The UMKC School of Medicine and Truman Medical Centers (TMC) have joined medical schools and teaching hospitals around the country in a multi-year initiative aimed to improve the quality and safety of health care. The initiative, Best Practices for Better Care, is sponsored by the Association of American Medical Colleges (AAMC), University HealthSystem Consortium (UHC), an alliance of academic medical centers, and the Centers for Medicare and Medicaid Services through their Partnership for Patients Program.
Best Practices for Better Care will help put patient safety and quality methods into widespread use at teaching hospitals and health systems in the United States, combining academic medicine, education, research and clinical care. The goal is to put the power and skills of the academic medical center behind solving some of the common patient quality and safety problems through education, research, and clinical care.
“The School identified this as an important initiative and was very excited to participate,” said Jill Moormeier, M.D., M.P.H., associate dean of Graduate Medical Education, who is coordinating the efforts by the School of Medicine with TMC. “We are a really good location to do stuff like this. Our students and residents are intimately involved in the care of patients and patient outcomes.”
The initiative began in June 2011 with participating medical schools and teaching hospitals gathering data during its first year.
The campaign recently released a progress report to the participating organizations that showed most hospital systems have in place well-established systems to improve patient care in the United States. But, Moormeier said, it was also clear there is some work to be done in educating students, residents and faculty in quality improvement.
Participating institutions, according to the AAMC, have committed to teaching quality and patient safety to the next generation of doctors; ensure safer surgery through use of surgical checklists; reduce infections from central lines using proven protocols; reduce hospital readmissions for high-risk patients; and research, evaluate, and share new and improved practices.
The School of Medicine and TMC will first tackle the preventable hospital readmissions component. Alan Salkind, M.D., professor of internal medicine, will be leading this endeavor.
According to Salkind, nearly 20 percent of Medicare hospitalizations are followed by readmission within 30 days, with 75 percent of these considered preventable. Readmissions within 30 days account for $15 billion of excess Medicare spending.
“Common reasons leading to hospital readmission are inadequate explanation to the patient about how to use medications after hospital discharge, recognition of warning signs that warrant a call to the patient’s physician, and lack of a timely post-discharge physician visit, all of which are preventable by clearly conveying information to patients and confirming understanding before discharge from the hospital,” Salkind said. “Another important objective of this project is to teach students and physicians the elements of discharging a patient from the hospital with appropriate and understandable instructions for their continued care.
“We want to determine and then fix the pitfalls in our discharge process that lead to preventable readmissions to the hospital. We will share that information with other medical schools and hospitals to develop best practices that reduce hospital readmissions.”
This project is scheduled to last for about six months, but as the School and TMC gather data, it may be extended. The campaign is ongoing.
John A. Spertus, M.D., M.P.H., F.A.C.C., Lauer/Missouri Endowed Chair and professor of internal medicine, and Shauna Roberts, M.D., ’84, professor of internal medicine, are members of Research on Care Community (ROCC), the research division of the Best Practices for Better Care initiative, established to serve as a home for academic leaders and their teams. Through webinars, peer-to-peer learning and other resources, members of ROCC will share strategies for building institutional effectiveness and implementation research.
