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![Page 1: PQCNC III The journey continues….. Agenda Update Review of 2006 Collaborative Report Review of the Blueprint Expectations of Families PQCNC Executive.](https://reader035.fdocuments.net/reader035/viewer/2022062407/56649c925503460f9494d8e8/html5/thumbnails/1.jpg)
PQCNC III
The journey continues….
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Agenda
• Update• Review of 2006 Collaborative Report• Review of the Blueprint• Expectations of Families• PQCNC Executive Board• Initiative proposals• Initiative selection• Wrap Up
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Update
• Organizational Efforts– Blueprint– Family recruitment– Site Visits– PQCNC Vermont Oxford Enrollment– Presentations
• Funding
• Project Development
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Site Visits
• Meet local clinical and quality improvement leaders
• Tour facilities• Meet hospital executive leadership• Identify concerns of local perinatal leaders• Present an overview of PQCNC
– Mission, vision and structural organization– State the case for PQCNC’s value to all
stakeholders
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Site Visits
• Participants at Meetings to date– Nurses– OBs– Neos– NNPs– Family Support Specialists and Staff– Quality Directors– Directors of Women’s and Infant Services– VP’s– CFOs– CEOs
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Site Visits
• Ideas for improvement
• Success stories
• Unsolicited presentations of local data– The good, the bad and the ugly
• Pride and enthusiasm
• A desire to share and improve
• Goal to visit all PQCNC hospital centers by years end
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Site Visits
• Discussion of MOA– VON membership required to be member
• Overwhelming desire for all data to be transparent amongst centers– Clear understanding data not to be used in marketing
etc
• Concerns re public reporting– Data issues and risk adjustment
• MOA being reviewed by UNC legal• Will distribute over next two weeks
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VON Enrollment
• 2005 report with 10 centers
• 2006 report includes 11 centers
• By end 2007 will be 14 centers in VON and included in the PQCNC report
• 83% of tertiary centers in the 2006 report
• At least 92% of tertiary centers will be in the 2007 report
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VON Enrollment
• An increasing number of community NICUs are interested in VON
• In the 2005 report 1 community NICU
• In the 2007 report there will be at least three…14 to go….
• Absolute commitment from PQCNC to generate core education module and support for data collectors
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PQCNC Comparisons Online: Nightingale
• www.vtoxford.org• https://nightingale.vtoxford.org/login.aspx?
ReturnUrl=%2freports.aspx
• MartyMc123456
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Funding
• Investments for the Future Grant– Dean SOM UNC Chapel Hill– Three years, ends 2010– Funding $655,000 over three years– Support personnel, infrastructure,
communication, consultation, travel– Defined timeline for organization, initiation of
projects, spread of work from neonatal to perinatal care
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IFF Timeline
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Funding
• Committed supporters in the State Legislature (Senators Purcell and Dalton)
• Recurring funds through the Education Committee for 2 years
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Future Funding Sources
• Private Organizations• Payers and Purchasers
– Private payers/insurers– Private purchasers– State and Federal Agencies
• Others
We are solvent for the next 2 ½ years.
Let’s prove our value!
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Outreach Education in Perinatal Care
Dr. Joe Holliday
Head Women’s Health Branch
Division of Public Health NC
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Update…Presentations
• NC MFM Think Tank (April 2007)– First organizational meeting for state MFMs
• ABP Subspecialties Meeting (July 2007)– CF Foundation, NACHRI, NNCVSG, CPQCC,
PQCNC – Pediatric subspecialists and MOC Part 4
• Tennessee Initiative for Perinatal Quality Care (TIPQC) (Nov 2007)– CPQCC, OPQC, PQCNC
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PQCNC…Looking Ahead
• Outreach as Quality Outreach and Education • Organizing of Maternal Care Providers
– Meetings later this month, larger meeting early 2008– Identify or develop a complete perinatal data set
• Pilot development of patient generated electronic data set linked to medical record
• VON expanding maternal indicators• Use current administrative data set: Mission Hospital and
NPIC– Maternal provider representation on Executive Board
• Interstate Collaboration– Data sharing between Ohio, California, Tennessee – Development of joint projects
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Why Perinatal Collaboratives? Current Environment
• Transparency– Increasing public reporting of selected clinical
outcomes• Voluntary reporting by hospitals (CMS)
– Hospital Compare (http://www.hospitalcompare.hhs.gov)
• Mandated in nine states currently• Maryland is requiring reporting of perinatal
outcomes
– Majority of reporting relates to adult diseases• Cardiac Failure, Heart Attack, Pneumonia, Surgical
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Top Hospit
als93%
AVERAGE FOR ALL REPORTING HOSPITALS IN THE UNITED STATES
AVERAGE FOR ALL REPORTING HOSPITALS IN THE STATE OF NORTH CAROLINA
CAROLINAS MED CTR-UNIVERSITY
FIRSTHEALTH MOORE REGIONAL HOSPITAL
NORTH CAROLINA BAPTIST HOSPITAL
UNIVERSITY OF NORTH CAROLINA HOSPITAL
80%
80%
90%
86%
75%
56%
Proper Antibiotics Within 4 Hours of Arrival at Hospital
www.hospitalcompare.hhs.gov
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Prince George's Hospital Center
122 5.1
Shady Grove Adventist Hospital 191 4.2
Sinai Hospital 181 6.1
Southern Maryland Hospital Center 58 4.6
St. Agnes Hospital 106 4.4
St. Joseph Medical Center 117 6.2
St. Mary's Hospital 32 2.5
Neonatal Indicators
• Maryland Health Care CommissionLOSVol
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PQCNC…Looking Ahead
• Perinatal Care Transformation– Call for indicators by National Quality Forum
• Numerous groups giving input re tested indicators• Indicators likely to be based on administrative data
sets• Current favorites are birth trauma/3 and 4th degree
lacerations
– Successful collaboratives will have the opportunity to be part of these discussions
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2006 PQCNC Report
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2006 PQCNC Collaborative Report
• Disc or hard copy• Compares PQCNC centers anonymously• 40 key indicators• 11 Centers• 2006 Report
– 1672 VLBW infants– 76% of VLBWs in NC
• Data from 2 tertiary centers not included this report
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PQCNC Blueprint
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PQCNC Blueprint
• Intended to make the case for PQCNC• Designed to provide some structure• Allow the Executive Board to develop rules
of order• Form an Executive Board which will guide
future PQCNC direction• Blueprint currently being reviewed by
reader volunteers• Final document for distribution by Dec 1
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PQCNC Blueprint
• Why do we need a perinatal Collaborative?
• The mission and objectives of PQCNC• Keys to our success
– Data – Collaboration – Action– Analysis– Education
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PQCNC Blueprint
• Describe the PQCNC organizational structure
• State PQCNC responsibilities
• Identify stakeholders and responsibilities
• Make the value case for PQCNC– Value to families– Value to payers and purchasers– Value to providers
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PQCNC Structural Organization
Data Comm
Project Committee
Projects &Education
ParticipatingCenters
PQITs
Communications(incl. website)
QualityImprovementConsultants
Data Management
VON
Executive Committee
Advisory Board
Administrative Core
ADVISORY RESPONSIBILITIES OPERATIONAL RESPONSIBILITIES
Education Committee
Other data sets
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Families and PQCNC
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PQCNC Executive Board
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Executive Board
• Key driver for PQCNC activities and function• A position which requires some heavy lifting
– Optimize travel– Limit time away from home
• Initial meeting in January– Communication beforehand– Establish working relationships– No proxies
• Many other leaders at local and state level will be needed to advance the PQCNC mission
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Executive Board
• Initial board selection– Manageable size– Demonstrated commitment– Balance regions, geography, hospital type,
personnel by medical and provider specialty
• Board service period, rules of operation and order and priorities are the Board’s decisions
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Executive Board
• Brenda Boberg• Mike Cotten• Jim Cummings• Kate Menard• Mildred Carraway• John Wimmer• Mike O’Shea• Ross Vaughan• Dave Fischer• Jincie Nichols• Joe Holliday• Barb Buechler
• Ginny Raviotta• Merry-K Moos• Nick Lynn• Keith Gallaher• Patti Forest• Sheri Carrol• Rob Silver • Jay Kothaida• Tom Ivester• Heidi Brown• Sam Cykert• Rob Silver
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Project Proposals
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Project Selection
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Next Steps
• Initial steps towards project development– Champions develop action plan in conjunction with Executive
Board – Administrative Core offers assistance (IT, consultative services,
education, data collection etc)– Execution has already begun, target implementation February
2008– Horizon for completion…Dec 2008
• Board discussions re organization and priorities over the next two months
• Subcommittees need to be established by the Board• Board meeting end January
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Next Steps
• Strengthen alignment with maternal providers – Present, ? Present at next state OB/MFM
meeting– Guidance of maternal care Board Members– Begin discussion of potential perinatal
projects
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Next Steps
• Complete site visits • Increase VON enrollement• As projects evolve so will communication
methods (interactive website) – PQCNC members updated on project
progress– Update on ongoing PQCNC activities
• Board will determine schedule, agenda, and location for next meeting
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Thank You!