Practitioner profiles in Premier’s QualityConnect program helped Knapp Medical Center prevent 27 deaths, eliminate 1,304 days of care and 98 readmission days, and avoid complications in 28 cases
Since The Joint Commission realigned its focus on professional practice evaluation in 2007, the pressure has been on hospitals to develop fair and constructive ways to evaluate physician performance. Now more than ever, the need to provide high quality, cost-effective care is essential with the recent passage of the historic healthcare reform legislation.
Knapp attributes approximately $2.8 million in savings to its OPPE program and practitioner profiles in QualityAdvisor. In the first year, Knapp’s reductions in average length of stay resulted in eliminating 1,304 days of care. The hospital also saved 98 days through eliminating readmissions, 27 deaths were prevented, and it avoided complications in 28 cases.
Knapp gave presentations to physicians when launching QualityAdvisor to explain the database of more than 600 facilities, the ability to benchmark against other “like” hospitals, risk adjustment for clinical and financial measures, and physician measures to be collected.
"I wouldn’t want to return to our old way of doing things before QualityAdvisor,” said Ginger Robles, RN, director of Quality Management at Knapp. “Now it is more exciting because we can see core measures and outcomes by individual physicians rather than just hospital-wide results. This makes a bigger impact with our physicians.”
Knapp likes QualityAdvisor’s practitioner profile, especially with its integration of core measures, and uses the profile for both focused and ongoing professional practice evaluation required by The Joint Commission. “We use the reports for quality reviews for OPPE and FPPE (focused professional practice evaluation). If we were to have a physician go on 100 percent review, we could easily pull a report from QualityAdvisor,” said Robles.
“We recently had a situation where a specific physician’s outcomes were questioned,” she noted. “We pulled a report from QualityAdvisor which showed that was definitely not the case. QualityAdvisor verifies outcomes and provides reports quickly and reliably. If we didn’t have it, we could use our electronic medical record to identify cases, but then we’d have to do a manual audit which would take valuable time and resources. QualityAdvisor is just so much easier. Instead of hours and days, we had the answer in minutes.”
Practitioner profiles are reviewed regularly by department chiefs and presented to physicians at quarterly department meetings. Robles and her team are available to answer physician questions. These reports also go in the credentialing files and to the chief of service who deals with members of the department if there is a problem.
“Doctors are competitive so they don’t like their peers to do better than they do,” Robles continued. “The practitioner profiles also allow us to easily pinpoint who’s not doing well so we can work with them. Overall, there has been continuing improvement since the program began.”
Knapp had a successful Joint Commission survey in February 2009. “It was a good survey. The surveyors liked the reports we used from QualityAdvisor.”
Core measures have improved. “One reason is the physician-specific information we have available through QualityAdvisor. The other is we’ve been out there, working with them, sharing information and data, educating them, helping them improve care. It has helped to be able to say about the practitioner profile: ‘This is your report,’” Robles said. Contracted hospitalists, who admit 60 percent of adults, get monthly profiles. Executive leadership team members meet with the hospitalists and their director to review financials and physician profiles from QualityAdvisor.
They “are very, very proactive in wanting to comply with core measures,” she said. “They really study their individual reports. We tell them when they are performing well on measures and where they are below expectations.”
Improvements have also resulted from Knapp’s strong case management program. The hospital’s Patient Safety team encompasses accreditation, medication safety, review policies and weekly safety rounds. The group involves nurses and clinical managers throughout the hospital.
Additionally, Knapp uses QualityAdvisor information in the Centers for Medicare & Medicaid Services’ (CMS) Care Transitions Project, seeking to eliminate unnecessary hospital readmissions. It is one of 14 communities around the nation that CMS chose to participate in the project.
About Knapp Medical Center
Knapp Medical Center in Weslaco, Texas, is a 233-bed not-for-profit hospital that serves a city and rural population of more than 175,000 people in the Mid-Valley region of the Rio Grande Valley. Knapp’s mission is to usher in new life, mend broken bodies and provide dignified end of life care with the vision of providing always and consistent excellence, every patient, every time. The medical staff is made up of more than 220 independent professional practitioners representing most specialties, and there are some 1,000 employees and 250-plus volunteers. www.knappmed.org
About the Premier healthcare alliance, Malcolm Baldrige National Quality Award recipient
Premier is a performance improvement alliance of more than 2,400 U.S. hospitals and 69,000-plus other healthcare sites working together to achieve high quality, cost-effective care. Owned by not-for-profit hospitals, Premier maintains the nation's most comprehensive repository of clinical, financial and outcomes information and operates a leading healthcare purchasing network. A world leader in helping deliver measurable improvements in care, Premier works with the Centers for Medicare & Medicaid Services and the United Kingdom's National Health Service North West to improve hospital performance. Headquartered in Charlotte, N.C., Premier also has offices in San Diego, Philadelphia and Washington. http://www.premierinc.com
Premier healthcare alliance
Alven Weil, 704-733-5797
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