Knowledge on the Go

Social Determinants of Health (SDoH) to decrease LOS and improve capacity

We know that social determinants of health such as housing instability, food insecurity, transportation barriers and limited access to education significantly influence individuals’ health outcomes. By screening for these factors, healthcare providers can provide, or healthcare providers can gain a more comprehensive understanding of patients' lives beyond their medical conditions. This holistic approach allows for tailored interventions that address the root causes of health disparities.
Heather Blonsky, Lead Data Scientist at Vizient, joins host Margaret Rudisill to talk about this topic and how we have used our Vizient vulnerability index tool, lovingly called the VVI tool, to address some of the nonclinical issues of each organization's top 2% in patient utilizers in our current collaborative, creating capacity transitioning of high-risk patients.
 
Guests:Heather BlonskyLead Data ScientistVizient
 
Moderator:Margaret RudisillPI Program DirectorVizient
 
Show Notes:
[01:27 – 04:04]  Why and how the Vizient Vulnerability Index tool was created
[04:05 – 06:09]  Homelessness and how it impacts health?
[06:10 – 10:02]  Other factors that are common in the top 2% utilizers and utilization of Z codes
[10:03 – 11:39]  How hospitals use that and Heather’s advice
[11:40 – 14:05]  What do hospitals do when you they identify these needs
[14:06 – 15:06]  How Vizient attempts to tie those 2% needs with the VVI and how beneficial it might be
 
Links | Resources:
For more information, email picollaboratives@vizientinc.com
 
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Readmissions

Reducing preventable hospital readmissions is a national priority for payers, providers, and policy makers seeking to improve health care and lower costs. More important than costs, are the goals of providing quality care to patients who present with healthcare needs, helping them heal, and returning them safely to their home and loved ones.
 
Tod Baker, Principal, Dawn Sagliani, Consulting Director, and Christine Pilley, Consulting Director, all from Vizient join host Marilyn Sherrill, Sr. Performance Improvement Program Director, to discuss the emerging practices related to reducing readmissions.
 
Guests:Tod BakerPrincipalVizient
Dawn SaglianiConsulting DirectorVizient
Christine PilleyConsulting DirectorVizient
Moderator:Marilyn SherillSr. PI Program DirectorVizient
 
Show Notes:
[01:14 – 02:48]  How hospitals are managing the financial challenges, and taking risks for readmissions
[02:49 – 03:11]  What hospitals are doing to reduce readmissions through better processes
[03:12 – 05:41]  Why are patients being readmitted to hospitals
[05:42 – 09:49]  The key elements to consider during the critical time of transition that can reduce a patient's risk of readmission
[09:50 – 010:40]  Role of Nurse Navigators
[10:41 – 11:41]  Benefit of assessing the home environment
[11:42 – 15:34]  Barriers to reducing readmissions
[15:35 – 16:13]  One recommendation for hospitals to bring about a more robust readmission program
 
Links | Resources:
For more information, email picollaboratives@vizientinc.com
 
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Building relationships: referral and marketing strategy for remote patient monitoring

Remote patient monitoring, commonly referred to as RPM, is a type of telehealth in which healthcare providers monitor patients outside the traditional care setting using digital medical devices. The data collected from these devices are then electronically transferred to providers for care management. Automated feedback and workflows can be built into data collection, and out-of-range values or concerning readings can be flagged and then addressed by patient’s care team. In this episode two leading experts discuss building relationships to help drive referrals for an RPM program.
 
Guest speakers:Stephen Kropp, MSDirector of TelehealthThe University of Kansas Health System
Jacob Finke, BSN, RNRemote Patient Monitoring Nurse SupervisorThe University of Kansas Health System
Moderator:Courtney Furrow-White, MPM, RNSenior Performance Improvement Program DirectorVizient
 
Show Notes:
[01:16] RPM program at The University of Kansas Health System
[02:20] Early focus areas and peripheral devices used
[03:22] Well-suited for patients with chronic conditions
[03:50] Barriers faced
[06:15] Increasing referrals
[07:53] Marketing strategy
[11:00] Drawing patients into the RPM program
[14:54] Finding staff with people skills
[15:29] Building patient trust
[18:04] Advice to those just starting out
 
Links | Resources:
Contacting Knowledge on the Go:
picollaboratives@vizientinc.com
Courtney’s email: Courtney.furrowwhite@vizientinc.com
Steve’s email: skropp@kumc.edu
Jacob’s email: jfinke@kumc.edu
 
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Zero Restraint Use in Pediatric Psychiatry

Restraints can have a negative emotional impact on pediatric patients. Being physically restrained can be traumatic and lead to feelings of helplessness, anxiety and loss of control. Having to put pediatric patients in restraints takes a toll on staff as well.
Tanya Isaacs, Behavioral Health Clinical Instructor and Cheryl Miller, Behavioral Health Registered Nurse from The Queen’s Medical Center in Honolulu, Hawaii join us to talk to us today about their journey toward zero restraint use in pediatric psychiatry are.
 
Guests:Tanya Isaacs, BSN, RN, PMH-BC Behavioral Health Clinical Instructor The Queen’s Medical Center
Cheryl Miller, BSN, RN-PMH-BC Behavioral Health Registered Nurse The Queen’s Medical Center
Moderator:Laura Hoffman, DNP, MSN, RN, CPHQ PI Program DirectorVizient
 
Show Notes:
[01:08 – 02:07]  How did Queen’s Medical Center determine the right path to take to zero restraint use in your pediatric psychiatry unit
[02:08 – 03:47]  Defining moment that helped to solidify this decision from Tanya and Cheryl
[03:48 – 05:32]  How they began this initiative
[05:33 – 07:28]  “The how to help me plan”
[07:29 – 09:42]  How the “how to help me plan” changed the way that you practice as a clinician
[09:43 – 11:47]  Were they able to reduce restraint use for your pediatric patients with mental health issues?
[11:48 – 14:29]  Other impacts other than a decrease in restraint use
 
Links | Resources:
Contact Knowledge on the Go: picollaboratives@vizientinc.com
 
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Updates for Antimicrobial Stewardship Standards

Antimicrobial resistance continues to be a public health threat across the globe.  Recent updates to the Joint omission standards provide an opportunity to evaluate our current programs for improvements.  Today’s program looks at what two health organizations are doing to optimize antimicrobial utilization, mitigate antimicrobial resistance and improve patient outcomes. 
Joining Vizient’s Jim Lichauer for this discussion are Michael Postelnick System Program Director of Antimicrobial and Diagnostic Stewardship at Northwestern Medicine and Lucas Schulz, Antimicrobial Stewardship Program Director and PGY1 and PGY2 for Infectious Disease at University of Wisconsin Health. 
 
Guest speakers:Michael Postelnick, RPh BCPS AQ-Infectious DiseasesSystem Program Director, Antimicrobial and Diagnostic StewardshipNorthwestern Medicine 
Lucas Schulz, PharmD, BCIDPClinical Manager, Acute Care ServicesResidency Program Director – PGYI and PGY2 Infectious DiseasesUniversity of Wisconsin Health
Moderator:Jim Lichauer, PharmD, BCPS, FASHPSenior PI Program Director, Pharmacy Vizient 
 
Show Notes:
[1:10] The Joint Commission and CMS updates are driving antimicrobial stewardship programs (ASP) forward
[3:50] EP 10 criteria to determine necessary resources to operate the stewardship program effectively and ensure that the resource allocation matches the determined needs
[5:20] EP 12 is revised to specifically require competency-based training for medical staff
[7:35] EP 20 recommends reporting ASP data to hospital leadership and prescribers
[9:45] Joint Commissions new standards include ambulatory care
[13:25] CMS rules for infection prevention and antimicrobial stewardship (CMSQSO-22-20)
 
Links | Resources:
Contact Knowledge on the Go: picollaboratives@vizientinc.com
 
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Mortality

Mortality is often viewed as a key indicator of the quality of care in a healthcare organization, and something that most organizations are working to improve upon.
Through Vizient's work with national organizations all working to improve mortality, key lessons learned have emerged that can help organizations improve mortality within their facilities. Shannon Hale Performance Improvement Program director at Vizient joins host Nicole Spatafora, AVP, Performance Improvement, Vizient, to discuss his work on mortality improvement.
 
Guest:Shannon HalePerformance Improvement Program DirectorVizient
Moderator:Nicole SpataforaAVP, Performance Improvement Vizient
 
Show Notes:
[00:47 – 02:48]  Why it is so important that healthcare facilities look at mortality
[02:49 – 04:24]  Getting C-Suite buy in
[04:25 – 07:36]  How organizations can get their frontline engaged
[07:37 – 08:58]  What happens if you don't have engagement at the C-suite level or frontline level
[08:59 – 10:55]  Sustaining change
[10:56 – 12:15]  PI Mortality future plans
 
Links | Resources:
For more information, email picollaboratives@vizientinc.com
 
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Task Rebalancing to Improve Discharge Efficiency

Transitions from hospital to post-acute care is both time consuming and complex. When discharge tasks are not coordinated and stacked on the patient’s last day, any disruption can cause a cascade of negative events. In fact, 30% of all hospital admissions have a 24-hour discharge delay due to non-clinical reasons.  
Bennett Masden, Director of Quality at Great River Health in West Burlington, Iowa joins host Margaret Rudisill, Performance Improvement Director at Vizient to explore how moving tasks before the day of discharge can help reduce a patient’s length of stay.   
 
Guest Speaker:Bennett Masden, BBADirector of QualityGreat River Health
Moderator:Margaret Rudisill, RN, BSN, MS-HQSPI Program DirectorVizient
 
Show Notes:
[01:22] Task rebalancing to alleviate resource constraints at discharge
[02:04] Use a process map to determine when tasks are happening and decide what tasks can move earlier
[03:13] How to respond to pushback
[04:10] A cross-functional team of stakeholders develops an action plan and encourages commitment
[04:31] Example: moving exercise oximetry tests to the day before discharge
[05:35] Other examples: medication reconciliation and physical therapy
[07:35] Staff reaction to task rebalancing
 
Links | Resources:
Contacting Knowledge on the Go:  picollaboratives@vizientinc.com
Bennet Masden’s email: bmasden@greatriverhealth.org
Margaret Rudisill’s contact: margaret.rudisill@vizientinc.com
 
 
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How a Nurse Residency Program supports Performance Improvement and Retention

Similar to residency programs physicians and other healthcare disciplines undergo, these programs give recently graduated nurses the support and learning opportunities to smooth the transition from novice to competent clinicians, while providing valuable peer and mentor support; keys that also address turnover.
 
Janine Lindgreen, nurse residency coordinator, and Dawn Profit, staff development specialist, both of University of Kentucky, Albert B. Chandler Hospital join Host LaTammy Marks to discuss what healthcare organizations can do to improve their new nurse graduate journey, utilizing the Vizient American Association of Colleges of Nursing, or AACN Nurse Residency Program, also NRP, and how they can increase the use of evidence-based practice while focusing on continuous performance improvement.
 
Guests:Janine LindgreenNurse Residency CoordinatorUniversity of Kentucky, Albert B. Chandler Hospital
Dawn ProfitStaff Development SpecialistUniversity of Kentucky, Albert B. Chandler Hospital
Moderator:LaTammy MarksPI Program DirectorVizient
 
Show Notes:
[02:56 – 04:39] How University of Kentucky operationalized the NRP
[04:40 – 06:55]  A performance and improvement project done by the nursing residents and how a process improved as a result of this work including evidence-based practice
[06:56 – 10:01]  Ways that University of Kentucky utilizes the NRP to monitor retention
[10:02 – 11:44]  Describing the quarterly scorecard and why focusing on  nurse retention is important to monitor on the scorecard for your organization
[11:45 – 14:23]  How participation in these PI Collaborative supports the NRP
[14:24 – 16:20]  What has contributed to the overall success of their NRP
[16:21 – 17:29]  Advice for organizations that are starting a NRP program to shift their focus to retention of nurses, especially new nurses
 
For more information, email picollaboratives@vizientinc.com
 
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Caring for patients where they are: Examining a successful home infusion program

Care is moving outside the hospital at a faster and faster pace. Due to  payer mandates, shifts in sites of care to locations outside the hospital will bring an additional 18 percent expansion of patient visits to physician offices and outpatient facilities by 2032. Strategies for home infusion will play a big role in this shift as well. Currently, over 550 medications are available for home infusion. On this episode, two leading experts will detail their successful home infusion strategy at their organization.
 
Guests:Alicia Ranasinghe, PharmD, IgCPMedication Access Services PharmacistFairview Home Infusion
Brett BenfieldDirector of Home Infusion and CompoundingFairview Infusion Consulting Services
 
Moderator:Jim Lichauer, PharmD, BCPS, FASHPPerformance Improvement Program DirectorVizient
 
Show Notes:
[01:35] Fairview Pharmacy Services and home infusion
[03:06] IVIG Stewardship Program
[04:13] Process to establish patients in home infusion
[05:25] Pharmacist involvement
[05:50] Getting buy-in from colleagues
[06:58] Impact on patients
[08:12] Looking to the future
[08:39] Take-aways from the program
 
Resources:
Contacting Knowledge on the Go: picollaboratives@vizientinc.com
Jim’s email: jim.lichauer@vizientinc.com
Alicia’s email: alicia.ranasinghe@fairview.org
Brett’s email: brett.benfield@fairview.org
 
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Sepsis Month: Racing to reduce readmissions

Recent studies have demonstrated that sepsis patients have a much higher readmission risk than other common conditions such as heart failure, heart attacks, and pneumonia. The National Institutes of Health states that sepsis is a substantial healthcare burden, accounting for 6.2% of total hospital costs in the United States.
 
Shannon Chase Weck, Performance Improvement Specialist and Sepsis Coordinator at Houston Methodist West in Texas joins Host Shannon Hale to discuss share their work to decrease sepsis readmissions.
 
Guests:Shannon Chase WeckPerformance Improvement Specialist and Sepsis CoordinatorHouston Methodist West Hospital
Moderator:Shannon HalePI Program DirectorVizient
 
Show Notes:
[00:58 – 01:24] Looking at Sepsis as an organization
[01:25 – 02:30] Organizations approach to sepsis readmissions
[02:31 – 03:09] Grand Prix theme and outcomes
[03:10 – 04:58] How they have sustained improvements
[04:59 – 06:15] The barriers
[06:16 – 07:23] Ah-has to share
 
For more information, email picollaboratives@vizientinc.com