Contact the Indiana QIO for more details Health Care Excel See QIO success in other states Success Stories: INDIANA

Health Care Excel, the QIO for Indiana , worked with CMS and hospital partners in a national Patient Safety Learning Pilot (PSLP) and is an active member of the Indianapolis Executive Session on Patient Safety. The PSLP allowed Health Care Excel to work with two large hospitals on improving patient safety through culture change, in-depth root cause analysis, human factors, process redesign, executive walk-rounds, and sharing of common knowledge. Health Care Excel also is working with a hospital on patient safety initiatives through the AHRQ and VA Patient Safety Improvement Corps. Health Care Excel of Indiana joined with minority health coalitions and was invited to participate in a Faith Health Initiative where 42 churches receive health-related information on a monthly basis. The QIO distributed 4,200 brochures, bookmarks, hand-held fans, and calendars with the theme, The Power to Control Diabetes is in Your Hands, reinforcing the importance of HbA1c testing and diabetes self-management. Minority health coalitions across the state also received the Spread the Word About Diabetes flip chart, developed by the QIO with input from a minority health coalition member focus group. The culturally appropriate chart is an educational resource on diabetes for African Americans. As a result of these activities, the QIO has seen a decrease in the disparity rate in this group compared to the Caucasian population. Maintaining normal blood sugar level is an important factor in reducing surgical infections in diabetic patients. Health Care Excel, Inc. the Indiana QIO, worked with The Indiana Heart Hospital in Indianapolis to increase from 0 to nearly 100% the number of diabetic heart surgery patients with appropriately maintained blood sugar levels. Ball Memorial Hospital in Muncie, Indiana, worked with their QIO, Health Care Excel to increase the rate appropriate antibiotic discontinuation after surgery from 0 to 86% for all patients receiving a total hip replacement. The Heart Group in Evansville improves treatment of Medicare beneficiaries with chronic atrial fibrillation (AF): Health Care Excel, the Indiana QIO, and the Heart Group partnered to improve performance on clinical indicators critical to treatment of AF: appropriate scheduling of prothrombin time (PT) or international normalized ratio (INR), monitoring patients with suspected or actual bleeding or medication changes within 24 hours, maintaining PT or INR within therapeutic range, and providing and documenting warfarin education to patients or caregivers. The most significant improvement was the education provided to the patients or caregivers. The Heart Group improved the proportion of chronic AF Medicare beneficiaries or caregivers who received education (or who had the need for education assessed and documented) from 21.7% at baseline in November 2001 to 95.0% at re-measurement in July 2002. Heritage House, a nursing home in Clinton, improves care for diabetes: Working with the Indiana QIO, Health Care Excel, Heritage House improved its rate of HbA1c testing of blood sugar for diabetes from 45.0% of residents at baseline measurement, May 2001, to 83.3% at the completion of a targeted intervention in August 2002. The i ntervention involved continuous quality improvement (CQI) education, diabetes education, and development of more effective policies and procedures for diabetes care. The nursing staff received CQI education materials and a training module in rapid cycle improvement. Physicians and providers were given education by mail about diabetes consensus guidelines, pertinent journal articles, diabetes web sites, and diabetes statistics. Staff also received an in-service about diabetes care and management.

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