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California
Success
Stories: CALIFORNIA
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- Lumetra, California ’s QIO, reached underserved and rural Latino
beneficiaries with diabetes through its “Viva la Vida!” outreach
program, using a multi-faceted approach. In June 2001 the clinical disparity
for annual HbA1c testing between Latino beneficiaries with diabetes and
their white counterparts was 7.2% statewide, and more than 15% in some
counties. Lumetra produced a bilingual self-management booklet for diabetes, “Live
Your Life: Control Your Diabetes!” in
both English and Spanish. Additional bilingual materials, including a Medicare
fact sheet and diabetes resource guide, were also produced. Lumetra used these
materials in conjunction with partnering with community organizations and launching
a media campaign for Spanish language radio and television. Between baseline
and re-measurement in the four targeted counties, the annual HbA1c testing rate
disparity among Latino and white beneficiaries decreased by 6.6 percentage points,
from 9.6% to 3%.
- Riverside
medical center cuts heart attack mortality in half: Working with Lumetra, the
California QIO, Parkview Community Hospital in Riverside has significantly
improved treatment of acute myocardial infarction (AMI). Three years
ago, the 193-bed facility put an AMI pathway in place as part of a
cardiovascular project conducted by Lumetra. Today, the hospital has
become a benchmark for better outcomes. Before Parkview implemented
the AMI pathway, its inpatient mortality rate was 16%; complications
14%, and beta-blocker use 31%. Afterwards, the mortality rate decreased
to 8% with zero complications and consideration for beta-blocker use
rose to 52%.
- Newport Beach
hospital dramatically improves pneumococcal and influenza vaccination
rates: In 2001, Hoag Memorial Hospital in Newport Beach, California,
conducted a pilot project with Lumetra, the California QIO, on the
National Medicare Pneumonia project. Within three months, pneumococcal
and influenza vaccination screening rates went from 5% at baseline
to 96%, and from 0% to 100% for vaccine administration. The hospital
subsequently rolled out the immunization program to all units with
the goal of sustaining rates of 80% for screening and administering
influenza and pneumococcal immunizations for appropriate hospitalized
patients.
- Brown and
Toland, a large California Medical Group, increases its rate of blood
sugar testing for senior diabetics from 50% to 90%: Working with Lumetra,
the California QIO, Brown and Toland improved glycemic control, retinal
exam testing rates and LDL rates for the 7,000 diabetic patients served
by the practice. Early on, the medical group established a Diabetes
Advisory Committee—a paid group of diabetes champions that meet
on a quarterly basis to examine data, recommend interventions, and
analyze the program's effectiveness. Brown and Toland also created
a valuable tool for physicians called the Provider Support Report,
which allows the medical group to collect and customize data for each
physician. On a monthly basis, this report provides physicians with
patient information such as overdue services or poor diabetes control.
- Timely pain
treatment at central California nursing home jumps to 100%
Horizon Health and Subacute
Center, located in Fresno CA, worked intensively with California ’s
QIO, Lumetra, on improving treatment for pain in 2003. Starting with
a pilot population, the year-long collaboration offered Horizon Health
training, expert assistance and clinical best practice methods on improving
care, with the goal of increasing the number of residents being screened,
assessed and treated for pain. In the course of the project, the facility
discovered that meeting these goals significantly increased residents'
satisfaction with the care provided in the facility. Now, 100% of the
home’s new residents receive consistent pain screening, up from
16% of residents in the pilot population. Where 62.5 % of residents received
timely treatment for moderate or severe pain before the collaborative,
more than 95% are now consistently treated for pain in a timely manner.
Increase in resident satisfaction scores rose from 13% in the beginning
of the collaborative to 100% at the end of project.
- California
nursing home takes ‘No New Pressure Ulcers’ challenge
An acute unit of a California
nursing home accepted the “No New Pressure Ulcers” challenge
and agreed to work with Lumetra, the California QIO, to improve the home’s
8% incidence rate. This challenge was especially difficult because residents
in this unit were high-risk for pressure ulcers and the nursing home
unit also faced difficulties with staff turnover. Working with Lumetra,
the California QIO, the nursing home began to use certified nursing assistant
for skin checks and assigned one nurse to provide all wound care. Addressing
workplace relations, the nursing home also focused more on staff helping
each other and providing ongoing education and direction on goals for
the unit. The home used data to show staff the outcomes of improvements
in prevention strategies and as a result this nursing home sub-unit went
85 days without any new pressure ulcers.
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