Announcing Our Maryland Health Quality Innovators of the Year
Health Quality Innovators (HQI) today announced the winners of the second annual Health Quality Innovator of the Year Awards for Maryland. HQI serves as the Medicare Quality Innovation Network—Quality Improvement Organizations for Maryland and Virginia and a Practice Transformation Network assisting practices in Maryland, Virginia, Washington, D.C. and West Virginia.
The awards represent HQI’s commitment to improving health care in communities across the region by recognizing health care organizations who are using evidence-based approaches to quality improvement that deliver better care, better population health and lower health care costs. The Health Quality Innovator Awards are HQI’s marquis program for gathering and sharing evidence-based, practical methods for enhancing quality of care across physician practices, hospitals, long-term care facilities and other settings.
The 2018 Maryland Health Quality Innovators of the Year are:
Collaboration: Charles County Mobile Integrated Healthcare
The Charles County Mobile Integrated Healthcare Project (MIH) is an integrated intervention among the Charles County Department of Health, the University of Maryland Charles Regional Medical Center and the Charles Department of Emergency Services. These groups have come together to address the health and social determinants leading to repeated use of emergency care. The MIH team includes a paramedic, a nurse and a community health worker who travel to the patient’s home to provide transitional support between discharge and resuming independence.
During an initial visit the MIH completes a medical evaluation, conducts an environmental scan of the home and provides health education. After the initial visit, the community health worker provides the high touch needed to keep the patients engaged in the program and out of the emergency department. Among the 66 initial program clients, the program has seen a 60% drop in emergency room visits and a 57% drop in inpatient admissions.
Data-Driven Care: Sinai Hospital
Founded in 1866, Sinai Hospital is a 504-bed nonprofit medical center affiliated with the Jewish Community Federation of Baltimore and focused on quality patient care, teaching and research. Sinai Hospital wanted to find a way to use data to decrease the incidence of sepsis. Seeing gaps in the ability of current electronic medical records to enable early identification of sepsis, the executive leadership team investigated and selected the Rothman Index as a more accurate predictive analytics tool. The Rothman Index is a patient score generated by an algorithm that evaluates vital signs, general lab results and nursing assessments. It is unique in the emphasis placed on nursing assessments and its visual nature, allowing for health care providers, patients and families to “see” a patient’s status on a screen. A pilot was implemented in the Intensive Care, Cardiac Intensive Care, Intermediate Care and Post-Anesthesia Care Units, and a nurse training program was initiated. Early results show promise—Sinai’s sepsis mortality rate has decreased from 25.49% in January 2018 to 16% in June 2018.
Patient-Centered Care: The Prince George’s Healthcare Alliance, Inc
The Prince George’s Healthcare Alliance provides community care coordination services to high-risk, high-need, high utilizers in healthcare. With a focus on addressing social determinants of access to care, the Alliance links patients to community resources and provides health literacy education to help improve health behaviors. What makes the Alliance unique is the important role of community health workers in incorporating the patients’ cultural values, beliefs and traditions in the service they provide. Community health workers work alongside patients and their families to increase health literacy and proactively manage their own care. From September 2017 to September 2018, the Alliance completed 2,334 outreach calls and conducted 1,527 home visits.
Population Health: Western Maryland Health System
Western Maryland Health System provides healthcare services for residents in Allegany and Garrett Counties in Maryland and surrounding counties in West Virginia and Pennsylvania. With a focus on social determinants, WMHS has introduced a number of population health initiatives to the community focused on improving health and reducing the cost of care. The health system has taken an active role in addressing food insecurity in the community—one of the biggest social determinants of health. WMHS offers a “Food Farmacy” that ensures diabetic patients are discharged with a 14-day supply of healthy food. They operate seven community gardens and orchards and a weekend backpack program to ensure school children go home on the weekends with healthy food. The health system’s annual pre-Thanksgiving feast involves hundreds of volunteers feeding thousands of the community’s most vulnerable citizens. Beginning this summer, WMHS will begin bringing produce from the gardens to additional food desert hot spots throughout the community through a mobile healthy food delivery service. When WMHS first began this program in 2010 they had 1,972 patients accounting for $140 million of costs. Today, that number has dropped to 834 patients accounting for $54 million of costs.
Rural Health: Atlantic General Hospital
Atlantic General Hospital is a 62-bed acute care facility serving the Eastern Shore of Maryland. In 2014, the hospital’s readmission rate was 11.09%, the 30th worst out of 46 hospitals in Maryland. To address this issue, Atlantic General deployed a community-based telehealth service using remote patient monitoring (RPM). Patients are discharged with a custom kit, which might include a tablet, blood pressure cuff, O2 pulse oximeter and standard weight scale. A multi-disciplinary collaborative team of a primary care physician, nurse, pharmacist, dietitian, palliative care team member, chaplain and care coordinator work together, focusing on the patient and family. Early results of this initiative indicate its effectiveness in reducing readmission rates. As of December 2016, Atlantic General had reduced its readmission rate to 8.89%, and as of today, the hospital is now ranked fourth best in the state for readmission.