Contact the Texas QIO for more details TMF Health Quality Institute See QIO success in other states Success Stories: TEXAS

TMF Health Quality Institute, the Texas QIO, worked with Linda Siy, MD, at John Peter Smith Health Network in Bedford on the Outpatient Rapid Assessment (OPRA) project, a physician office tool designed to prompt physicians to discuss preventive services for diabetes management, breast cancer screening, and adult immunization with Medicare patients. Since June 2003, Dr. Siy's office has shown statistically significant improvement in the area of breast cancer screening. Following collaboration with TMF Health Quality Institute, Las Palmas Healthcare Center in McAllen, Texas, was one of the few nursing homes in the country to substantially reduce the number of facility-acquired pressure ulcers among residents from 2002 to 2005, improving on the pressure ulcer measure from 10.78% of residents to just 5.26% of residents. Las Palmas also eliminated the use of restraints (from 20.6%), reduced post acute pain from 12.2% to 1.2% and chronic pain from 7.3% to less than one percent. The nursing home also reduced staff turnover by 50%. From January 2005 to the present, TMF Health Quality Institute, the Texas QIO, assisted the Internal Medicine Clinic in Dallas in establishing more efficient use of electronic health records to shorten patient wait time from check-in to check-out. Staff also reduced the amount of paper the patient signs (one document per visit) and the amount of time spent registering the patient each year (once). Texas Cardiac Care worked with TMF Health Quality Institute in 2003 to decrease hospitalization rates related to congestive heart failure by 60% in two months; daily census of patients during the same time frame jumped from 16 to 60 patients. Graham Regional Medical Center in Graham, Texas, collaborated with TMF Health Quality Institute, the state’s QIO, and the Alliance of Rural and Community Hospitals to outperform national averages for three pneumonia measures in 2004 and 2005. The medical center’s performance in pneumococcal vaccination ended up at 95% in the first quarter of 2005, far above the national average of 46%. Windsor Place, a nursing home in Dangerfield reduces the prevalence rate of facility-acquired pressure ulcers from 9% to 3.2% from March 2001 to August 2002: Working with the TMF Health Quality Institute, the Texas QIO, Windsor Place implemented new care guidelines that required staff to screen all new patients for the risk of pressure ulcers and monitor those patients carefully to help prevent ulcers from occurring. The facility created pressure ulcer prevention care plans for patients at risk and increased the use of equipment and techniques designed to reduce pressure on patients’ skin. Windsor Place integrated a reminder system into its procedures to ensure that weekly skin monitoring occurred for patients with ulcers or at risk for ulcers. TMF assisted with evidence-based guidelines, interim data reports to help staff monitor their progress and clinical materials (such as the assessment and reminder tools). During the last six months of the project, no new pressure ulcers were acquired in the facility.

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