Qualis Health, the QIO for Washington and Idaho , conducted an outreach
campaign targeted at dually enrolled Medicare and Medicaid beneficiaries
with diabetes stressing the importance of dilated eye exams. In a series
of display ads in local ethnic newspapers in Chinese, Korean, and English,
Qualis urged people who are dually enrolled to seek an eye exam at
no cost. Poster-sized copies of the ads were placed in community centers,
health offices, and other locations. Qualis also met with providers
and practitioners to review data on dually enrolled diabetics and asked
them to commit to improving rates of eye exams for this population.
These efforts helped increase the rate of eye exams by 5.0 percentage
points among the dually-enrolled population, reducing the disparity
with the general Medicare population by 3.7 points.
Care Center in Mount Vernon, Washington worked with Qualis Health,
the Washington State QIO, from July 2003 to June 2005 to improve
processes on prevention and management of pressure ulcers within
the nursing home. The center improved on or decreased the percent
of pressure ulcers for high-risk residents by 71%—from
20% in 2003 to 6% in 2005.
the QIO for Washington State, worked in recent years with Providence
SoundHomeCare and Hospice to reduce hospital and emergency room visits
and improve medication management. Specifically, a previous hospitalization
rate of 20% in 2002 dropped to 15% in 2004; emergency room rates
decreased from 18% to 15% and medication management improved from
29% to 40%.
the QIO for Washington State, worked with Stevens Healthcare hospital
officials in 2005 to assist in implementation of an Immunization
Standing Order Policy and Program. Following the QIO intervention—which
included intensive research and participation in a Quality Improvement
Committee meeting—the pneumococcal vaccination rate at Stevens
Healthcare rose from zero in the second quarter of 2004 to 71% in
the second quarter of 2005.
Hospital and Medical Center in Seattle, Washington, with the help of
the state QIO, Qualis Health, implemented a program in August 2003
to vaccinate patients during hospitalization and immunize all employees
to prevent the spread of influenza. After one year, the influenza immunizations
improved from 122 to 505 patients and 700 to 900 employees.
- Yakima Valley
Memorial Hospital in Yakima, Washington participated from October 2002
to June 2004 in the Northwest Regional Surgical Infection Prevention
Collaborative, sponsored by QIOs from Washington, Idaho, and Oregon.
The hospital’s participation and collaboration with QIOs resulted
in elimination of hip and knee prosthesis infection rates – hip
from 3.64% to 0% and knee from 9.26% to 0%.
- Six hospitals
in Washington State volunteered for a hospital payment monitoring program
one-day admissions project from October 2004 to May 2005 with Qualis
Health, the state QIO. Together, the hospitals achieved a 74% reduction
in potentially inappropriate one-day admissions (which typically cost
$3,902) and each achieved a substantial reduction in rate of one-day
admissions that failed inpatient screening criteria, ranging from 94%
Francis Care Center in Washington State reduces resident falls: St Francis Care Center worked
with Qualis Health, the Washington QIO, to cut down on falls by eliminating
the use of motion detectors to track movement by residents. The center
found that residents were actually monitored more closely by staff
when they removed the alarms. It is then that they had a 50% reduction
in falls, and now have eliminated all of the bed alarms. St Francis
has developed a "gentle care" program that allows more flexibility
in the resident's schedule. Residents are waking on their own in
the morning and can reset their schedules activities and meals accordingly.
The staff has found that not only are the residents more rested and
more alert, but there are less behavioral outbreaks.
Mother Joseph facility in Olympia reduces the number of residents
having constant or intermittent pain by changing medications: This
152 bed long term care facility worked with Qualis Health, the Seattle-based
QIO, over a three-month period, to reduce the number of residents
having constant or intermittent pain by changing medications from
a transdermal patch to an oral form of medication. None of the residents
have required breakthrough pain medication after implementation of
the change. The staff also reports that the residents are more alert
and their appetites have improved.
boost diabetes education; Care improves: A rural clinic saw a 40%
jump in the number of patients receiving professional diabetic education,
while a Seattle-based group of family practitioners made significant
strides in diabetes care by participating in a collaborative run
by Qualis Health, the QIO for the state of Washington. A statewide
effort of a dozen clinics, the collaborative worked to spread techniques
in diabetes management and adult preventive services. At Seattle
Primary Physicians, a group of 23 family practitioners, diabetes
patients with blood pressure less than 140/90 increased to 61% from
47% and patients with a blood sugar level lower than 8% increased
to 81% from 71%. Clinicians at the NEW Health Program, a small rural
clinic in Chewelah, began asking patients to take their shoes off
as a reminder for doctors to perform regular foot exams. As a result,
the rate of regular foot exams increased in a year to 93% from 62%.
The clinic also went from zero to 40% in the number of patients receiving
professional diabetic education.
state home reduces chronic, acute pain: Pinewood Terrace Nursing
Center in Colville, WA, substantially improved pain management, reducing
chronic pain by 87% and post-acute pain 88% while participating in
an intensive 18-month collaboration with Seattle-based QIO Qualis
Health. The collaborative developed educational materials on attitudes
toward pain, which were used for staff training; implemented a tool
and a protocol to allow the staff to accurately assess pain in cognitively
impaired residents; developed and implemented a new protocol to promote
faster relief for residents in chronic pain.