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New York
Success
Stories: NEW YORK
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Through
focused assistance from the state QIO, IPRO, the North Shore-Long
Island Jewish Home Care Network was able to achieve statistically significant
improvement across all three of its agencies in dyspnea (shortness
of breath), upper body dressing, and stabilization in bathing. The
improved outcomes potentially impacted more than 20,000 patients receiving
home health care services across the network.
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IPRO,
the New York State QIO, employed between April 1999 and March
2004 a multi-faceted approach to reduce the gap in lipid testing
rates between white and African American Medicare beneficiaries with
diabetes in select counties within New York City . Specifically,
IPRO worked with physician offices, health centers, and clinics to
provide technical assistance, training and support, decision support
tools, provider feedback, and cultural competency training. Following
the collaboration with IPRO, data showed that the gap in lipid testing
rates declined from 19 percent in April 1999 to 9.8 percent in March
2004.
- Doctors working
with the New York QIO, IPRO, raise state flu and pneumococcal immunization
rates for Medicare beneficiaries: IPRO developed a comprehensive
contact management system that helped more than 5000 high-volume Medicare
physicians improve their immunization practices. The system manages
physician performance profiles and intervention material distribution,
as well as tracks outreach activities and physician office implementation
of quality improvement strategies. For example, Dr. Mark Krotowski,
a family physician in Brooklyn, worked with IPRO to redesign the way
his practice tracks immunizations, subsequently improving his immunization
rates over 6% per year.
- The Visiting
Nurse Association of Staten Island helps 73% of patients improve
the status of their surgical wounds in 2001, compared to 66% previously:
Working with IPRO, the New York QIO, VNASI became more effective
at caring for surgical wounds by using Outcome Based Quality Improvement
(OBQI) to improve policies and procedures for assessing wounds. VNASI
used OBQI principles to update staff training on the new policies,
which stressed more accurate wound assessments and timely notification
of supervising physicians. “We want to make things better and
that’s what OBQI allows us to do. I’ve been in the service
community for 32 years, and this was the first time we got objective
data. In home health, we have gone through lots of challenges over
the years, but OBQI allows individuals providing care to see that
they are making a difference.” said Lois Moses, Vice President
of Patient Services.
- Nursing
Home reduces pain for residents: A New York State
nursing home facility working with IPRO, the New York QIO, identified
pain management as a topic area in which improvements could be made.
The nursing home formed a workgroup to direct a facility wide effort;
to examine current policies, processes and tools; and to encourage
the involvement of staff in advocating for effective pain management.
The facility succeeded in decreasing the percentage of its residents
with post acute care pain from 25 percent to 8 percent in the period
between the second quarter of 2002 and the second quarter of 2003.
The facility also demonstrated a decrease in the percentage of its
residents with chronic pain from 15 percent to 4 percent in the same
period.
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- NorthShoreLong
Island Jewish Health System improves antibiotic administration for
surgery patients: The Long Island Jewish Health System—a network
of 11 acute care facilities—participated in the Surgical Infection
Prevention (SIP) collaborative conducted by IPRO, the New York QIO.
With the involvement of anesthesia departments, modifications were
made to anesthesia records to capture the time that antibiotics were
administered, as well as the antibiotic prescribed. The hospitals
have demonstrated an administration time of less than one hour in
80 percent of cases and 90 percent compliance with guidelines calling
for appropriate choice of antibiotic prescribed.
- In New
York nursing home, post acute pain dropped from 26% to 4%: By making
pain management tools more user-friendly and pain assessment more
timely, Providence Rest Nursing Home in the Bronx cut post-acute
pain among residents from 26% to 4% and reduced chronic pain to just
1% of its residents. IPRO, the New York QIO, worked with staff at
Providence from June 2002 to December 2003. An interdisciplinary
quality improvement team reviewed the facility’s systems and
processes related to pain quality measures—including assessment
tools, flow sheets and car plans—for both the chronic and the
post-acute care populations. The team then developed a one-page pain
assessment form for all residents that reduced unnecessary work for
nursing home staff and increased the timeliness of pain assessments.
The team also identified interventions for managing pain and implemented
data tracking tools for concurrent review of resident records at
weekly care meetings.
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