A little bit about the journey …

Our mission is to provide good, safe patient care.

Medicine is not an exact science, and the people

treating you are human.
Greatly increased focus on
quality and patient safety,
and it is paying off.

But it’s a journey.

We need your help
Patients, family members and the community have a
vital role to play in their care.
We invite you to join us on this journey to better
health, and we’ll give you some tools to do this.
During this presentation, I’ll share some of our
challenges, our progress, as well as the things you
can do.
Why is this work so critical?

More than 9.8 million patients a year

9191353

665788

Inpatients Outpatients
Today’s hospital patient is really sick …
With the expansion of outpatient and less invasive
procedures, hospital lengths of stay have decreased,
but the patients are sicker.
Nearly half of Medicare patients have an average of
three or more chronic conditions.
The current 65-and-older population is expected to
double by 2050.
Hospital care is not cheap
Skilled staff available 24/7, millions of dollars
70
in equipment
Overhead for 60

surgical suites, 50

patient rooms, etc. 40

30 59.5

20

10 20.4
14.2
5.9
0
Wages and Benefits Other Services Prescription Drugs Other Supplies
Cost of hospital care decreasing …
Hospital care as a percent of total spending has
actually declined from 43 percent in 1980 to 33
percent in 2009.
Alabama’s hospitals are extremely efficient when
compared to other states.
 16th lowest cost per discharge in the country
 9th lowest net patient revenue per discharge
The cost to you, the consumer
Per capita health spending (all services) for 2009
was $8086
Average annual premium for employer-sponsored
coverage - $15,745 in 2012.
Key drivers of increased cost:
 Increase in technology and new medications
 Rise in chronic disease – 75 percent of increase
 Administrative costs – average about 7 percent for
government and private insurance plans
The hospital journey to improve care and reduce costs …
Began coordinated statewide effort to improve care:
 Monthly meetings of Quality Task Force
 Twice-a-year forums for networking/education

Formed valuable partnerships:

 Work with Alabama’s Quality Improvement Organization
 Reinforce focus on key quality initiatives
 Huge participation in automated infection surveillance system
More on partnerships
Worked with deans of nursing schools to help
integrate latest science of patient safety into
curriculums
Joined with key state organizations to form a
clearinghouse for information from IHI, a national
quality improvement organization
Alabama hospitals benefitted from a grant to help
reduce specific infections.
More on partnerships
Many Alabama hospitals have joined a national effort
to reduce readmissions by 20 percent and hospital
acquired conditions by 40 percent by the end of
2013.
 Examples of the 10 focus areas include: the prevention of
infections, falls, pressure ulcers and adverse drug events
 Work includes regional workshops, best-practice sharing, data
collection and use of evidence-based initiatives to improve
care
Efforts paying off … reducing infections
Alabama’s hospitals helped pilot automated
surveillance system and are leading the country in
our progress
Alabama had the 2nd highest rate of participation in a
national project focused
on prevention of
blood stream infections.
Decreased infections by
53% in two years!
Reducing infections …
Of the hospitals participating, 40 percent went
without a single blood stream infection for two years!
Another project prevents catheter-associated urinary
tract infections
Alabama’s hospitals worked with Public Health to
create a statewide system for reporting infections.
The public can view hospital-specific infection
information online.
Efforts are paying off … literally
CMS, the agency that pays hospitals for caring for
Medicare patients, has begun pay for performance.
One percent of all hospital reimbursement withheld
and used to reward hospitals on their performance.
Alabama hospitals ranked number one in quality
performance and quality improvement.
As a result, Alabama’s hospitals will receive the
second largest bonus payment of any state.
Efforts paying off … for patients!
Not every quality improvement project is easy to
quantify, but …
Estimates are that through the two-year program
targeted at reducing blood stream infections:
 11 lives were saved
 $4.8 million was saved by reducing infections and shortening
days in the hospital
The journey never ends
Research on techniques, medications, etc.,
continues to provide evidence of ways to improve
care.
Quality and patient safety are being built into the
culture of hospitals, but it takes reinforcement
Being in the 95th percentile for infection reduction is
fine until it’s your mother who gets an infection …
striving for 100 percent!
We need you to join us on the journey
Through next spring all hospitals will be working with
patients and families to improve care.
Information about how you can help is available at
www.jointhehealthjourney.com.
Your role in the journey … be informed
Ask questions when you go to the doctor or the
hospital
Many tools available including these websites:

 Hospital Compare
 Blue Cross Blue Shield
 Alabama Department of Public Health

Listen carefully to instructions, particularly when

leaving the hospital
Your role in the journey … fight infection
While in the hospital, wash your hands frequently

Don’t touch surfaces that need to be germ-free

Ask visitors to stay home if they are sick

Cover your hands and mouth when coughing

Ask your caregivers if they’ve washed their hands

Your role in the journey … more info.
On the new quality website, you’ll find:

 Lists of suggested questions to ask your doctor/hospital

 Links to the quality reporting websites mentioned
 Information on advance directives
 A list of medical terminology
 A resource list for businesses to use with employees
So, join us on the journey
It’s a never-ending road, but one that’s well worth
traveling!