HEN programs report better safety, fewer adverse events
Executive Summary
Hospitals participating in Hospital Engagement Networks (HENs) are reporting improvements in patient safety and decreases in falls and adverse events.
The program is sponsored by the Department of Health and Human Services’ (HHS’) Center for Medicare and Medicaid Innovation.
Twenty-six organizations and 3,700 hospitxsals nationwide participate in the program.
Participating hospitals have avoided 15,000 deaths.
Member hospitals participating in the Department of Health and Human Services’ (HHS’) Hospital Engagement Network (HEN) have made significant improvements in patient safety and saved 15,000 lives, prevented 560,000 patient injuries, and saved $4 billion in healthcare-related spending.
In addition HEN participants prevented 23,105 harmful or undesirable hospital-related events and readmissions, according to data released by the Centers for Medicare and Medicaid Services (CMS). More than 3,700 hospitals are operating within 26 HENs at the hospital system, state, regional, or national level.
The goal of the networks is to help identify solutions already working and disseminate them to other hospitals and providers.
HENs develop learning collaboratives for hospitals, provide a wide array of initiatives and activities to improve patient safety, conduct intensive training programs to help hospitals make patient care safer, and provide technical assistance to help hospitals achieve quality measurement goals. (More information about HEN is available online at http://tinyurl.com/me676qr.)
UnitedHealthcare was selected in 2010 to serve as an HEN. Data from UHC’s Clinical Data Base/Resource Manager indicate that since 2010, more than 90 UHC HEN participants avoided harmful events and their associated costs by reducing readmission rates and the incidence of hospital-acquired infections, which resulted in shorter hospital stays, fewer hospital visits, and better-quality care, says Cathleen Krsek, MSN, MBA, RN, FAAN, senior director of quality operation with the UHC HEN in Chicago.
To achieve the improvements, UHC’s HEN members have spent the last three years implementing performance improvement strategies to meet two primary goals of the initiative: reducing hospital-acquired conditions by 40% and hospital readmissions by 20% by the end of 2014.
"I think it’s been successful because of the focus on these adverse events with our members," Krsek says. "These are issues that they have been working on for a long time, but the added focus and the targeted data we have presented to them has brought it to the forefront of their priorities."
UHC HEN members have decreased Medicare 30-day all-cause readmission rates by 6.3% and have seen significant reductions in the incidence of adverse drug events, device-related infections, injuries related to falls and immobility, obstetrical adverse events, and surgical site infections. Participating hospitals also have implemented successful patient engagement programs that have personalized patient experiences and have established new data structures and proactive processes to help keep patients from returning to the hospital, Krsek says.
Member hospitals have credited their successes to the improvement collaboratives, educational sessions, and conferences offered by UHC, as well as the opportunities UHC provides for networking with other members and learning about hundreds of case studies and healthcare improvement stories.
"Risk managers get involved when the issues being addressed include a sentinel event, such as a fall with a severe injury," Krsek says. "Quality leaders usually lead the efforts that come out of the HEN."
Krsek says the success of UHC’s HEN is due in part to UHC’s Performance Intelligence program, which offers an extensive suite of performance solutions to academic medical centers and their community hospital partners nationwide.
Similar positive results are being reported from hospitals that are part of the HEN of VHA, which is a national network of not-for-profit health care organizations based in Irving, TX. VHA recently announced that the 182 hospitals participating in its HEN have achieved significant improvements in patient safety and quality care.
HEN participants strive to improve their performance by 40% in specific areas, and VHA’s HEN hospitals have met or exceeded that improvement goal in two areas of focus. They are making strong progress in four other areas of focus. These are the achievements so far:
• catheter-associated urinary tract infections: 31% decrease for an aggregate measure of two indicators;
• central line associated bloodstream infections (CLABSI): 40% decrease for an aggregate measure of four indicators;
• early elective delivery (EED): 78% decrease for an aggregate measure of two indicators;
• falls: 30% decrease for an aggregate measure of six indicators;
• pressure related ulcers (PrU): 39% decrease for an aggregate measure of six indicators;
• surgical site infections (SSI): 39% decrease in abdominal hysterectomy standardized infection ratio (SIR).
VHA’s HEN results are based on April 2014 data and confirmed by the Partnership for Patients evaluation contractor, explains Keith Kosel, PhD, MHSA, MBA, vice president and program director for VHA’s HEN. The evaluation contractor used measures with at least 60% of VHA’s HEN hospitals reporting data.
"It is gratifying to see the results our HEN hospitals are achieving, and it builds on our long-standing commitment to help hospitals improve their performance," Kosel says. "We hope that our overall network’s results inspire hospitals that are not currently in a Hospital Engagement Network to join."
VHA’s HEN has provided more than 4,000 individualized performance improvement coaching sessions and 1,000 on-site visits to help its network of hospitals work through any obstacles to improvement, Kosel says. In addition, VHA has hosted more than 200 educational events that have attracted more than 13,500 participants.
For the future, the goals for VHA’s HEN include:
• a continued focus on hospitals’ frontline staff through VHA’s Rapid Adoption Networks, a proprietary improvement framework to drive reductions in patient harm;
• increased focus on creating a culture of accountability from leadership to the frontline staff within hospitals to enhance patient safety;
• implementation of a patient/community awareness campaign to educate expectant mothers and their communities on the health benefits of full-term pregnancies to reduce the demand for early elective delivery;
• increased efforts to strengthen patient and family engagement through collaboration with nationally recognized experts.
Sources
- Keith Kosel, PhD, MHSA, MBA, Vice President & Program Director, Health Engagement Network, VHA, Irving, TX. Telephone: (972) 830-000. Email: kkosel@vha.com.
- Cathleen Krsek, MSN, MBA, RN, FAAN, Senior Director of Quality Operations, Health Engagement Networks, UnitedHealthcare, Chicago. Phone: (312) 775-4238. Email: krsek@uhc.edu.