Interdisciplinary Performance & Outcomes Excelcare Collaboration For Nursing
Performance & Outcomes Challenges: Hospital-Acquired Contitions
Costs to Medicare related to preventable hospital-acquired conditions amount to billions of dollars a year. CMS and Medicare identified ten (10) specific HAC’s to withholding payments for preventable conditions. Overall, the costs to treat patients who experienced these ten preventable hospital-acquired conditions that were identified in FY 2007 was over $22 billion. For example, in Medicare Fiscal Year (FY) 2007 there were 29,536 vascular catheter-associated infections that resulted in an average cost of $103,027 per hospitalization, or over $3 billion nationally (Centers for Medicare and Medicaid Services, 2008). CMS expects to save approximately millions of dollars per year from withheld reimbursement and is projecting savings to grow by 20% from aggressively withholding reimbursement for treatment of patients who acquire these conditions in hospitals.
The benefit of QualOptima to improve care while reducing costs targets the prevention of HAC’s, to reduce costs and to improve hospital revenue while improving patient outcomes. The Center for Disease Control (CDC) warned in April 2014 that one in every 25 patients end up with hospital-acquired infections. A study in 2011 concluded every day of the year, just over 205 deaths are caused by hospital-acquired infections!
Complications of care are estimated to account for up to 15% of inpatient costs, with approximately half of these considered preventable. Hospital payments actually increase from provider-caused complications. Complications result in new diagnoses and even readmissions, triggering higher costs and revenue under the fee-for service payment system.
Value-based payment by Medicare and insurance companies dramatically changes financial incentives. Quality of care measured as and resulting from clinical performance and outcomes drives the urgent need for our customers to incorporate QualOptima in their technology and analytics informatics systems.
Quture demonstrated QualOptima’s improvement of clinical, operational and financial outcomes in a joint project with Excelcare, Q’s strategic alliance, aimed at one specific type of HAC, catheter-acquired urinary tract infections (CAUTI) in intensive care at Niagara Falls Memorial Medical Center (NFMMC), Niagara Falls, New York.
NFMMC is a long-established customer of ExcelCare providing an extraordinary clinical setting to transform manual data collection to electronic data capture on the InterSystems platform. The NFMCC project has implemented an evidence-based optimal clinical process for on prevention of catheter-acquired urinary tract infections (CAUTI) in the intensive care unit. This clinical condition was selected as an example of Hospital Acquired Conditions (HAC), which is one of several federal initiatives of the Centers for Medicare and Medical Services (CMS) targeted for significant payment reductions.
The initial success in this demonstration resulted from adopting the CDC evidence-based guideline and identifying evidence-based metrics implemented in the Excelcare data collection and aggregation system. Adding one key metric of this protocol for bladder screening dramatically improved the optimal clinical process for performance measurement and impact the goal of zero CAUTI outcomes.
The second profound success was to convert manual processes of performance and outcomes data to electronic data collection and aggregation. The existing science of performance and outcomes measurement has relied upon manual data abstraction processes. The absence of a valid scientific data model has been magnified by the dependence of health care organizations to abstract data manually, heightened by proprietary vendor disparate databases and fractured clinical data platform strategies. The existing scientific data model was demonstrated to rapidly and transcendently advance implementation of electronic data collection and analytics technology with Excelcare and QualOptima technology.
The third key success was to demonstrate the key role of performance and outcomes measurement is now being adopted in nursing as well as physician practices.
The fourth success was demonstrated by the QualOptima system to facilitate data analysis related to complications derived from non-compliance with evidence-based optimal clinical processes. Tracking longitudinal outcomes provides new insights into patient care. The QualOptima system can be used for a myriad of purposes across the healthcare enterprise. Actionable insight from electronic data tools connect and empower clinical transaction systems, business intelligence systems, and quality surveillance and improvement systems, such as tracking adverse events.
Landon Feazell, Chairman and CEO of Quture, in collaboration with Dr. Judith Daugherty, President & CEO of ExcelCare said: “We are committed to integrating nursing and physician clinical performance for measurement and analytics. For hospitals to be competitive, profitable, and meet federal mandates in the immediate future, manual and paper-based patient care and nursing-sensitive quality processes and data collection must rapidly transition to electronic systems.”