Grantee Organization and Principal Investigator
(PI) |
Reported Changes in Care Delivery Processes or
Provider Practices |
Reported Changes in Patient Outcomes (clinical
indicators, functional status or health status) |
Other Reported Outcomes |
1. Altarum
Institute PI: George J. Miller |
NA |
NA |
Provided information useful to public health
officials in planning for, and reducing demand for medical care in the event
of a smallpox outbreak. Also validated the use of a model for estimating
casualties and disease spread during outbreaks. |
2.
American Academy of Pediatrics (AAP) PI:
Carole M. Lannon, Center for Health Care Quality, Cincinnati
Children's Hospital Medical Center |
Results not yet
available as of 8/06 for the following measures:
- % of charts
demonstrating target level of care for 7 ADHD dx and rx components |
Not measured; previous
research established effectiveness of providing care in accordance with ADHD
guidelines on better outcomes |
Results not yet
available as of 8/06 for the following measures
- Frequency and
participation in QI activities for the two types of practices |
3. American College of Physicians (ACP) PI: Vincenza Snow |
Results not yet
available as of 8/06 for the following measures:
- process of care
indicators, e.g. eye and foot exams, flu vaccines, from 15 enrolled
diabetes patients in each practice at baseline, during intervention and
post-intervention |
Results not yet
available as of 8/06 for the following measures:
- clinical
indicators, e.g. blood pressure, % patients with LDL < 100 mg/dL, etc.
from 15 enrolled diabetes patients in each practice at baseline, during
intervention and post-intervention
Early pilot program
with 4 practices showed 75% of patients' blood pressure levels improved from
baseline, and 50% achieved their target BP goal. |
85% of experimental
practices participated in entire training program
Training improved team
collaboration by helping non-physician practice staff become more integrated
in care process
Program spurred
workflow changes (e.g. new forms and databases) to improve care of diabetes
patients
Experience prompted AMA and ANA to award CME
credit for participating in practice-based training |
4. American
Hospital Association (AHA), Health Research and Education Trust PI:
John R Combes |
Results not yet
available as of 8/06 for the following measures:
- length-of-stay
and financial/cost information for 3 initial learning labs' palliative care
units |
NA |
60-70 hospitals
visited learning labs over the course of the project—but not yet known
how many established newpalliative care units or enhanced existing units. |
5. American
Medical Association (AMA) PI: Karen S. Kmetik |
NA |
NA |
Lessons on integrating perfomance measures
into different types of electronic health record systems used in ambulatory
care practices and data export issues/challenges |
6. American Medical Directors Association (AMDA) PI: David F. Polakoff |
Results not yet
available as of 8/06 for the following measures:
- Process of care indicators for pain management
and pressure ulcers in nursing facilities that participated |
Results not yet
available as of 8/06 for the following measures:
- clinical
outcomes for pain management and pressure ulcers in nursing facilities that
participated |
Results
not yet available as of 8/06 for the following measures
- #
of staff and amount of time spent on implementation, participation in each
component of implementation process |
7. Association of California Nurse Leaders PI: Nancy Donaldson, CalNOC & UCSF School of Nursing |
NA |
Preliminary analysis indicates no significant
change in mean falls and falls with injury/1000 patient days between the pre
and post period for participating units, nor were the changes significantly
different between participating and non-participating units. But falls/1000
patient days in participating units were "trending" (downward). |
3-year period needed to implement
interventions may be too long in view of most hospitals' single-year budget
horizon. |
8.
Catholic Healthcare Partners (CHP) PI: Donald E. Casey |
Preliminary
data indicates that patients under care of HF Advocates have fewer hospital
re-admissions, lower 30-day all-cause readmission rate, and longer time
between re-admissions than those not under care of HF Advocates. Performance
in 4 HF core measures have improved over the 4-year project period; CHP
composite score = 95%. Final data not yet available as of 8/06. |
NA |
Increased referrals to
palliative care and hospice.
Improved document and
coding by 20%. |
9.
Child Health Corporation of America (CHCA) PI: Paul J. Sharek, Stanford University School of Medicine & L Packard Children's Hospital (member of CHCA) |
Results from preliminary data
analysis of the hospitals that participated in the project to reduce adverse drug events (ADE) related to narcotics showed
a decrease from 39.1 to 17.1 ADEs per 1000 narcotic doses, a 49% reduction.
12 sites that implemented measures to improve
communication during transfers the ER and inpatient units improved pediatric
patient safety as manifested by fewer duplicate or missed medications &
lab tests, and incorrect or absent infection control information. |
Preliminary data shows lower
infection rates in several sites; overall bloodstream infection (BSI) rate
for all 29 participating hospitals decreased from 6.9 to 4.8 per 1000 line
days, a 31% drop (statistically significant); 11 hospitals decreased
catheter-associated bloodstream infection (CABSI) rates more than 50% and an
estimated 112 CABSIs were avoided. |
The CHCA pediatric trigger tool identified 22 times more
adverse drug events than traditional reporting mechanisms (i.e. incident
reports).
Savings from the ADE collaborative, in
which 662 ADEs were prevented, was between $1.7 and $3.1 million depending on
the whether these ADEs were "not preventable ($1.7 million) or "preventable"
($3.1 million) using the cost data provided by Bates et al. 1997. |
10.
Connecticut Department of Public Health PI:
Louise Dembry, Yale-New Haven Health System & Yale School of Medicine |
NA |
NA |
Physicicans taking the bioterrorism
preparedness course had a statistically significant increase in knowledge
from pre-test to immediate post-test mean exam scores (67.4 to 77.2) , while
those of the control group did not significantly change (56.6 to 55.6).
However, long-term FU scores among MDs taking the course declined almost to
the baseline score mean (64.4). |
11.
HealthFront PI: Michael Callahan |
NA |
NA |
Survey of medical groups and physician practices to
understand their acceptance of and response to quality incentives showed that
physicians are uncertain and wary of them. |
12. International Severity Info Systems, Inc. PI: Susan Horn |
Results not yet
available as of 8/06 for the following measures:
- hospital
admission and ER visits |
Preliminary findings showed reduction in
pressure ulcer incidence for all patients and for high-risk patients in all
participating facilities; six of 11 facilities were below the national
average—which did not decline over the project period. |
# of forms used in each facility for
documenting patient status has declined in all facilities; data for QI is now
available in "real-time" and reviewed at least weekly. |
13. Joint
Commission for Accreditation of Healthcare Organizations (JCAHO) PI: Jerod M. Loeb |
NA |
NA |
Performance
measurement: Hospitals' self-abstracted
data on performance measures are statistically similar to third-party
abstracts, rendering self-reports accurate enough for P4P purposes.
Preliminary results show statistically signficant correlation between
perceptions of the value of core measures, QI actions taken and performance,
but may not be clinically meaningful.
Bioterrorism preparedness: The majority of hospitals responding to the survey
conduct "basic readiness" drills and planning, but are not well linked to
public health and community health care entitites. |
14. The
Leapfrog Group PI: Suzanne Delbanco |
NA |
NA |
In one pilot site (Boeing) rigorously
evaluated, program did not have any significant effect on consumer choice of
hospitals; physician referral proved to be a stronger determinant. Overall,
project increased knowledge and tools for creating successful incentive and
reward programs. |
15. Lehigh Valley Hospital and Health Network PI: Mark Young, later Kenneth
D. Coburn |
Preliminary data showed increases in % of MDs
screening for all appropriate tests and lower-performing MDs showed improved
scores on ABCs |
Patient lab scores showed statistically
signficant improvement in all core clinical measures "corrected for
regression to the mean" |
Financial feasibility study of group visits
found that 12-15 patients/group provides income comparable to routine office
visits. |
16. New York State Dept Of Health PI: Suzanne
Broderick/Beth Dichter |
NA |
Results not yet available as of 8/06 for the
following measures: falls,
hospitalizations, weight loss and incontinence |
Preliminary data indicates that many of the
experimental facilities did not implement the interventions, despite having
received training to do so. |
17.
Physicians Micro Systems, Inc. PI: Steven M Ornstein, Medical University of South Carolina |
Preliminary mid-project results show the
Summary Index Measure (% of eligible targets met for all 78 indicators,
adjusted for patient complexity) rose from 33% at baseline (9/02) to 46% 3
and ½ yrs later (p<.0001); 6 condition-specific indices also had
statistically significant improvements. |
NA |
Regression analysis
suggests the practices attending a 2-day network meeting had greater
improvements in the diabetes summary measures than those that did not. |
18.
Research Triangle Institute PI: Lucy A
Savitz |
NA |
NA |
Lessons and findings for strategies to
support knowledge transfer within and across health systems. |
19. Texas A&M University Health Sciences Center, Rural
and Community Health Institute (RCHI) PI: Josie R
Williams |
NA |
NA |
Findings from studies regarding: 1) use of
bioterrorism funding on response readiness, 2) disease surveillance at the
US-Mexican and US-Canadian borders and 3) rural hospitals' use of planning
exercises and drills for emergencies. |
20.
Visiting Nurse Service of New York, Center for Home Care Policy and Research PI: Penny H
Feldman |
Clinical measures for diabetes care and control:
chart review data showed improvement in the proportion of persons with
diabetes receiving a comprehensive foot exam within 10 days of admission to
home care, an increase of over 50 percentage points during the course of the
project. Increases of over 30 percentage points, were also demonstrated for %
of patients with an individualized glycemic control plan, % receiving
education about foot care, and % whose medications reviewed for
contraindications.
Preliminary data suggests acute care hospitalization
reduction of 2.5 percentage points agency-wide (31.5% to 29%) |
30 percentage point increase
in % of patients with blood glucose in target range most or all of the time
40 percentage point increase
in % of patients testing their blood glucose according to their care plan
most or all of the time |
Majority of CEOs &
clinical managers said that their agency's participation led them to revise
they way they approach QI initiatives, and helped to identify changes that
they intended to spread across the entire organization. |