In the 1970s, after investigators reported that more than 70 percent of air crashes involved human error, the aviation community worked with psychologists to develop a training protocol to improve teamwork, decision-making and safety. Since then, that core training has been adapted for use in other professions, including the military, firefighting and medicine. Now, health professionals in Connecticut have taken those basic lessons and drafted a training protocol for yet another high-risk setting: Nursing homes. The authors of the program, called TeamSTEPPS for Long-Term Care, say the simple training can save lives and money. They plan to pilot the program in Connecticut in the fall and promote it nationally.
Connecticut has saved an estimated $5.4 million in Medicare costs since 2010 by reducing re-hospitalizations of patients through a collaborative “communities of care” model in place in 14 regions around the state, including Hartford, New Haven, Milford, Meriden and Torrington. The estimate by Qualidigm, the state’s Medicare quality improvement organization, coincides with a study in the Journal of the American Medical Association (JAMA) that showed a marked decrease in both hospitalizations and readmissions of Medicare patients in regions where quality improvement organizations (QIOs) coordinate interventions that engage community partners to improve care after discharge. Hospital clinicians and their community partners in the 14 regions of Connecticut have stepped up “to find solutions (so that) patients are benefitting from enhanced coordination among providers across the care continuum,” said Dr. Mary Cooper, vice president and chief quality officer of the Connecticut Hospital Association, which is working with Qualidigm on the “communities of care” model. Readmitting Medicare patients to the hospital within a month of discharge is a frequent—and expensive — occurrence. A new report published this week by the Robert Wood Johnson Foundation shows that hospitals and their community allies made little progress from 2008 to 2010 at reducing readmissions for elderly patients.
Connecticut fared second-worst in the country in the percentage of hospitals hit with federal penalties for selected quality-of-care measures and in the overall rate of loss of Medicare reimbursements associated with those penalties, new federal data shows. Eighty-six percent of the state’s 30 acute-care hospitals were penalized under Medicare’s Value-Based Purchasing Program, an incentive program created under the Affordable Care Act to reward hospitals on a number of quality measures related to treatment of patients with heart attack, heart failure, pneumonia and certain surgical issues, as well as patient satisfaction. Overall, the state’s hospitals lost .15 percent of their Medicare reimbursement, compared to a .02 percent average loss nationally, the data shows. In addition to the penalties on quality measures, 23 Connecticut hospitals lost Medicare funding because of high rates of readmitting patients within 30 days of a hospital stay. Four faced the maximum loss, a 1 percent reduction in funding: Griffin Hospital in Derby, the Hospital of St.
Twenty-three Connecticut hospitals will forfeit Medicare funds in the next year under a new federal policy that penalizes hospitals with significant numbers of patients who are readmitted within a month of discharge.