1. NoCVA HEN Preventing Avoidable Readmissions Collaborative - Virginia Abraham Segres, MHA Vice President, Quality and Patient Safety Virginia Hospital & Healthcare Association June 11, 2012

2. NoCVA HEN This activity is part of the North Carolina Virginia Hospital Engagement Network(NoCVA HEN) The NoCVA HEN is led by the NC Quality Center in partnership with the Virginia Hospital & Healthcare Association The NoCVA HEN exists to support the goals of the CMS national effort - The Partnership for Patients 2

3. Partnership for Patients Goals By the end of 2013, preventable hospital acquired conditions would be reduced by 40%, compared to 2010 By the end of 2013, 30-day hospital readmissions would be reduced by 20%, compared to 2010 This Collaborative is designed to impact the goal of reducing avoidable readmissions 3

4. Describe the NoCVA Virginia Preventing Avoidable Readmissions Collaborative goals, methods and measures Understand the IHI’s STAAR model for Improving Care Transitions and Reducing Avoidable Rehospitalizations Identify specific strategies to reduce avoidable rehospitalizations Understand the expectations of collaborative participants Objectives 4

5. Introductions & Project Overview Individual Hospital Readmission Improving Care Transitions and Reducing Avoidable Rehospitalizations Lunch Readmission Measures Introduction to the IHI Readmission Diagnostic Tool Next Steps – Action Planning 5 Agenda

6. The Problem of Readmissions 6 Frequent and costly Many are avoidable Many represent complications Poor care transitions impact patient well- being and contribute to readmissions Value based purchasing: penalty for readmissions

7. Collaborative Mission 7 To improve transitions in care and reduce avoidable hospital readmissions.

8. Collaborative Goals 8 Reduce readmissions rates by 20% Increase medication reconciliation at discharge to 95% Additional hospital specific goals based on hospital assessment of readmission patterns

9. Participating Virginia Hospitals 9 Augusta Medical Center Bedford Memorial Hospital Carilion Franklin Memorial Hospital Carilion Roanoke Medical Center Carilion Tazewell Community Hospital Centra Lynchburg General Hospital Chesapeake Regional Medical Center Culpeper Regional Hospital Fauquier Hospital Prince William Health System Rappahannock General Hospital Southern Virginia Regional Medical Center Southside Community Hospital – Centra Southside Regional Medical Center Virginia Hospital Center

10. Priority: Top priority for 33%; Top 3 for 67%; Top 4 for 80% Team Status: 57% has a structured quality team in place Performance Status: 19% better than goal; 14% at goal; 48% worse than goal; 19% not a goal/don’t know Transition of Care Models: 52% homegrown; 37% none; 5% BOOST, 5% Impact, 10 NOAT Survey Results: Readmissions in VA Hospitals

11. The Model 11 Institute for Healthcare Improvement (IHI): o STARR – State Action on Reducing Avoidable Readmissions o How-to-Guide: Creating an Ideal Transition Home to Reduce Avoidable Rehospitalizations

12. Methods Develop multidisciplinary project team Assess recent readmissions Conduct observations of patient admission, education, and discharge Review assessment and observation information Develop targets for improvement Identify and connect with local community organizations, services and practices Develop & implement action plans for improvement targets 12

13. Methods 13 Monthly webinars Group coaching calls In-person learning sessions Apply specific improvement tools such as Lean’s value stream mapping

14. Website for Resources 14 NoCVA HEN: Readmissions Virginia

15. Timeline Pre-workMay – June, 2012 Learning Session 1June 11, 2012 – Richmond, VA Action Period 1June – December, 2012 Content WebinarsJune, July, August, September & December Coaching CallsJune, September & December Monthly Data Collection - Submitted Quarterly May-December 2012 Learning Session 2January 30, 2013 – Richmond, VA Action Period 2February – June, 2013 15

16. Questions? 16

17. Individual Hospital Readmission Experience 17

18. Familiarize yourself with your hospital’s current readmission data. Familiarize yourself with work your hospital has done or is doing to address readmissions. Identify one recent patient readmission story that revealed opportunities for process improvement. 18 Current State