In December 2011 the Centers for Medicare and Medicaid Services (CMS) launched the Partnership for Patients Program as a collaborative comprising 26 “hospital engagement networks” (HENs) representing more than 3,700 hospitals, in an effort to reduce the rates of 10 types of harms and readmissions.
One of those HENs, the Ohio Hospital Association (OHA), has offered its members access to software called Wayfinder developed by Healthcare Colloquium Inc., a subsidiary of Columbus, Ohio-based research nonprofit Battelle.
Wayfinder uses records to compare an individual hospital’s performance against regional, state and national peers. It allows hospitals to flag issues such as a spike in falls, said Mike Abrams, CEO of the OHA, in a recent interview. “Wayfinder is still evolving, but it allows us to deploy data to empower hospitals to compare results on important patient safety initiatives with other hospitals and health systems,” he said. “Also there is a predictive modeling element to it so we can predict what trajectory you are on in terms of potentially preventable adverse events. If you know the trajectory you are on, you can take action to arrest it and put yourself on a more acceptable path.”
Several Ohio hospitals were beta users that provided input into Wayfinder’s development, Abrams said, adding that both large health systems like the Cleveland Clinic and small rural community hospitals are using Wayfinder. “We believe that the pricing mechanism is such that it is not a barrier,” he said. One thing that is a barrier is the whole concept of hospital fatigue in dealing with so many quality measurement programs. “We try to explain that this is a platform that will ease that fatigue rather than add to it,” he said.
One of the beta sites was Southeastern Med, a community hospital in Cambridge, Ohio. In an e-mail exchange, Angie Long, R.N., vice president of clinical services and chief nursing officer, said the hospital has had success accessing and validating data that it was previously unable to obtain. “As a hospital we are reporting numerous quality metrics and are concerned with the improper reporting of metrics and how these metrics may be interpreted by others. We have been focusing on quality measures with unexplainable outliers. These outliers could not be correct based on our day-to-day operational oversight of these measures.”
For example, elements of the PSI (patient safety indicator) score showed that Southeastern was very high in accidental punctures or lacerations. “I knew this could not be correct data and have been researching this issue,” Long said. “Wayfinder enabled us to quickly dive through a significant amount of data to obtain specific information regarding this indicator. This data was used to identify specific cases and review for accuracy. It was discovered that we had an error in how we were coding this information and have targeted education for both are coding staff and our physicians.”
Quality is important, Long added, but so is accuracy in reporting and interpreting the data. “This tool has allowed us to validate our data in order to provide direction of improvement.”
I asked Abrams if getting data from hospital systems into Wayfinder was a challenge. He said that was not a big issue. “We already have data from every hospital in Ohio,” he said. “Our hospitals were saying, ‘we already give you a vast amount of data. What we want is for OHA to do cooler things with the data we give you rather than ask us for still more data submissions.’ After they saw Wayfinder, they said, ‘hey, we think you could build another module if we gave you this other data set, too.’ So I think it had a tipping point effect, where now that they are impressed with it, they are offering up other data sets to us as well.”
Seven other state hospital associations have expressed interest in using Wayfinder, Abrams noted, adding that the quality conversation has shifted away from local comparisons. “We may have somebody in Toledo who finds something going on in Cincinnati very relevant. Rather than building an artificial wall around Northwest Ohio in terms of what we can learn from peers, we are opening that up and saying we’ll look across the state and even across the country to learn from entities that are mastering ventilator-associated pneumonia or catheter-associated UTIs or any number of things.”