data results: early elective deliveries

Data Results:Early Elective Deliveries

September 17, 2012

Learn. Act. Improve. Spread.Learn. Act. Improve. Spread. Keep the Drum Beat Going.Keep the Drum Beat Going.2

Where did we start?

• CMS and the National Content Developer charged all HENs to reduce HAC’s by 40%

• Adding reducing readmissions by 20%

• Finally adding reducing EEDs by 40%


Who helped us start?

• Buy-in from hospitals

• March of Dimes

• Department of Public Health

• Georgia Chapter of OBGYN Society

• Georgia Chapter of the Society for CNM

• Georgia Nurses Association

• AmeriGroup

• And others


How did we start?

• EED Action Group met in April 2012 to review 2009 data regarding EED

• Developed and agreed upon plan to reduce EED’s by 40%– Ultimate overall goal for Georgia: 0%

– Timely goal for August 2012: 5% or less

• Plan: Encourage use of “hard stops” or IHI bundles to empower nurses and schedulers


EED Action Group


The Journey

• In-person meeting inviting all birthing hospitals in Georgia– March of Dimes

– Department of Public Health

– WellStar Health System

– Athens Regional Health System

– Liberty Medical Center

• Pledge was signed to reduce EEDs across Georgia

• Telnets/Webinars and one-on-one calls with hospitals were held including subjects on physician engagement, hard stops, risks to moms and babies and more!


Commitment Poster signing


Commitment poster signing 2


The Journey

• Several hospitals shared their success in reducing EED’s– Atlanta Medical Center

– Emory University Midtown

– Piedmont Henry


The Results

• There are 75 birthing hospitals in Georgia

• 57 (77%) of those hospitals turned in data

• 19 (33%) of the 56 hospitals were already at a 0% EED rate

• Of the 38 hospitals needing improvement about ½ showed significant gains!!

• 3 of those hospitals went from a 14% or higher EED rate to a 0% rate sustained for at least 3 months!!


The Results 1

• 2009 – 65%

• 2010 – 56.7%

• August 2012 – 3.62%

• YTD 2012 – 5.98%

• That’s a 93% decrease in Early Elective Deliveries!!!

• For YTD that’s a 90% decrease!!


The Results 2

• From March 2012 baseline data to August 2012 data:– We can celebrate a 56% decrease in EEDs


The Results 3

• According to Managed Care Magazine it costs around $41,000 for a late preterm NICU visit

• The incidents went from 147 incidents in March 2012 to just 30 in August 2012

• That’s a decrease of 117 incidents

• If even a ¼ of the babies went to NICU, we saved Georgia Healthcare $1,199,250.00

OVER 1 MILLION Dollars!!


The Results 4


The Results 5


The Results 6


Lessons Learned

• Important to work as a team

• Get physician buy-in and have a physician champion

• Empower your schedulers and nurses

• Have a peer review for non-medically necessary EED

• Educate patients early starting at first visit

• Collaborate with others even outside your hospital:– Share best practices

– Share forms

– IHI

– March of Dimes


Lessons Learned 2

• Use data to sustain the gain

• Present data to administration and physicians

• Celebrate your success!!!

Questions??

data results: early elective deliveries

Documents

drum beat

data results

birthing hospitals

journeyseveral hospitals

reducing eeds

eed rateof

baseline data

ytd thats