Healthcare Quality and Compliance

R. Chris Christy, FACHESenior Director, Global Healthcare IndustrySAP Business Objects

March 16, 2009

1. Introduction and Overview

2. Quality in Hospitals today

3. Threats to the provision of quality

4. Strategies for quality improvement

5. Application of technology to track quality measurement

6. Q+A

Agenda

1. Introduction and Overview

2. Quality in Hospitals today

3. Threats to the provision of quality

4. Strategies for quality improvement

5. Application of technology to track quality measurement

6. Q+A

Agenda

International quality trends

Many countries are assessing and defining measures to increase performance of their health care systems.

The reasons for the increased interests include rising costs, aging populations, medical errors, lack of accountability, and inequalities in the distribution of care

Undisputed recognition that healthcare is expensive and going to continue to increase in cost

What’s of interest is the relationship between cost and outcomes, defined as healthcare value

USHealthcare Quality

Organizations

Government or Government

Affiliated

Agency for Healthcare

Research and Quality

Institute ofMedicine

CMS

Consumers

AmericanHeart

Association

Healthscope

AARP

PhysiciansAnd

Clinicians

Ambulatory CareQuality Alliance

American MedicalAssociation

Institute for SafeMedical Practices

Health Grades

National CommitteeFor Health QualityAssurance (NCQA)

Institute forHealthcare

Improvement(IHI)

Cross Professional

Alliances

Bridges to Excellence

AmericanSociety of

Quality

PerformanceMeasurement

Accreditation

Employers

Researchand PolicyCommercial

Vendors

Gallup Healthcare

HealthLeaders

Source: PwC Health Research Institute, 2007

Joint CommissionOn Accreditation

of HealthcareOrganizations

Utilization ReviewAccreditationCommission

(URAC)

Healthcare QualityCertification Board

National BusinessGroup on Health

Leapfrog Group

Pacific BusinessGroup on Health

Kaiser FamilyFoundation

The CommonwealthFoundation

Robert Wood JohnsonFoundation

Hospital Compare

Quality Check

State byState

Tracking

No Shortage of Oversight Agencies

Quality can be determined in various ways

What is our relative quality of care in the local environment?What is our relative quality of care in the local environment?

What is the absolute level of quality in our hospital?

What is the absolute level of quality in our hospital?

How do we compare with other organizations like us?

Is our care getting better or worse – what’s the trend?

What are the root causesof problems in quality of care?

How do we compare with other organizations like us?

Is our care getting better or worse – what’s the trend?

What are the root causesof problems in quality of care?

Are we on track to achieve key quality & safety objectives?

Are patients receiving carebased on internationallyaccepted standards of care?

Are we on track to achieve key quality & safety objectives?

Are patients receiving carebased on internationallyaccepted standards of care?

It is widely believed that there is an unacceptably high number of patient safety issues in provision of patient care

It is widely believed that there is an unacceptably high number of patient safety issues in provision of patient care

The European CommissionThe European Commission

Canada—The National Patient SafetyInstitute

Canada—The National Patient SafetyInstitute

Denmark—National Danish Indicators ProjectDenmark—National Danish Indicators Project

The United Kingdom—The National PatientSafety Agency (NPSA)

The United Kingdom—The National PatientSafety Agency (NPSA)

Information drawn from a range of sources. National reports on patient safety have also been produced by the National Audit Office

Information drawn from a range of sources. National reports on patient safety have also been produced by the National Audit Office

National organizations focused onpatient safety

Australia—Australian Commission on Safetyand Quality in Health Care

Australia—Australian Commission on Safetyand Quality in Health Care

A new organization is being established with a reporting function. It takes over from the Australian Council for Safety and Quality in Health Care, which commissioned a report on a sustainable

A new organization is being established with a reporting function. It takes over from the Australian Council for Safety and Quality in Health Care, which commissioned a report on a sustainable

SIMPATIE Project will be conducting a stock take of a range of patient safety activities including measurement studies

SIMPATIE Project will be conducting a stock take of a range of patient safety activities including measurement studies

A organization working with the Canadian Institute for Health Information (CIHI) that publishes a report based on available national level data

A organization working with the Canadian Institute for Health Information (CIHI) that publishes a report based on available national level data

The Danish Patient Safety Act requires reporting of patient safety and published in conjunction with the Danish Patient Safety Association

The Danish Patient Safety Act requires reporting of patient safety and published in conjunction with the Danish Patient Safety Association

Source: International Journal for Quality in Health Care; September 2006Source: International Journal for Quality in Health Care; September 2006

Common Patient Safety Indicators

Hospital-acquired infections Ventilator pneumonia, Wound infection, Infection due to medical care, Decubitus ulcer

Operative and post-operative complications Complications of anesthesia, Post-operative hip fracture, Post-operative pulmonary embolism or deep vein thrombosis, Post-operative sepsis

Sentinel events Transfusion reaction, Wrong blood type, Wrong-site surgery, Foreign body left in during procedure, Medical equipment-related adverse event, Medication errors

Obstetrics Birth trauma—injury to neonate Obstetric trauma—vaginal delivery, Obstetric trauma—Caesarean section, Problems with childbirth,

Other care-related adverse events In-hospital hip fracture or patient fall

Source: International Journal for Quality in Health Care; September 2006Source: International Journal for Quality in Health Care; September 2006

1. Introduction and Overview

2. Quality in Hospitals today

3. Threats to the provision of quality

4. Strategies for quality improvement

5. Application of technology to track quality measurement

6. Q+A

Agenda

Threats to the provision of quality

Financial resources Availability of healthcare

providers No timely reporting of data Difficulty managing data

quality Lack of uniformity and

standardization in performance measurement

Aligned reporting incentives

1. Introduction and Overview

2. Quality in Hospitals today

3. Threats to the provision of quality

4. Strategies for quality improvement

5. Application of technology to track quality measurement

6. Q+A

Agenda

Strategies for quality improvement

Create a system of awareness regarding quality standards

Provide recognition for areas of performance excellence where standards are being met and an environment for improvement

Create a structure of accountability for those parties contributing to patient care outcomes

Create a system transparency to quality indicators internal to the hospital + externally with patients, MOH or other payers

Utilize technology to significantly impact an indicatoror group of indicators

11

22

33

44

55

55

Accreditation: Why get accredited?

Creates a culture of safety and quality

Improve public trust

Increases worker satisfaction

Negotiate payment for care based on the quality of care

Establish priorities for quality and patient safety levels

Creates a learning organization environment

1. Introduction and Overview

2. Quality in Hospitals today

3. Threats to the provision of quality

4. Strategies for quality improvement

5. Application of technology to track quality measurement

6. Q+A

Agenda

Technology Solutions to Quality

Quality Dashboards: Indicators of clinical and process outcomes reported at an institutional

level with a drill down to internal organizational groups that contribute to or impact performance

Externally Reported Quality Metrics – An aggregation of the latest data reported to external regulatory

agencies A mixture of data captured automatically from clinical systems and

manually extracted data

Internal Process Metrics – near real time feedback

Health Matters

Balanced Scorecard

URL:

Thank you!

Questions

Contact information:Chris Christy

chris.christy@sap.com+1 (817) 416-8888

Contact information:Chris Christy

chris.christy@sap.com+1 (817) 416-8888

Q &A