Atrium Healths Approach to Serious Illness Care John Barkley MD, - - PowerPoint PPT Presentation

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atrium health s approach to serious illness care
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Atrium Healths Approach to Serious Illness Care John Barkley MD, - - PowerPoint PPT Presentation

Feb 13, 2024 237 likes •405 views

Atrium Healths Approach to Serious Illness Care John Barkley MD, FCCP Lauren Heeter MHA, CPHQ 9/06/2019 2 3 Resources Available to our Patients & Community: Palliative Care Non-oncology ambulatory clinics - 5 Levine Cancer

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Atrium Health’s Approach to Serious Illness Care

John Barkley MD, FCCP Lauren Heeter MHA, CPHQ 9/06/2019

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  • Non-oncology ambulatory clinics - 5
  • Levine Cancer Institute clinics - 5
  • SNF Palliative Care
  • Acute Care Facilities
  • 2017: 6,970 (7.11%)
  • 2018: 7,682 (7.81%)
  • Q1 2019: 2,182 (8.04%)

Resources Available to our Patients & Community:

Palliative Care

Data Source: CAPC PowerBI dashboard Excludes Levine Children’s Hospital

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  • 2013 - HEN-LEAPT contract
  • 755 patients served
  • NP, RN, LPN, MSWs, Health Advocate

Resources Available to our Patients & Community:

Advanced Illness Management

Site of Care Utilization Reduction (%) Charge Reduction (%) ED 20.9 22 IP 10.8 6.0 Readmission 53.6 53.0 Observation 18.0 10.0 Overall 37.0 38.7

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  • Atrium Health - Hospice of Union County, Hospice &

Palliative Care of Cabarrus County

  • ADC 300
  • 2 IPUs
  • Hospice Collaborative – hospices across Atrium footprint

Resources Available to our Patients & Community:

Hospice Services

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  • 2018
  • 21,231 Care Alignment Tools completed
  • 18,695 Advance Care Planning Visits Billed
  • 4,621 Advance Directives Completed through outreach and education
  • 3,964 Community Members Educated through Community Organizations, Faith

Community and Library Workshops

Resources Available to our Patients and Community:

Your Care Your Choice

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30-day Mortality

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30-day Mortality Analysis

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  • Acute Care
  • Sanger Heart and Vascular Institute
  • Levine Cancer Institute
  • Disease Specific pilots
  • Ambulatory Care
  • AIM
  • Ambulatory Care Management
  • Continuing Care
  • SNF Palliative Care
  • HH - YCYC
  • Community
  • YCYC
  • Teammates
  • Internal Campaign
  • Episode of Care Work

Current Initiatives

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Challenges

  • Culture Change
  • Performance Variability
  • Risk Stratification
  • FFS Payment Model
  • Defining Quality EOL care

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Performance Variability

  • Oncology Hospice LOS
  • Outpatient Referrals
  • Mean LOS: 44.5 days
  • LOS < 7 days: 21%
  • Inpatient Referrals
  • Mean LOS: 20.3 days
  • LOS < 7days: 43.3%

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  • 1 Year Mortality Prediction Tool
  • Disease Specific Criteria
  • HF
  • AMI
  • COPD

Risk Stratification

Metro Hospitalized - AH Scoring System

Mortality N Mortality (%) C-stat Cut-off Score/PROB Sensitivity Specificity PPV ReachOutVol (%) 1-Year 161,235 14,621 (9.1%) 0.882 25/9.4% 0.836 0.773 26.8% 45,571 (28.3%)

van Walraven C. J Clin Epidemiology. 2014 (67): 1025-1034.

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  • Creating Standard Work
  • Annual Wellness Visits
  • Leadership Scorecard

Fee for Service Payment Model

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  • Which Measures?
  • Which Patients?
  • Who is Responsible?
  • What are the Minimum Standards?

Defining Quality End of Life Care

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