – Disease Management – Fall Prevention – Cross Settings

20. Potential ACH Problems / Barriers Identified in Data? Not using a Hospital Risk Assessment? Hospital Risk Assessment Patient Self- Hospitalization Assessment

21. Other Problems/ Barriers with ACH Data? Hospitalizations resulting from exacerbated chronic diseases? Zone & Stop Light Tools

22. Available Zone Tools  Fundamentals of Reducing Acute Care Hospitalizations BPIP – ZONE ToolsZONE Tools – COPD – Depression – Diabetes – Heart Disease – Heart Failure – High Blood Pressure – Urinary Catheter

23. Communication Challenges?  Are your triage logs indicating patients are not calling agency before going to hospital Call Me First Posters

24. Medication Reconciliation

25. Medication Adherence

26. Video BPIPs  Video BPIPs – Short patient and clinician videos – Supplement education using multimedia – Perfect for patient education

27. No Inglés?  Spanish translations – Many tools and patient resources  Patient Video BPIP subtitles

28. HHQI University  Monthly educational opportunities  Free CE opportunity for RNs  Great way to share best practices for improving patient outcomes

29. Questions?

30. Thank You! Contact Info: HHQI: HHQI@wvmi.orgHHQI@wvmi.org Cindy Sun: csun@wvmi.orgcsun@wvmi.org This material was prepared by Quality Insights, the Medicare Quality Innovation Network-Quality Improvement Organization supporting the Home Health Quality Improvement National Campaign, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The views presented do not necessarily reflect CMS policy. Publication number 11SOW-WV-HH-MMD-060515C