Hospital Improvement Innovation Network (HIIN)
HCIF is pleased to be a partner to the Hospital & Healthsystem Association of Pennsylvania (HAP) in the Partnership for Patients Hospital Improvement Innovation Network (HIIN) aimed at reducing readmissions and hospital-acquired conditions. HCIF is involved in the following three programs:
HCIF has co-led two HAP HIIN programs focusing on the reduction of readmissions. Beginning in 2016, a palliative care program aimed at reducing high volume readmissions among patients with a serious or advanced illness was launched entitled, Plan on it! A Palliative Care Collaborative. This program engaged local and national experts in the delivery of an innovative educational curriculum, organizational best practices, and fostered the exchange of experiences, strategies, and tools among organizations. Pennsylvania Order for Life Sustaining Treatment (POLST) training was offered to develop the skills to facilitate goals of care discussions for individuals with advanced illnesses wishing to define their preferences for care.
The second program, a Behavioral Health Comorbidity in Readmissions pilot project, was initiated in 2018 to reduce readmissions for chronic obstructive pulmonary disease, sepsis, and heart failure patients with behavioral health comorbidities. The program consisted of a clinical advisory group providing guidance, one-on-one coaching calls with participating hospitals, physician office hours, and measurement of interventions deployed by clinicians to treat and reduce readmissions of patients with behavioral health conditions. Reduction in readmissions continues to be a HAP HIIN priority.
HCIF and the Pennsylvania Patient Safety Authority have partnered in a groundbreaking program that will address radiologic diagnostic errors in the emergency department. Diagnostic errors represent a complex and understudied area of patient safety with countless opportunities for improvement. Studies have shown diagnostic error rates in the emergency department (ED) as high as 12% and in visual specialties, such as radiology, around 5%. In the first year of the program, a diverse group of stakeholders will be convened to establish standardized performance measures, approaches, and tools for addressing these errors. In the second year, hospitals will use rapid-cycle improvement to pilot and demonstrate the usability of the tools and reliability of the established measures and approaches.
CT Radiation Safety
HCIF and ECRI Institute, a leading authority in imaging technology and radiation safety, will work with hospitals to optimize and manage radiation doses with the goal of preventing undue exposure. While computerized tomography (CT) can be a life-saving tool for diagnosing illnesses and injuries, it is the largest single contributor of radiation dose delivering 100-400 times the radiation than a conventional x-ray. In this two-year program, hospital improvement teams will collect and report CT dose data, identify potential areas of overuse or inappropriate use, establish CT protocols that ensure optimization of radiation doses, provide education and training to medical and technical staff, implement dose control tools and strategies, monitor progress, and provide on-going feedback to staff.