Contact the Ohio QIO for more details Ohio KePRO See QIO success in other states Success Stories: OHIO

Ohio KePRO is a founding member of the Ohio Patient Safety Discussion Forum convened by the Ohio Department of Health to explore joint efforts to promote safer care. Other members of the Forum include the Ohio Hospital Association, the Ohio Nurses Association, the Ohio Osteopathic Association, the Ohio Patient Safety Institute, the Ohio Pharmacists Association, and the Ohio State Medical Association. In February 2003, the Forum launched the Ohioans First campaign with an initial goal of eliminating the use of dangerous medication abbreviations in Ohio . Ohio KePRO staff are also active in the Ohio Patient Safety Institute (OPSI) that brings together all the stakeholders in patient safety to share data, resources, and expertise. Ohio KePRO developed a project to reduce the disparity in frequency of lipid testing between African American Medicare beneficiaries and their non-African American counterparts. Focus groups were held with beneficiaries and physicians to determine the causes of lipid testing disparity. Ohio KePRO distributed its workbook, “Managing Your Diabetes,” to educators, physicians, nurses, and other health care providers, and mailed 13,000 copies of its educational brochure to households throughout the state. In addition, 7,000 copies were distributed to beneficiaries at health fairs and through housing authorities. Ohio KePRO also placed informational messages, which urged Medicare beneficiaries to get lipid profiles, on buses in Cleveland , Columbus , and Cincinnati. Saint Francis Home in Tiffin , Ohio , participated in a project led by Ohio KePRO, the state’s QIO, aimed at improving urinary incontinence within the home’s resident population. Saint Francis Home had a 31.1 percent improvement in the prevalence of falls among residents and a 135 percent improvement of residents with improved continence. Parma Community General Hospital in Ohio participated in a one-year collaborative project with Ohio KePRO, the state’s QIO, to achieve collaborative-related improvements of more than 90 percent through staff education, prompts on pre-surgical checklists, and medication administration records. Success has also been noted in discontinuing IV antibiotics within 24 hours after bariatric surgery cases, with compliance near 100 percent. Southwest General Hospital in Middleburg Heights participated in a one-year collaborative project led by Ohio ’s QIO, Ohio KePRO. After working with the QIO, Southwest had 98 percent successfor on-time antibiotics administration prior to surgery. With the consultative services of the state QIO, Ohio KePRO, Professional Nursing Services—a small home health agency—developed and implemented a plan of action to improve “Any Emergent Care” rates beginning in July 2003. (Improvement in Emergent Care means a decrease in the percentage of patients who need urgent, unplanned medical care.) By instilling best practices and changing the focus to client education, the agency improved on Any Emergent Care by 22.7 percent as of May 2004. To assist with the claims and billing process for HbA1c diabetes tests (a blood sugar measurement), Federally Qualified Health Centers in Ohio called upon the state’s QIO, Ohio KePRO. The QIO helped the health centers adapt proper billing methods, allowing them to back bill and recapture revenue and accurately represent care provided through claims data. The collaboration with the QIO resulted in new revenue streams expected to exceed $20,000 in some cases, as well as improved revenue and claims documentation for the future. Ohio KePRO, the state QIO, assisted Church Square Family Health Center in Cleveland in improving the quality measures forimmunization, diabetes care, and mammography. After collaborating with the QIO, the health center saw a seven percent increase in mammograms ordered, 17 percent increase in eye exams ordered, 32 percent increase in HbA1c tests ordered, 33 percent increase in lipids ordered, and a nine percent increase in pneumococcal vaccine ordered. Winchester Terrace participated in a mini-collaborative project in 2004 led by Ohio KePRO, the state’s QIO. The goal of the six-month project was to improve urinary incontinence within the nursing home’s resident population. By the end of 2004, Winchester Terrace saw a 56.8 percent improvement in the percentage of residents with improved continence. In addition, the nursing home saw a 34.8 percent improvement in residents with an improved change in mood and a 142 percent improvement in percentage of residents who were 50 percent or more continent every day per month. Maria-Joseph Living Care Center reduced percentage of short-stay residents with pain from 45% to 1%. Maria-Joseph, a 350-bed nursing facility in Dayton, Ohio, began a pain control program following their medical director’s attendance at the Ohio QIO-sponsored pain seminar. Maria-Joseph did a chart audit after attendance that determined they were only assessing 80% of their short stay residents for pain at time of admission. This assessment is now at 99%. Maria-Joseph also worked with discharging hospitals and physicians to change pain medication protocol to routine vs. PRN both prior to hospital discharge/transfer and at time of admission to Maria-Joseph. Progress in these areas was charted for facility staff so that they could be recognized for successful efforts. Bradley Bay improves post acute pain scores by 26%. Through attendance at training seminars, on-site support and use of educational materials provided by the QIO, Bradley Bay updated their pain management policy and developed both a Pain Assessment Tool and a separate tool for the cognitively impaired. A 126-bed facility in Bay Village, Ohio, Bradley Bay implemented a new protocol for appropriate medication orders to significantly reduce the use of PRN medication and increase resident comfort within the first 14 days of stay. Their efforts have spread to three sister homes that have begun implementing this new policy and its tools. Bellbrook Rehab and Health Care Center reduces the percentage of residents reporting serious pain from 17% to 1%. This 78-bed facility in Dayton, reduced the percentage of residents complaining of serious pain from a baseline of 17% in the second quarter of 2002 to 1% in the 2 nd quarter of 2003. Bellbrook attributes this to QIO technical assistance in the form of pain resource manuals and educational seminars. Bellbrook instituted new pain screening policies and provided education to their clinical staff on appropriate treatment regimes and MDS coding, and to all staff members on the recognition of pain. Bellbrook has also utilized their medical director and local hospice as additional resources for ongoing pain management programs for staff. Royal Oaks Nursing and Rehab Center improves care for pain in chronic and post acute population. This 99-bed facility in Middleburg Heights, OH, improved quality measure scores for pain in the chronic care population from 13% to 5%, and in the post acute population from 20% to 5%. Following attendance at QIO pain management seminars, Royal Oak looked held facility-wide pain awareness meetings and information-gathering sessions, and developed of a new pain assessment policy that has spread for implementation to its nine sister facilities

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