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Iowa
Success
Stories: IOWA
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- Trinity
Regional Medical Center Home Health in Fort Dodge, IA, worked with
their QIO, Iowa Foundation for Medical Care, to achieve relative
improvement of nearly 40% on the publicly reported quality measure
for dyspnea (shortness of breath or difficult breathing).
- Cass
County Memorial worked with Iowa Foundation for Medical Care
(IFMC), the state’s QIO, to increase pneumonia vaccinations
in Medicare beneficiaries admitted to the hospital from 26%
to 100%. Among other things, IFMC helped the hospital implement
a database to track and communicate patient immunization status
and a concurrent review process to ensure eligible patients
are identified before discharge.
- Fort
Madison Community Hospital makes rapid improvements in heart failure
care: Fort
Madison, a 50-bed acute care hospital, worked with the Iowa Foundation
For Medical Care (the Iowa QIO) to develop a strategy to improve
care for heart failure patients. The hospital began by looking at
d ischarge instructions provided to heart patients. The facility’s
rate during 2000-2001 was 50%. Case managers at Fort Madison developed
protocols and orders to enhance communication and collaboration among
team members, emphasize resource utilization, and emphasize education
of the patient and family. Data for 2001-2002 show discharge instructions
increased to 95%. In addition, the provision of ACE inhibitors for
heart failure improved from 58%-98% from 2000-2001 to 2001-2002.
- Iowa Health
System, serving 58,000 patients, improves blood sugar testing for
diabetes: Iowa Health System (IHS) worked with the Iowa QIO, Iowa
Foundation for Medical Care (IFMC), to lower Hemoglobin A1c (HbA1c)
to near normal levels for their patients with diabetes. By doing
so, the risk of further complications from diabetes is significantly
reduced. When patients entered the IHS program, their HbA1c (blood
sugar) levels ranged from 8.5 to 9.0 percent. An HbA1c level under
6 percent is considered normal. After participation, their HbA1c
levels were reduced to 6 to 7 percent. To accomplish this, IHS
adopted a standardized curriculum for patients with type 2 diabetes
and their caregivers; adopted uniform standards of care based on national
quality standards; provided staff training in patient education, data
collection, chart abstraction, data entry and behavior education; introduced
the use of reminder calls to patients for return appointments;
and used IFMC quality improvement tools.
- Iowa
home cuts pressure ulcer rates down to 1.4%
In a year-long improvement
process, the Fleur Heights Care Center in Des Moines, IA, cut its
pressure ulcer rate from 14.8% to just 1.4% with the help of the Iowa QIO,
the Iowa Foundation for Medical Care. The nursing home developed incentive
programs for the staff to adopt QIO interventions, including using
a clinically validated assessment tool that allows nurses and other
health care providers to reliably score a patient's level of risk
for developing pressure ulcers; i mplementing a quick, reliable tool to
monitor the change in pressure ulcer status over time; adopting t
urning schedules; purchasing pressure relief products such as mattress overlays
and chair cushions; instituting a protocol for treatment; and giving
one nurse responsibility for measuring pressure ulcers. The success
of the interventions demonstrated the importance of data tracking
as well as increasing awareness and involvement in the process. As a result
of the nursing home’s work with IFMC, Fleurs Heights not only
experienced a significant reduction in the percentage of pressure
ulcers among its residents, it also went 101 days without experiencing
a new nosocomial pressure ulcer.
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