INTERACTIVE SESSION: Where to Find Your Data—Electronic, Paper and Case Studies
- Identify convenient sources of data for quality improvement
- Recognize risks and benefits of various data sources
- Create an action plan for seeking data in their local environment
Description: This talk will introduce the idea that Quality Improvement is based on data—you can’t improve what you can’t measure. Participants will be provided numerous examples of how to find, steal and create data for quality improvement, presenting examples from anesthesia departments with paper, electronic and hybrid systems. Participants will be challenged to think about what they could know about their practice but don’t.
INTERACTIVE SESSION: Reporting Your Data to the Hospital
- Describe current regulatory structures for reporting data to your hospital including OPPE and FPPE
- Suggest strategies for acquiring quality data on anesthesia practice including EMR reports, billing analysis and partnerships with other hospital entities
- Highlight the importance of controlling your own quality data
Description: Participants will learn how to describe current regulatory structures for reporting data to your hospital and suggest potential strategies for acquiring and using quality data to improve Anesthesia practice.
INTERACTIVE SESSION: Balancing the Cost and Return on Quality Measures
- Discuss the estimate of costs of medical errors and adverse events
- Discuss the kinds of financial return to expect on a quality program
- Develop a plan and prioritize for capturing cost and return information with quality and safety indicators
- Identify expectations on future costs and savings
Description: Health care reform legislation contains a number of provisions for improving the delivery of health care, most impactful of which may be the modifications in the packaging of quality and payment for care that is bundled into episodes. When your hospital invests in a new program, quality improvement intervention management often wants to know what kind of financial return it will achieve for that investment. A return on investment (ROI) analysis is a way to calculate your net financial gains (or losses), taking into account all the resources invested and all the amounts gained through increased revenue, reduced costs or both.
Integrating MOC within Quality Improvement
- Recognize the key objectives of the clinical data registry
- Discuss preparations to employ the available tools for successful NACOR participation
- Identify internal and external uses of NACOR reporting
Description: The ABA seeks engagement and partnership with our Diplomates as they participate in our Maintenance of Certification in Anesthesiology Program (MOCA). Specifically, we are working to create value in terms of supporting lifelong learning and improvement in practice which aligns with federal and other payer changes. This presentation will review the MOCA program, including those elements which can be immediately credited to Quality Payment Programs.
Human Factors Engineering
Description: Human factors engineering is the science and practice of understanding how to achieve optimal performance though the design and configuration of people, tasks, technologies, working environments and organizations. It helps us understand why we can achieve high levels of performance; and why catastrophic errors can happen. Applying this approach to clinical work almost invariably leads to new and often profound changes in understanding clinical systems. This presentation will use examples from a range of acute clinical contexts – such as handovers, cardiac surgery and robotic surgery, to illustrate how the audience can begin to apply these principles to understanding and improving their own practice.
Description: Attendees can expect to learn about what are the underappreciated and unrecognized areas of risk in the practice anesthesia. In addition, this session will discuss an approach to the key elements that promote risk reduction. A majority of the information provided is immediately and or easily implemented in practice if the organization is desirous of a “culture of safety.”
NACOR v 2.0 (AQI Today)
- Recognize the key objectives of the clinical data registry.
Description: We will discuss the process of maturing our clinical data registry to meet the evolving needs of anesthesiologists. Over its first several years, several important lessons have been learned about the features important to NACOR participants and the registry has invested in making the necessary adaptations.
How to Successfully Use a Registry
- Identify the practice resources and activities necessary to successfully participate in NACOR
- Recognize registry trends
Description: Participating in a registry is challenging. During the session attendees will learn what it takes to be a successful NACOR participant and where registries are headed in the future.
Establishing Bundled Payments with Quality Measures
- Discuss how to select an episode to bundle payments in your institution
- Discuss how to select relevant quality measures for an episode
- Review how to measure and allocate the responsibility of quality measures achievements
- Develop strategies for gain sharing in bundled payments, based upon both quality and financial gains.
Description: The move away from fee for service payment models to payment for coordinated care delivered as episodes has potential to enhance quality and reduce costs. In many established payment bundles the quality metrics are defined by the payor. In others, quality metrics can serve to indicators of reduction of costs, complications and adverse events. Quality metrics should be selected that allow attribution to responsible parties and provide meaningful information for gain sharing.
ASA Standards, Guidelines and Practice Parameters: How to Individualize Them to Fit Your Practice
- Identify specific ASA Standards and Practice Parameters applicable to your practice
- Apply your understanding of the document(s)
- Formulate clinical policies for implementation at your practice
Description: Many anesthesiology groups struggle with how they can assure compliance with ASA standards, guidelines and practice parameters in their daily practice. This session presents a simple way to incorporate critical information on patient care based on ASA standards and guidelines into a local policy and procedure manual.
Using Simulation to Improve Communication and Drive Quality
- Define high-fidelity simulation and in situ simulation
- Apply a simulation scenario to address specific quality issues (e.g., latent errors, provider knowledge gaps)
Description: Participants will learn how to design simulation scenarios to evaluate latent and other system threats to patient safety. By using simulation to identify threats to patient safety, key countermeasures can be developed to prevent and or address these issues. After attending this session, participants will walk away with the proper knowledge to immediately develop simulation sessions, in situ and in the lab, to evaluate patient safety threats.
Facilities on the Hook Too: Prospective Payment Systems for Hospitals and ASCs
- Identify the prospective payment systems (PPS) developed to control expenditures for three facility programs: hospital inpatient, hospital outpatient and ambulatory surgery center (ACS)
- Describe the quality reporting programs for each of the three facility systems
- Describe the payment methodologies associated with the three quality reporting programs
Description: Health care expenditures are a large and increasing fraction of the U.S. national economy, reaching 17.8% GDP in 2015. The largest segment of that cost is hospital care, and prospective payments systems have been developed through federal (Medicare) legislation and regulation specifically to control expenditure. There are different PPS for acute inpatient hospitals, hospital outpatient and ASCs, although they share structural similarities. In addition, facilities have quality reporting systems that further constrain payment. These increasing economic pressures on the facilities we work in strongly influence their interaction with physician anesthesiologists and all practitioners.
Federal Performance Measurements
- Recognize the Merit-based Incentive Payment System (MIPS) Anesthesia measure set for 2017 and 2018
- Recognize approved qualified clinical data registry (QCDR) measures for 2017 and 2018
- Identify new measures currently in the federal pipeline
Description: It’s a grizzly topic, but every anesthesia department needs an expert on federal pay-for-performance requirements. This is often “the tail that wags the dog of quality improvement” because of the heavy financial penalties imposed by Medicare on groups that don’t send data. This can add up to millions of dollars for large practices. This session will provide concrete and immediately actionable information on how to look up the Centers for Medicare & Medicaid Services (CMS) performance data, as well as thoughts on how to set up this reporting if the group is not already doing it.
Creating a Culture of Safety
- Define safety culture and the key elements of a patient safety program
- Describe the contributors and detractors to a robust safety culture
Description: During this session, participants will have the opportunity to benefit from an overview of the current science related to safety culture and putting in place an effective patient safety program. The presentation will also include examples and scenarios to encourage participation and feedback during the session.