IPG Hospitals Show Greater Improvement than Non-IPG Hospitals on Appropriate Care Measures
By Rita Bowling, RN, MSN, MBA, CPHQ, Director, Acute Care Services; and
Barbara Stiebeling RN, MSN, Quality Improvement Project Leader, Acute Care Services
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In January 2006, Ohio KePRO launched the 8 th Statement of Work (SoW) with a statewide meeting for those hospitals that applied and were selected for the Appropriate Care Measure (ACM) Identified Participant Group (IPG). Since that time, Ohio KePRO has worked intensively with these 28 hospitals in a consultative role to assist them in providing the “right care for every patient every time.” The ACM score is an all-or-none scoring methodology that illustrates how often patients receive all the care they are eligible to receive for acute myocardial infarction (AMI), heart failure (HF) and pneumonia (PN), based on the starter set of 10 measures.
During regularly scheduled meetings, discussions have been directed toward looking at system-level interventions that might lead to transformational change. These discussions included issues such as organizational culture, leadership support, system barriers and identifying how change is uniquely accomplished in each organization.
IPG hospitals making the most improvement demonstrated common signs of cultural competence including senior leader and board member engagement, interdisciplinary teams and effective physician or clinical champions. |
Quarter 4, 2004 ACM data comprised the baseline measurement. Re-measurement was Quarter 4 of 2006. No additional data collection was required by hospitals as these measures were already being collected and reported to the clinical data warehouse for their annual payment update.
As seen in the accompanying graph, the mean IPG hospitals’ baseline ACM score was 75 percent as compared to the non-IPG hospitals in the state whose mean baseline ACM score was 80 percent. At re-measurement, IPG hospitals’ mean ACM scores rose 11.66 percent to 88 percent while the non-IPG hospitals’ mean ACM scores rose 5.7 percent to 85 percent.
Another way to compare the difference is to look at the overall goal of the project, which was a 50 percent reduction in failure rate. Forty-two per cent of IPG hospitals achieved this goal while 30 percent of non- IPG hospitals experienced this level of improvement.
IPG hospitals making the most improvement demonstrated common signs of cultural competence including senior leader and board member engagement, interdisciplinary teams and effective physician or clinical champions. Listed below are a few specific interventions adopted by IPG hospitals:
System Changes
- Senior leader involvement in articulating expectations for quality
- Protocols developed and implemented as the standard of care
- Policies consistent with best practices
- Procedures/protocols established for direct admissions based on best practices
- Pharmacy involvement in follow-up with physicians
- Redesign of Emergency Department triage processes
- Spreading the message that quality is everyone’s job
QI Methods
- Use of effective physician champions
- Admission/discharge improvement teams
- Lean methodology for Emergency Department analysis and flow changes
- Use of Failure Modes Effects Analysis (FMEA) and root cause analyses (RCA) to identify and address barriers
- Addressing issues directly rather than developing work-arounds.
- Interdisciplinary Quality Improvement (QI) team meetings held regularly
- Clinical managers conducting weekly quality rounds
- Coordination with other initiatives such as medication reconciliation
Monitoring and Feedback
- Concurrent review of charts and unit level feedback performed by case managers, unit champions, clinical nurse specialists or nurse managers
- Weekly or monthly reporting of data to all staff and physicians
- Regular analysis of any patient who did not receive appropriate care
- Use of physician report cards
- Individual communication with non-compliant physicians
- Use of unit-specific score cards
- Physician credentialing to include core measure performance
- Morning rounds for core measures
Standardization
- Standing orders for vaccines
- Standardized patient education for discharge
- Checklists for concurrent chart review, discharge processes, and core measure compliance
- Development of standardized order sets/protocols/pathways to reflect evidence-based medicine
- Efficient forms to improve documentation
- Standardized care through use of technology such as forcing functions
Reminders
- Medication Administration Record (MAR) reminders for vaccines
- Color coded chart stickers for core measure topics
Knowledge Management
- Medical staff education on core measures and evidence-based practices
- Front line staff education on core measures and the concept of appropriate care
- New employee orientation on core measures
These are but a few of the interventions that have helped ACM IPG hospitals improve care to their patients. As we continue working with hospitals, we will focus on these processes being sustained and spread throughout their organizations.
Coming of Age: Family Advisory Councils
by Barbara G. Stiebeling, RN, MSN, Quality Improvement Project Leader
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In the March 15, 2007 edition of the Commonwealth Fund newsletter, Quality Matters: Patient-Centered Care, Sarah Klein, an independent journalist writes: “With the exception of healthcare, the customer is king.” This is but one example of how consumers view their role in the hierarchy of healthcare. Instead of feeling as if they are the central focus, many consumers feel their healthcare needs are secondary to that of the healthcare system.
In the Institute of Medicine’s (IOM) report titled Crossing the Quality Chasm: A New Health System for the 21 st Century, patient-centered care is identified as one of the six domains of healthcare quality. Defined as care that is respectful of and responsive to individual patient preferences, needs and values , this type of care is missing in many hospitals today, despite research linking it to improved outcomes and satisfaction. Exceptions are most notable in pediatric and other specialty care hospitals or services. Ohio is no different, although some hospitals are steadily heading down this “road less traveled” and some specialty hospitals have been enlightened for years.
Bridging the gap
Family Advisory Councils (FACs) are not new to University Hospitals Case Medical Center (UHCMC). Rainbow Babies and Children’s Hospital (RB&C), a part of UHCMC, first developed such a council in 1991. Since its inception this council has bridged the gap of communication between patients, families, community members and hospital administration by providing an opportunity to identify patient and family needs and concerns and channel them in a constructive manner to improve services for these groups.
Championed by Dalia Zemaityte, RN, MSN, Director of Special Projects, RB&C, this council has grown from an informal group to one that meets regularly, has bylaws, conducts family-to-family outreach, presents educational programs to nurses, physicians, volunteers, community members, other hospital networks and lawmakers, and develops documents such as a family Bill of Rights and newsletters. Recently, this concept has spread to the adult care units of UHCMC through the leadership of Caryl Eyre RN, MSN, Clinical Nurse Specialist in Medical-Surgical Nursing, UHCMC and Janet Kloos, RN, CCRN, PhD, Clinical Nurse Specialist in Medical Surgical Nursing, UHCMC.
Eyre and Kloos attended a conference last fall sponsored by The Institute for Family-Centered Care and returned to UHCMC with renewed enthusiasm and determination to implement such a council. With the senior leader support of Jane Dus RN, ND, Vice President of Medical-Surgical Nursing, UHCMC and Catherine Koppelman, RN, MSN , Senior Vice President, Chief Nursing Officer, UHCMC, the program was born shortly thereafter and has gained tremendous momentum in a short period of time.
One of the top issues identified in the initial brainstorming session with the adult group was the need for flexible visiting hours in the intensive care units. While challenging, great progress is being made to design visitation guidelines that are user-friendly. This transformational shift in philosophy drives home the notion that hospitals exist to serve and meet the needs of the patient, family and community. Historically, hospitals have operated in ways that are efficient and convenient for staff and independent practitioners rather than for those they serve.
At UHCMC, the adult Family Advisory Council meets monthly for dinner. The group provides input into policies and procedures, acts as a peer support vehicle and learns about advancements and improvements in care. Comprised of 11 members ranging from age 40 to 70, this group is open to new members and guests and always includes senior leaders. Based on the core concepts of the Institute for Family Centered Care, these meetings foster dignity and respect, and provide information as well as opportunities for participation and collaboration.
Planting the seed
The real work of this initiative occurs between meetings. Group facilitators Eyre and Kloos hold memberships on internal committees dealing with patient care issues. In addition, their work with staff, patients and families allows them to “plant the seed” in many places throughout the organization. The participation of senior leaders on the Family Advisory Council demonstrates the institution’s committment to innovation and ensures that system issues are addressed and resolved wherever possible. A few examples include the incorporation of patient and family-centered care concepts into the new RN orientation, nursing leadership conferences and residency training . In RB&C, new physician orientation has incorporated the telling of family stories for many years.
The Institute for Healthcare Improvement promotes a framework for patient-centered care that will “enable health care providers to reliably meet the needs and preferences of patients, e nable fully informed, shared decision-making, and include patients and their loved ones on health care improvement and design teams.” The Family Advisory Councils at UHCMC have developed a model of patient-centered care consistent with these goals and we are pleased to share their story with Quality Matters readers.
For additional information, please contact:
Janet.Kloos@Uhhospitals.org PH: 216-844-2311
Caryl.Eyre@UHhospitals.org PH: 216-844-8533
Dalia.Zemaityte@UHhospitals.org
Additional Resources :
Conway et al. Partnering with Patients and Families to Design a Patient and Family-Centered HealthCare System. Found at: http://www.familycenteredcare.org/pdf/Roadmap.pdf
Institute of Medicine. Crossing the Quality Chasm: a new health system for the 21st century 2001. National Academies Press. Found at:
Klein, S. Issue of the Month: Bringing Patients to the Center of Hospital Care.
Quality Matters: Patient-Centered Care. March 15, 2007 | Volume 23. Found at: http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=468284#issue
Parma Community General Hospital Brings Transformational Change to Cardica Care
By Ann Fitzsimmons, RN, MBA, Quality Improvement Project Leader
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Transforming healthcare organizations and systems is a complicated process requiring extraordinary leadership. The central work of leaders is reframing core cultural values and bringing about needed change. It involves creating a collaborative work environment among stakeholders, providing a clear statement of vision and expectations, aligning structures and processes with the vision and expectations, fostering a culture to empower staff to innovate, and supporting continual performance improvement.
Hospitals around the country are looking for ways to make transformational changes to meet the needs of the patients they serve. Current methods of organizing and delivering care are unable to meet the expectations of patients and their families because the science and technology involved in health care – knowledge, skills, care interventions, devices and drugs – have advanced more rapidly than our ability to deliver them safely, effectively, and efficiently (The Robert Wood Johnson Foundation, 1996).
Crossing the Quality Chasm: A New Health System for the 21 st Century (National Academy Press, 2001) provides a blueprint for redesigning healthcare delivery systems, improving quality while focusing on patient-centered care. The Committee on the Quality of HealthCare in America was formed in June 1998 and charged with developing strategies that would result in substantial improvement in the quality of health care over a 10-year period. The Committee developed an aggressive agenda that proposes six aims for transformational change. Health care should be:
- Safe – avoiding injuries to patients from the care that is intended to help them.
- Effective – providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding under use and overuse).
- Patient-centered – providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.
- Timely – reducing waits and sometimes-harmful delays for both those who receive and those who give care.
- Efficient – avoiding waste, in particular waste of equipment, supplies, ideas, and energy.
- Equitable – providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socio-economic status.
There is ownership in this process, from the CEO and Board of Trustees who support core values and beliefs in patient-centered care to the page operators who call the Code STEMIs. |
Transformational change—this process for creating new ways to provide health care—is not a short-term project. There is no magic timeline by which to gauge the beginning or end of such an endeavor. In fact, according to Durant (2004), it is important to understand that transformation is an ongoing and permanent campaign. Cebrowski (2003) adds that change processes, “whether or not they…have a preconceived end point, are intended to create or anticipate the future and to simultaneously deal with the co-evolution of concepts, processes, organizations, and technologies wherein change in any one of these necessitates change in all.”
Leaders as change agents
Senior leaders acting as change agents direct cultural change strategies. Boards of Trustees and CEOs must lead by example and personal involvement. They establish the mission, goals and performance measurement targets for the organization. Simply going through the motions of setting these standards from the top of the organization will not likely result in meaningful change. Instead, they must be involved and committed to becoming champions for change through motivation and participation at all levels of the organization.
Parma Community General Hospital (PCGH) is a facility where transformational change is improving cardiac care for patients in the community it serves. For this hospital, the journey began in February 2005 when senior leaders identified a need to find better ways to manage patients coming to the emergency department (ED) with an acute myocardial infarction (AMI). Silos of practice between specialties and departments were creating barriers to safe, timely, efficient, effective, equitable, patient-centered care. Door to PCI times in 2004 averaged 119 minutes. These same senior leaders had a vision of what PCGH’s cardiac service could be if they created a new culture focusing on patient-centered care.
PCGH’s executive team called together stakeholders to redesign their care model for AMI patients. Core team members included physicians from the ED and cardiology along with senior leaders. Executive and physician leader involvement made an unequivocal statement about the importance of this project. Their task was to create a new care model: one where AMI patients would receive safe, efficient and effective care in a state-of-the art facility. The team looked at current patient flow processes to identify barriers causing delays in treatment. They researched standards of care as set forth by the American College of Cardiology and the American Heart Association. They also studied best practices around the country and determined how they would measure achievement of milestones.
Challenging every step
The AMI Team became the steering committee for a multidisciplinary team of both clinical and non-clinical professionals who were empowered to make the vision come alive. Known as the AMI Core Measure Team, this group began examining every step of the AMI patient flow process to find ways to deliver the right care for every patient every time. Some of the barriers they tackled included: the triage process in ED, cardiology and interventionist on-call schedules, protocols for communication among clinicians, transportation concerns when patients were being moved from ED to the cardiac catheterization lab, and other point-of-care delays.
Throughout the next year, the AMI Core Measure Team developed a new system of care for AMI patients. Regular meetings gave them the opportunity to compare progress to goals and to communicate key messages of importance and progress back to the hospital Board of Trustees and Administration. The steering committee fostered a climate in which people were empowered to innovate and try new ideas.
Door to PCI time improved
In 2006, PCGH began to see a transformation in the delivery of life-saving care to their AMI patients. The average door to PCI time improved to 68 minutes. Nationally, in 2006, about 35 percent of AMI patients were treated within the 90-minute goal for Door to PCI time. At PCGH, 85 percent of the AMI patients were treated within the 90-minute goal. When a Code STEMI (ST-segment Elevation Myocardial Infarction) is called in the ED, a specialized cardiac team moves into action:
- Crucial care decisions are made promptly and efficiently.
- Communication between the ED and cardiac interventionists is streamlined.
- A Heart Center nurse goes to the ED when a Code STEMI is called.
- They insert access lines and assist with monitoring patients.
- The Heart Center surgical intensivist responds.
- Respiratory therapy and Lab personnel also respond to the Code STEMI page.
The steps of each Code STEMI are measured against targets set by national guidelines. Staff receive feedback within 24 hours so they can adjust processes toward better outcomes. There is ownership in this process, from the CEO and Board of Trustees who support core values and beliefs in patient-centered care to the page operators who call the Code STEMIs.
Success needs to be rewarded, and PCGH takes pride in celebrating their achievements. Patient satisfaction scores reflect their approval and appreciation for the intense work PCGH has done to create a cardiac center of excellence for the community.
Moving project into community
PCGH is not stopping here. They have partnered with EMS squads in the surrounding communities to promote ways to expedite care for AMI patients before they arrive in the ED. Twleve-lead ECGs done in the field as well as the administration of aspirin by the EMS squads improves patient care. Door to PCI data is shared with the fire chiefs to demonstrate how their actions in the field directly save heart muscle and improve patient outcomes.
Transformational change is a strategy to meet the demands of an ever-evolving health care system. A clear and compelling vision is a key ingredient for successful transformation. Leadership must develop and communicate that vision and align the organization’s structures and resources to allow the vision to become a reality. Once the direction has been set, stakeholders must be allowed to explore new ideas, and to plan and execute change. Ultimately and collectively, a hospital should make patient-centered care the focus of cultural change.
References:
Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21 st Century. Washington, DC: National Academy Press, 2001.
The Robert Wood Johnson Foundation. Chronic Care in America: A 21 st Century Challenge. Princeton, NJ: The Robert Wood Johnson Foundation, 1996. Online. Available at http:// www.rwjf.org/library/chrcare/.
Transformation: A Strategy for Reform of Organizations and Systems (June 29, 2006). Western New York Care Coordination Program. Summary available at www.samhsa.gov/matrix/mhst_keys.aspx.
Westat Survey: Your Response Helps Improve Quality of Care
By Daniel B. Moss, BSBA, Media & Public Relations
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As a valued stakeholder for acute care services in Ohio, your hospital has an upcoming opportunity to assess and validate the contribution and support received from Ohio KePRO, Medicare’s Quality Improvement Organization (QIO) for Ohio, toward your quality improvement goals.
Westat, a research corporation serving agencies of the U.S. Government including the Centers for Medicare & Medicaid Services (CMS) and other businesses, foundations, and state and local governments, will be conducting surveys of provider satisfaction from May – August 2007. Ohio KePRO asks you to begin carefully considering the scope, nature, and quality of assistance provided to your hospital by Ohio KePRO since August 1, 2005.
Ohio KePRO has been assisting hospitals with quality improvement since 1999. During the current 8 th Statement of Work (8 th SoW), your hospital may have benefited from quality improvement assistance from Ohio KePRO. You may recall that Ohio KePRO:
- Held abstraction and educational teleconferences
- Provided consultative services on quality improvement teams
- Facilitated sharing of best practices through Community of Practice calls and networking
- Supplied educational materials including pocket cards, posters, and newsletters
- Promoted and facilitated transformational/culture change
Your feedback ultimately improves the quality of health care and will help shape the vision, direction, and implementation of quality improvement assistance for hospitals throughout Ohio. |
CMS will use the results of this survey to measure both the value you attribute to our services and your overall satisfaction with this assistance. This survey is a key component of the evaluation of our contract with CMS for the 8 th SoW contract cycle.
Ohio KePRO acknowledges that your time is valuable, and we truly appreciate your consideration to participate in this voluntary study. Please be assured that all information provided to Westat remains confidential. The results of the study will be shared with Ohio KePRO in aggregate and will not disclose your name or the name of your hospital . Your feedback ultimately improves the quality of healthcare and will help shape the vision, direction, and implementation of quality improvement assistance for healthcare providers throughout Ohio.
By Daniel B. Moss, BSBA, Media & Public Relations
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Ohio KePRO’s efforts to improve patient safety and physician practice efficiency through the use of electronic prescribing (e-prescribing) technology were cited as a critical factor for Ohio receiving the Safe-Rx™ Award in February 2007.
The award goes to the top 10 e-prescribing states in the nation and three physicians within those states who have demonstrated outstanding leadership through their use of e-prescribing technology. Drs. Mohamed Shahed (Cleveland), Diane Eden (Willoughby) and Paul Martin (Dayton) were commended for Ohio, with additional recognition of contributing efforts by The Cleveland Clinic, Ohio’s Partners in Technology for Patient Safety Project, and Ohio KePRO’s partnership with University Hospitals Health System.
Ohio finished ninth in the nation as part of the second nationwide review and ranking of electronic prescribing activity. States are ranked by the number of prescriptions routed electronically in 2006 as a percentage of the total number of prescriptions eligible for electronic routing.
With more and more physician practices getting connected, e-prescribing has proven to be a more efficient and safe alternative to the traditionally paper-, phone- and fax-based prescribing process. |
Ohio KePRO and University Hospital Medical Practices (UHMP) recently completed a yearlong study of technical standards and clinical impact of electronic prescribing of medications under one of only five federally funded initiatives nationwide for the Centers for Medicare & Medicaid Services (CMS). Ohio KePRO also has been an active partner with the Ohio Pharmacists Association and the Ohio State Medical Association in determining Ohio physician office capacity to streamline communications with pharmacies.
The National Association of Chain Drug Stores (NACDS), the National Community Pharmacists Association (NCPA) and SureScripts® created the Safe-Rx Award to raise awareness of e-prescribing as a more secure, accurate and informed means of prescribing medication.
More efficient and safe
Over the last three years, Ohio pharmacies have made significant upgrades to their computer systems to allow electronic exchange of prescription information with physician practices. With more and more physician practices getting connected, e-prescribing has proven to be a more efficient and safe alternative to the traditionally paper-, phone- and fax-based prescribing process.
For more information about how to start prescribing electronically, prescribers can go to www.GetRxConnected.com/OH. The site includes an online tool designed to help prescribers and their staffs determine if their practice already possesses the technology to establish a direct, two-way, computer-to-computer connection with their local pharmacies.
Memorandum of Agreement Needed for Medicare Participation
By Robert A. Feigenbaum, MS, Communications Writer/Editor
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In order to participate in the Medicare program, certain providers are required under federal law to have a Memorandum of Agreement (MOA) with a Quality Improvement Organization (QIO). Medicare Advantage Organizations (MAs) must have an MOA with a QIO or an independent quality review organization. MOAs outline the QIO’s and provider’s responsibilities during the review process. MOAs are also intended to be informational.
Ohio KePRO is the QIO authorized by the Medicare program to review medical services provided to Medicare beneficiaries in Ohio. As you may know, we review medical records to determine whether services delivered to these beneficiaries meet medically accepted standards of care, are medically necessary, and are delivered in the most appropriate setting. In addition, we review written complaints from Medicare beneficiaries about the quality of Medicare services they have received and conduct quality improvement projects to make measurable improvements in beneficiary health status or satisfaction.
Section 1866 (a)(1)(E) of the Social Security Act requires providers of services to have an agreement with QIOs to release data related to patients when a QIO requests it.
Section 1866 (a)(1)(F)(ii) of the Social Security Act requires hospitals, critical access hospitals (CAHs), skilled nursing facilities (SNFs), hospices, LTACs, CORFs and home health agencies (HHAs) to maintain an agreement with a QIO to perform certain functions. |
Section 1866 (a)(1)(F)(i) of the Social Security Act requires hospitals which provide inpatient hospital services paid under the Prospective Payment System (PPS) to maintain an agreement with QIOs to review the validity of diagnostic information provided by such hospitals, the completeness, adequacy and quality of care provided, the appropriateness of admissions and discharges, and the appropriateness of care provided for which additional payments are sought.
Section 1866 (a)(1)(F)(ii) of the Social Security Act requires hospitals, critical access hospitals (CAHs), skilled nursing facilities (SNFs), hospices, long-term acute care hospitals (LTACs), comprehensive outpatient rehabilitation facilities (CORFs) and home health agencies (HHAs) to maintain an agreement with a QIO to perform certain functions.
The MOA describes (a) Ohio KePRO procedures with respect to certain contract obligations, (b) review and appeal rights providers have with respect to these obligations, and (c) opportunities providers have to partner with Ohio KePRO in local and national quality improvement projects.
Ohio KePRO has sent two previous requests for MOAs since the start of the contract cycle on August 1, 2005. Ohio KePRO is most appreciative of those who have signed and returned their MOAs to us. If you have not signed and returned your MOA to Ohio KePRO, it is imperative that you do so immediately. If you require another copy of the MOA or have any questions, please contact Linda Greel at 216-447-9604, ext. 2102 or via e-mail at lgreel@ohqio.sdps.org.
Proposed Legislation Would Mandate 24/7 Emergency Departments
By Daniel B. Moss, BSBA, Media & Public Relations
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Legislation currently under debate in the Ohio Senate would require all hospitals to operate 24/7 emergency departments (EDs). Ohioans depend on hospitals for certain services such as emergency departments, and Senate Bill 120 would require that these services be available.
Limited-service hospitals currently do not operate EDs, burn units or other less profitable services. This endangers citizens who may require immediate emergency care or those who mistakenly visit a limited-service facility seeking emergency care. It also puts the financial health and ED capacity of other local hospitals at risk as they are asked to treat more patients at the same time they may be losing more profitable services to specialty facilities.
In addition to SB 120, the Ohio Hospital Association (OHA) also is looking at other opportunities for improving the efficient use of hospital EDs. One example is hospitals’ support of Rep. Ross McGregor’s (R-Springfield) proposed legislation that would support Federally Qualified Health Centers in Ohio, which could reduce ED visits by providing high-quality, affordable health care for populations who otherwise would not have access to primary and preventive care.
Ohio Hospital ED Stats* |
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How many times did Ohioans visit a hospital ED in 2005? |
Ohioans made 5.2 million visits to hospital EDs |
How many of those patients were admitted to the hospital? |
Of those visits, 851,984 (16%) hospital ED patients were admitted. |
Are most adults who visit the ED insured? |
Yes, 39% are covered by private insurance, 20% are covered by Medicaid and 18% are covered by Medicare. |
* Ohio Hospital ED Stats compiled and provided courtesy of the Ohio Hospital Association.
For further information or to contact your state senator or representative, please visit www.legislature.state.oh.us.
Medicare/Prevention Bus Tour Comes to Ohio
By Daniel B. Moss, BSBA, Media & Public Relations
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Rolling to the tune of “Beautiful Day” by U2, the Medicare/Prevention bus arrived to bright sunshine on the Ohio State Fairgrounds in Columbus the morning of June 5.
The bus and its mobile message from the Centers for Medicare & Medicaid Services (CMS) are part of the larger A Healthier U.S. Starts Here initiative to improve people's lives, prevent and reduce the costs of disease, and promote community health and wellness. The bus has been traveling to local events, health fairs, and senior centers across the 48 continental states since April 2007 to help fulfill this goal by promoting awareness of Medicare’s prevention benefits, including Medicare Part D benefits for prescription drug coverage.
Acting CMS Administrator Leslie V. Norwalk disembarked from the bus this day and was welcomed by several prominent state healthcare leaders including Ohio Department of Health Director Alvin Jackson, MD; Ohio Department of Aging (ODA) Director Barbara Riley; Ohio Senior Health Insurance Information Program (OSHIIP) Director Gretchen Margraf; and Ohio KePRO Medical Director Ronald A. Savrin, MD.
Inside the Voinovich building, ODA Director Riley as moderator of the roundtable event welcomed the healthcare leadership in attendance and asked that each attendee describe their organization’s role in providing and promoting quality care.
Aligned with the mission of the bus tour, Ohio KePRO has partnered with OSHIIP to produce and distribute a brochure to educate Ohio’s seniors about the importance of preventive health and the coverage and services available under the Medicare program. |
Attendees then welcomed Administrator Norwalk’s keynote presentation on tenets and challenges in preventive health. She noted that while Medicare covers the flu shot, at least a quarter of Ohio’s Medicare beneficiaries did not receive this vital immunization in 2006. She went on to say that nearly half of beneficiaries in Ohio have not had their blood sugar levels checked to prevent or help manage diabetes.
Marc Molea, Chief of the Older Americans Act Division at ODA, followed Administrator Norwalk’s presentation with a state of the state account and perspective on working together to meet the goals of the campaign for seniors in Ohio.
Following the presentation, Administrator Norwalk visited the Martin Janis Center on the Fairgrounds, where over 1,200 seniors were in attendance for the fifth annual Ohio Senior Farmers’ Market. Sponsored by the U.S. Department of Agriculture and administered by ODA, the program provided those aged 60 and over and meeting poverty requirements with nine $5 coupons to use at farmers’ markets across central Ohio through October.
Aligned with the mission of the bus tour, Ohio KePRO has partnered with OSHIIP to produce and distribute a brochure to educate Ohio’s seniors about the importance of preventive health and the coverage and services available under the Medicare program. KePRO, Inc. Chief Medical Officer Alice Stollenwerk Petrulis, MD, FACP, will iterate this message on July 29 on “Golden Opportunities” on NBC affiliate WKYC-TV 3 in Cleveland.
Following the visit to Columbus, the bus departed for the Victor Cassano Health Center in Dayton, its final stop in Ohio and the hometown of Administrator Norwalk. More information about future stops through August and the vision and goals of the campaign are available on the Web site at www.healthierus.gov.
“You’ve been all over, and it’s been all over you.” The lyric heralding the Medicare/Prevention bus’ arrival aptly summarizes the progress and goal of the tour to spread the preventive health message to seniors and Medicare beneficiaries nationwide.
Acute Care Services Team
Ronald A. Savrin, MD, MBA, FACS
Rita Bowling, RN MSN, MBA, CPHQ
Jennifer Bitterman, RHIA, MBA
Susan Ferrante
Ann Fitzsimons, RN, MBA
Frances Hober, RHIA, MBA
Dawn Knopp, RN, BSN, CPHQ
Donna Moore, RN, MBA, CPHQ
Patricia Nelson, RN
Karl E. Peters
Liz Simpson
Barbara G. Stiebeling, RN, MSN
Karen S. Terlaak, RN
Mona D. Wendell, RN, BA, MBA
Medical Editor: Ronald A. Savrin, MD, MBA, FACS
Editor: Robert A. Feigenbaum, MS
Associate Editor: Barbara G. Stiebeling, RN, MSN
To Contact Us
E-Mail: hospital@ohqio.sdps.org
Provider QIC Line: 1.800.385.5080
Rock Run Center, Suite 100 · 5700 Lombardo Center Drive · Seven Hills, OH 44131 · www.ohiokepro.com
Ohio KePRO, the Medicare Quality Improvement Organization (QIO) for Ohio, is working with committed hospitals, nursing homes, home health agencies, and physicians throughout the state who are dedicated to the common goal of Continuous Quality Improvement for Medicare beneficiaries.
All material presented or referenced herein is intended for general informational purposes and is not intended to provide or replace the independent judgment of a qualified healthcare provider treating a particular patient. Ohio KePRO disclaims any representation or warranty with respect to any treatments or course of treatment based upon information provided.
Publication No. 8031-OH-017-7/2007. This material was prepared by Ohio KePRO, the Medicare Quality Improvement Organization for Ohio, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy.