SCIP HF Results
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Transcript of SCIP HF Results
MO-11-02-SCIP May 2011This material was prepared by Primaris, the Medicare Quality Improvement Organization for Missouri, under contract with the Centers for Medicare & Medicaid
Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy
SCIP/HF Project Results
PrimarisJune 2, 2011
Measures
Heart Failure – 3 SCIP-Cardiac - 2 SCIP-Infection - 1 SCIP-Infection - 2 SCIP-Infection - 3
SCIP-Infection - 4 SCIP-Infection - 6 SCIP-VTE - 1 SCIP-VTE - 2
Best Practices
HF-3: – Auto-alerts for continuing ACE/ARBs at hospital DC (for
those appropriate patients) has been integrated into hospital’s EHR
SCIP-Inf. 1: – Considering performance in SCIP metrics in hospital’s
credentialing process for physicians
SCIP –Card. 2:– Implementation of an EHR integrated “flagging tool” to
improve compliance– Beta blocker use is being flagged, on admission, with
protocol to continue post-op, unless physician over-ruled by exception
Best Practices
SCIP-Inf. 3: – Hospital reports implementing auto-stop alerts for
prophylactic abxs., and integrating it into their hospital comprehensive EHRs
– Hospital has implemented a surgical abx. monitoring program that they call “the Antibiotic Stewardship Program.”
– Process is keyed on an auto-alert type process, using a timing start initiated in hospital E-MAR. Timing process / auto-alert triggers prophylactic abx auto-stop, unless, within 24 hours post; unless over-ridden by the ordering physician.
Best Practices
VTE-1/2:– Using a “rule-out” approach for all admissions– Utilizing their EHR with generated alerts, including
patient risk-related flags, and VTE prophylaxis start/ timing alerts, in time-frame calculated with EHR
– Established the 20th hour as “deadline” to implement VTE intervention with process to auto-start at the 20th hour
Best Practices
VTE-1/2:– Implement steps to educate staff on alerts– Fully implement a “rule-out” approach to VTE
prophylaxis implementation and management for both medical/surgical patients and initiating prophylaxis protocol, unless specifically ordered as contraindication/exception
– Active support of medical staff and nursing services
Teamwork
Focused metric review of performance, barriers, and process improvement opportunities
Discussed metric performance history with cardiology group and provided ongoing performance feedback
Worked closely with nursing leadership and line staff to identify current and potential monitoring/documentation “workarounds” in the hospital’s EHR
Teamwork
Teamed up with nursing education to correct and resolve documentation problems in EHR
Made their medical staff “partners” in the SCIP QI process by providing aggregate, compliance and individual performance reports to staff
Conducted ongoing “concurrent review” to identify potential metric outliers
Promoted hospital-wide recognition of “DVT Awareness month”
Teamwork
Recruited orthopedic surgeon as a physician champion member for the SCIP/HF Project Team
Broke down measures by physician to identify those that needed reminders and/or official letters
Provided physician report cards to show compliance/performance on pertinent measures
Teamwork
Provided blinded, physician-specific reports at meetings to encourage “friendly competition” with peers
Shared unit and/or team specific data to encourage competition and rewards
Questions?
Visit: www.primaris.org