Arbor Hospice Makes Early Leap to Data-Driven Improvements
Posted: November 26, 2012
Arbor Hospice has been named a finalist in Crain's Detroit Business Best Managed Nonprofit contest. The following article ran in Crain's on November 26. The article can be found at: http://www.crainsdetroit.com/article/20121125/SUB01/311259996/arbor-hospice-makes-early-leap-to-data-driven-improvements.
In advance of the pending requirement to do so under federal health care reform, Arbor Hospice integrated quality-reporting software into its electronic medical records program to enable it to efficiently and cost-effectively audit and review all of its patients' charts to ensure they are receiving optimal end-of-life care.
Hospices were required to initiate a quality-reporting program by Oct. 1 of this year.
Beginning next year, hospices will be required to report how well they are addressing 100 percent of their patients' pain within 48 hours of initial assessment.
Hospices that don't submit required quality data by fiscal 2014 could see their Medicare reimbursement reduced by 2 percent, Arbor Hospice said.
But the organization's interest in instituting a quality-reporting system was separate from the government mandate, said President and CEO Gloria Brooks.
"We had all of this data in (electronic medical records) that we couldn't get out of the system," she said.
So Arbor Hospice, which operates on a $19 million budget, became an early adopter of quality-reporting software with its purchase of Suncoast Solutions Inc. Intelligence software.
"Using technology has allowed us to put nurses at the bedside rather than working on charts," Brooks said.
Arbor Hospice's quality-reporting system replaces manual audits of a fraction of patient charts and the roughly 45 minutes each individual chart took to review. The system lets the organization audit specific quality measures across all patient charts to ensure it is providing care that helps prevent falls, controls shortness of breath, controls pain to the level the patient desires and ensures that patients have an advance directive in place.
Last year, the Ann Arbor organization was able to manually review the charts of only 10 percent of its nearly 1,900 patients.
With the new system, "we're able to review 100 percent of patient charts," Brooks said.
"Our median length of stay is 15 days for patients," she said. "We need real-time data, and we need it quick."
The hospice and its nurses can quickly identify patients whose pain is not being managed and look for ways of improvement, she said.
Electronically documenting patient data has also helped to reduce errors in patient treatment for the organization, which provides about 10 percent of its patient care at its Ann Arbor inpatient site and the remainder in homes, nursing homes and hospitals across Washtenaw County and six adjoining counties. Arbor Hospice is one of 12 early adopters across the U.S. on a steering committee providing Suncoast with feedback on the quality-reporting software.
Through that role, Arbor Hospice is helping to shape future versions of the software for ease of use and customization. And it's working with Suncoast to establish standardized searches of patient data.
"What we really hope is (that) the outcomes of the data will lead to best practices for hospices across the country," Brooks said.