Newly Published Report Documents Improvements
Patricia Simino Boyce
LAKE SUCCESS, N.Y. – September 4, 2014 – Recent enhancements in healthcare quality for New York’s Medicare beneficiaries are detailed in IPRO’s new Medicare Quality Improvement Report. The report covers clinical areas in which the state’s healthcare providers have worked with IPRO, Medicare Quality Improvement Organization (QIO) for New York State, in the 10th Statement of Work (SOW). The 10th SOW was a three-year quality improvement contract that ended July 31, 2014.
As New York’s QIO, IPRO has worked to improve the quality of healthcare provided to more than three million Medicare beneficiaries in the state. IPRO’s work during the SOW was funded by the Centers for Medicare & Medicaid Services (CMS) to support healthcare providers across New York with evidence-based clinical interventions and expert technical support in order to improve patient care.
“These improvements show that, with the support of organizational leadership and a collaborative team effort, healthcare providers can achieve real improvements that benefit patients,” said Clare B. Bradley MD, MPH, Senior Vice President and Chief Medical Officer, IPRO. “We are proud to have helped facilitate these improvements.”
One major area of IPRO’s focus has been in working with New York hospitals to reduce the rates of healthcare-acquired infections. Hospitals working with IPRO reduced central-line associated bloodstream infections (CLABSIs) by 62%. While re-measurement is still underway on another measure – reductions in Clostridium difficile infections (CDIs) — hospitals working with IPRO have already achieved a 21.5% improvement rate.
IPRO has worked with the state’s nursing homes to reduce the incidence of pressure ulcers and the use of physical restraints. Pressure ulcer incidence has dropped from 14.65% to 10.45%, a relative improvement of 28.65%. Physical restraint usage dropped from 6.14% to 1.86%, a relative improvement of 69.68%.
In order to improve transitions of care between healthcare settings and prevent rehospitalizations, IPRO led the development of and assisted 20 Care Transitions community coalitions across the state, working intensively with two of these coalitions. IPRO helped achieve 30 to 40% relative reductions in rehospitalization rates in these two communities, and saw an average 19% relative improvement rate for all 20 communities.
IPRO recruited 178 physicians and other clinicians to participate in the CMS Physician Quality Reporting System (PQRS). PQRS uses a combination of payment adjustments and incentive payments to encourage eligible healthcare professionals to report quality information focused on evidence-based prevention measures such as influenza and pneumococcal immunization, and breast and colorectal cancer screening. IPRO has also worked with New York-based regional extension centers to help ensure that 346 physician practices used health information technology to facilitate the improvement of heart health and care coordination, and to adopt the use of electronic health records that help these practices track and encourage disease prevention.
As part of Million Hearts™, a national initiative of the U.S. Department of Health and Human Services, IPRO worked with the New York State Department of Health (NYSDOH) to convene learning and action networks (LANs) of consumers, physicians and medical experts. These LANS worked to increase rates of smoking cessation and appropriate cardiovascular medication usage, and to control patients’ levels of blood pressure and cholesterol. IPRO recruited 181 clinical offices for the LANs, and established a far-reaching Cardiac Population Health initiative with the NYSDOH.
Over the last three years, IPRO worked with ambulatory care facilities throughout the state to prevent adverse drug events related to warfarin – a widely used anticoagulant that is critical to stroke prevention in many patients, but can have serious risks if not managed properly. IPRO formed the New York Anticoagulation Coalition to encourage best practices in anticoagulation through a range of educational and clinical projects. Among these projects was publication of the Managing Anticoagulants in the Peri-Procedural Period (“MAP”) tool, a unique, easy-to-use guide to managing anticoagulants surrounding invasive procedures. The tool has already been adopted by national organizations promoting anticoagulant best practices.
Although most of its QIO efforts have been directed at healthcare professionals, IPRO has also helped Medicare beneficiaries and their families better manage their care. Expanding on a successful pilot project, IPRO partnered with community-based organizations in New York City to bring diabetes self-management education workshops to 3,000 Latino beneficiaries who have diabetes. IPRO is on track to graduate 2,500 from the evidence-based program.
IPRO also used a “train the trainer” model to provide culturally and linguistically appropriate self-management education for caregivers of Latino New Yorkers who have Alzheimer’s disease and other forms of dementia. In addition, IPRO implemented a pilot hypertension self-management program, in partnership with the hospitals of the New York City Health and Hospitals Corporation.
To download a copy of IPRO’s Medicare Quality Improvement Report, go to: https://ipro.org/about/publications
IPRO is a national organization providing a full spectrum of healthcare assessment and improvement services that foster more efficient use of resources and enhance healthcare quality to achieve better patient outcomes. Founded in 1984, IPRO is highly regarded for the independence of its approach, the depth of its knowledge and experience, and the integrity of its programs. IPRO holds contracts with federal, state and local government agencies, as well as private-sector clients, in more than 33 states and the District of Columbia. A national not-for-profit organization, IPRO is headquartered in Lake Success, NY. For more information, visit www.IPRO.org.
This material was prepared by IPRO, the Medicare Quality Improvement Organization for New York State, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents do not necessarily reflect CMS policy. 10SOW-NY-AIM6-9-14-05.