Partnership for Patients and Million Hearts: Two National Initiatives from ACA CDR Frances R. Jensen Medical Officer, USPHS Learning and Diffusion Group Center for Medicare and Medicaid Innovation (CMMI)

Partnership for Patients: Better Care, Lower Costs Nationwide public-private partnership to tackle all forms of harm to patients. Our goals: 40% Reduction in Preventable Hospital Acquired Conditions over three years 1.8 Million Fewer Injuries 60,000 Lives Saves 20% Reduction in 30-Day Readmissions in Three Years 1.6 Million Patients Recover Without Readmission Bonus: Potential to Save $35 Billion in Three Years

Our Federal Partners

Some of our National Partners Hospitals: HENs Hospital Corporation of America and its 163 hospitals Kaiser Foundation Hospitals and its 35 hospitals Tenet Healthcare Corporations and its 49 hospitals Department of Veterans Affairs and its 171 hospitals Virginia Mason Hospital & Medical Center American Hospital Association Federation of American Hospitals National Association of Public Hospitals and Health Systems Clinicians: American Academy of Pediatrics American Academy of Family Physicians American Board of Medical Specialties American College of Physicians American College of Surgeons American Medical Association American Nurses Association American Society of Health-System Pharmacists National Hispanic Medical Association Consumer Organizations: Campaign for Better Care National Partnership for Women and Families National Patient Safety Foundation Unions: AFL-CIO UAW Retiree Medical Benefits Trust UNITE HERE HEALTH Employers Business Roundtable CalPERS Catalyst for Payment Reform The Dow Chemical Company General Electric Healthcare Leadership Council Honeywell IBM Intel Corporation Johnson & Johnson Motorola Solutions, Inc. National Business Coalition on Health National Business Group on Health Pacific Business Group on Health Safeway Starbucks Walmart Xerox Health Plans: Aetna America’s Health Insurance Plans BlueCross BlueShield Association Cigna Group Insurance Commission, Commonwealth of Massachusetts United Health Group Wellpoint Other Partners Cerner Corporation The Joint Commission The Leapfrog Group Planetree NQF

Hospital Engagement Networks $218 million awarded to 26 organizations to operate hospital networks across the country that will make patient care safer by: –Developing learning collaboratives –Identifying solutions and strategies for improvement and spread them –Providing intensive training programs and technical assistance –Establish data system to monitor hospital progress in meeting quality improvement goals

Hospital Engagement Networks American Hospital Association Ascension Health Carolinas HealthCare System Catholic Healthcare West Dallas-Fort Worth Hospital Council Foundation Georgia Hospital Association Healthcare Association of New York State Hospital & Healthsystem Association of Pennsylvania Intermountain Healthcare Iowa Healthcare Collaborative Joint Commission Resources, Inc. Lifepoint Hospitals, Inc. Michigan Health & Hospital Association Minnesota Hospital Association National Public Health and Hospital Institute New Jersey Hospital Association Nevada Hospital Association North Carolina Hospital Association Ohio Children’s Hospital Solutions for Patient Safety Ohio Hospital Association Premier Tennessee Hospital Association Texas Center for Quality & Patient Safety UHC VHA Washington State Hospital Association

Hospital Engagement Networks Coverage States with extensive coverage States with limited coverage

Reach of the HENs Over 4000 hospitals Every State From the C-Suite to the Bedside and Everyone in between

Ten Areas of Focus Hospital Engagement Networks are required to address ten areas of focus: Adverse Drug Events Catheter-Associated Urinary Tract Infections (CAUTI) Central Line Associated Blood Stream Infections (CLABSI) Injuries from Falls and Immobility Obstetrical Adverse Events Pressure Ulcers Surgical Site Infections (SSI) Venous Thromboembolism (VTE) Ventilator-Associated Pneumonia (VAP) Preventable readmissions

What can Nurses do to Help us Achieve Our Aims? (Besides Everything!) HACs Adverse Drug Events CAUTI CLABSI Injuries from Falls and Immobility Obstetrical Adverse Events Pressure Ulcers SSIs VTE VAP Preventable readmissions RN roles Careful med admin Take out inappropriate catheter! Help with checklist; line care Risk assessment; ambulate Insist on hard stops for EEDs Turn patients; daily assessment Vigilance in OR; wound care Prophylaxis insistence Elevate HOB; sedation vacation Discharge planning; med recon

Focus on Readmissions Community Based Care Transitions Program (CCTP) …Its not just about the hospitals Section 3026 of the ACA

Community-Based Care Transitions Program 12 Improve transitions of beneficiaries from the inpatient hospital setting to home or other care settings. $500 million available for this program over 5 years. 2-year program agreements for participants, renewable annually based on success Accepting applications on rolling basis as long as funding is available Applicants define and price a new cost-effective care transitions service for Medicare patients in their communities - tailored to their own unique circumstances and capabilities

Eligible Applicants for CCTP Subsection (d) acute care hospitals with high readmission rates in partnership with a community based organization (CBOs) that provide care transition services CBO: is a legal entity, i.e., w/ taxpayer ID number, so we can pay them for services provided. Which proposals are preferred: –Include participation in a program administered by the AoA to provide concurrent care transition interventions with multiple hospitals and practitioners –Provide services to medically-underserved populations, small communities and rural areas Has a governing body with multiple health care stakeholder representation, including consumers.

CCTP Partners 14

For more information The solicitation and application are available on for CCTP program web page at Or visit: Please direct any additional questions to

What Can USPHS Nurses (You!) do to Help DHHS/PfP Achieve our Aims? Continue to provide the highest quality health care you can. Patient, family, caregiver, clinician education on the front lines. Spread the word to all!

Million Hearts™ National initiative co-led by CDC and CMS Partners across federal and state agencies and private organizations 17 Goal: Prevent 1 million heart attacks and strokes in 5 years Goal: Prevent 1 million heart attacks and strokes in 5 years

Heart Disease and Strokes Leading Killers in the United States Cause 1 of every 3 deaths Over 2 million heart attacks and strokes each year –800,000 deaths –Leading cause of preventable death in people <65 –$444 B in health care costs and lost productivity –Treatment costs are ~$1 for every $6 spent Greatest contributor to racial disparities in life expectancy Roger VL, et al. Circulation 2012;125:e2-e220 Heidenriech PA, et al. Circulation 2011;123:933–4 18

Status of the ABCS A spirin People at increased risk of cardiovascular events who are taking aspirin 47% B lood pressure People with hypertension who have adequately controlled blood pressure 46% C holesterol People with high cholesterol who are effectively managed 33% S moking People trying to quit smoking who get help 23% MMWR: Million Hearts: Strategies to Reduce the Prevalence of Leading Cardiovascular Disease Risk Factors — United States, 2011, Early Release, Vol

The Problem with Blood Pressure

How Can Nurses (You!) Support Million Hearts? Pledge at: Drive excellence in the ABCS Develop, support, test, improve models and systems of care –Teams –Disparities –Adherence –Behavior Change Share what you’re working on, what works, what you learn Probe, push, prod, “PULL” this initiative to 2017 CAPT Marsha Davenport, MD

QUESTIONS?