209377 Linking Clinical Measures and Cost Avoidance

Monday, November 9, 2009

Consuelo Dungca, EdD, RN , Quality Management and Clinical Affairs, NYC Health & Hospitals Corporation, New York, NY
Juliet G. Gaengan, RN, MSA , NYC Health and Hospitals Corporation, New York, NY
Sue Lee, MPA, RN , Quality Management, New York City Health and Hospitals Corporation, New York, NY
NYC Health and Hospitals Corporation (HHC) is a public benefit corporation, the largest municipal health care system operating $4.5 billion It operates facilities in all 5 boroughs, providing general, chronic , ambulatory and skilled nursing care, and specialized patient care services. It has 11 acute, 4 long term care, 6 diagnostic/treatment centers, a health/home care and a managed care agency providing care to largely disadvantaged and underserved population. HHC at its transformational quality path that is safe, effective, efficient and patient-centered.

HHC has been leading in information technology by adding state-of-the-art features to electronic medical record, picture archiving communications system, computerized physician order entry, chronic disease registry for Diabetes, HIV, depression screening, asthma action plan and e-commerce.

To comply with NYS mandate on hospital-acquired infections, “bundles” were implemented on all critical care- central line and urinary tract bundles consisting of personal protective equipments; gowns, gloves, masks, including antimicrobial-impregnated catheters and chlorhexidine skin antisepsis for central line. This “bundle” best practice is now part of ICU daily supplies. The electronic PHQ9 depression screening tool translated into 7 languages was the result of collaborative work of Corporate Behavioral Health staff.

HHC's HIV services are supported by funding from NYC Department of Health and US Health Resources Services Administration. Screening increased by expanding program from AIDS centers and prenatal clinics to ED, inpatient and outpatient.

PACS and CPOE are now part of daily clinician routine in HHC facilities and most embarked to digitize clinical information; sonograms, EKGs and monitoring strips. Decision1, data repository for clinical information, and Vista, a new graphical user interface that allow users to point and click through the electronic medical record. The upgrades allowed building of chronic disease registries. Corporate clinical indicator reports on A1c, BP and Lipids are generated and reported to the QAC of the Board of Directors

Learning Objectives:
Identify strategies and measures on a large scale expanding effective and efficient technology. 2. Understand key ideas and priority initiatives aimed at improving and sustaining performance. 3. Identify potential challenges to the implementation process and successful methods for overcoming these challenges. 4. Identify factors involved in decision making to effect changes.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I manage the Corporate Quality Management program of HHC
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.