Hierarchical Condition Categories (HCCs) aren’t a new concept, but as more and more organizations shift to value-based care, there has been renewed issue in the subject. This is based on the recognition that without solid foundational knowledge of HCCs, health systems risk lower rates of reimbursement, or sometimes not getting paid at all.

On this program, we will explore the use of HCCs and their importance to medical practice.

Guest speaker:

Angela Hunt, RN, MBA, CCDS

Principal

Operations and Quality

Vizient

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Principal

Clinical Operations and Quality

Vizient

Show Notes:

[01:36] Background and definition for HCCs

[02:24] Using HCCs

[02:54] Physicians and clinicians who use HCCs

[04:08] Importance

[05:34] Documentation approaches

[08:47] Deriving value through the HCC designation

Links | Resources:

To contact Modern Practice: [email protected]

Angela Hunt’s contact email: [email protected]

Hierarchical Condition Categories Coding (AAFP) Click here

HCC Fact Sheet (Vizient) Click here

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On this episode, we conclude our series on mortality by examining palliative care, home care and hospice care. These are underused yet better and more beneficial for end-of-life situations than traditional inpatient approaches.

Guest speaker:

Steve Meurer, PhD, MBA, MHS

Executive Principal

Data Science and Member Insights

Vizient

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Principal

Clinical Operations and Quality

Vizient

Show Notes:

[00:28] Risk adjusted mortality: examining the most relevant hospice care approaches

[01:35] Effective palliative care

[01:58] Bullish on palliative care: broadening beyond the dying population

[03:24] Leveraging home care and hospice approaches

[05:02] Challenge in caring for a dying patient

[06:06] Facing mortality: getting the patient in the right place at the right time

[08:14] Mortality review: not finding fault but improving performance

[09:35] Example from mortality review: care for multiple myeloma patients

Links | Resources:

To contact Modern Practice: [email protected]

Steve Meurer’s contact email: [email protected]

To contact Tom regarding mortality reduction: [email protected]

Mortality Measures Hospital-Specific Reports (CMS) Click here

Selected Best Practices and Suggestions for Improvement – Mortality (AHRQ) Click here

Variation in US Hospital Mortality Rates for Patients Admitted With COVID-19 During the First 6 Months of the Pandemic (JAMA Internal Medicine) Click here

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Reducing hospital mortality is crucial to improve care and meet stringent reporting and reimbursement requirements. Improvements involve a complex effort involving multiple areas in the organization. On this episode, we continue our series on mortality by focusing on transfer centers and admissions as factors in reducing mortality.

Guest speaker:

Steve Meurer, PhD, MBA, MHS

Executive Principal

Data Science and Member Insights

Vizient

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Principal

Clinical Operations and Quality

Vizient

Show Notes:

[00:35] Risk adjusted mortality: focusing on one factor can make a difference

[02:13] Transferring patients

[02:40] Example: using telehealth instead of transfers for stroke patients

[03:16] Example: developing a co-management program

[04:08] Example: mini-ICU in the ER

[04:39] Example: in-hospital mortality for sepsis patients

[05:33] Supportive care for the dying patient

Links | Resources:

To contact Modern Practice: [email protected]

Steve Meurer’s contact email: [email protected]

To contact Tom regarding mortality reduction: [email protected]

Mortality Measures Hospital-Specific Reports (CMS) Click here

Selected Best Practices and Suggestions for Improvement – Mortality (AHRQ) Click here

Variation in US Hospital Mortality Rates for Patients Admitted With COVID-19 During the First 6 Months of the Pandemic (JAMA Internal Medicine) Click here

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“The longer you stay in the hospital, the higher chance that you have of dying in that hospital.” So says our guest in this crucial series on reducing hospital mortality. Mortality, always a leading quality indicator, is under increasing public scrutiny, with mounting pressure on health care organizations to reduce it. In this three-part series, we will discuss the multiple factors that affect hospital mortality and come into play when trying to lower mortality rates.

Guest speaker:

Steve Meurer, PhD, MBA, MHS

Executive Principal

Data Science and Member Insights

Vizient

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Principal

Clinical Operations and Quality

Vizient

Show Notes:

[01:43] Tracking a quality indicator

[03:04] Improvement is multifactorial

[03:49] The longer the stay, the higher the chance of mortality

[04:38] Effective mortality review

[05:58] Effective clinical documentation

Links | Resources:

To contact Modern Practice: [email protected]

Steve Meurer’s contact email: [email protected]

To contact Tom regarding mortality reduction: [email protected]

Mortality Measures Hospital-Specific Reports (CMS) Click here

Selected Best Practices and Suggestions for Improvement – Mortality (AHRQ) Click here

Variation in US Hospital Mortality Rates for Patients Admitted With COVID-19 During the First 6 Months of the Pandemic (JAMA Internal Medicine) Click here

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In this final episode of our series on the blood supply, our discussion goes beyond managing red blood cells to the management of every blood component. We examine hospital practices for conserving blood and using alternatives to transfusion.

Guest speaker:

Akiva Faerber

Senior Principal

Vizient

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Principal

Clinical Operations and Quality

Vizient

Show Notes:

[00:22] Extending management beyond red blood cells

[00:52] Platelets

[03:23] Other products and technologies for blood management

[04:21] More on platelets, other products/technologies and the need for platelet donors

[07:26] Vizient recommendations concerning platelets

[09:41] Avoiding transfusions

Links | Resources:

To contact Modern Practice: [email protected]

Akiva Faerber’s contact email: [email protected]

Conservation of Blood Products (The Ohio State University Wexner Medical Center) Click here

Severe Blood Shortage (American Red Cross web page) Click here

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Because of the critical shortage of the blood supply across the nation, health care organizations are having to work with less. On this episode, part two of a three-part series, we discuss reducing the number of transfusions and other strategies that will help you manage a more limited blood supply.

Guest speaker:

Akiva Faerber

Senior Principal

Vizient

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Principal

Clinical Operations and Quality

Vizient

Show Notes:

[00:32] Not focusing on eight as the magical number

[01:37] Managing red blood cells (RBCs)

[03:53] “Why two? Why not one? Why one? Why not none?”

[05:11] Autologous transfusion

[07:26] RBC-stimulating drugs

[09:05] Financial issues

[09:34] Old blood vs new blood

Links | Resources:

To contact Modern Practice: [email protected]

Akiva Faerber’s contact email: [email protected]

Conservation of Blood Products (The Ohio State University Wexner Medical Center) Click here

Severe Blood Shortage (American Red Cross web page) Click here

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In normal times in this country, only three percent of the population donates blood. Yet, the pandemic has worsened the situation even more, causing donor fatigue and lack of supply. In addition, more stringent guidelines have reduced the number of donors as well. On this episode, beginning a three-part series, we discuss the causes and effects of a shrinking blood supply and how to face this challenge.

Guest speaker:

Akiva Faerber

Senior Principal

Vizient

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Principal

Clinical Operations and Quality

Vizient

Show Notes:

[00:52] A grim situation

[02:26] Effect from an increased number of tests and guidelines

[03:41] Recruiting donors

[06:10] Changing clinical practice on use of blood

[07:50] Restrictive vs liberal blood use policies

[08:46] Vizient data to guide blood management

Links | Resources:

To contact Modern Practice: [email protected]

Akiva Faerber’s contact email: [email protected]

Conservation of Blood Products (The Ohio State University Wexner Medical Center) Click here

Severe Blood Shortage (American Red Cross web page) Click here

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In this final episode of our series on HACs, we examine the challenge of Clostridium difficile infection (C. diff, or CDI) for clinicians and patients. Highly infectious and unsusceptible to alcohol, CDI is cause for concern, with infection rates rising after COVID-19, as they are for all HACs. Yet, a systematic approach according to new guidelines can curb and eliminate this condition.

Guest speaker:

Richard Beaver, B.S. Chem, MBB, CPHQ

Senior Consulting Director

Vizient

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Principal

Clinical Operations and Quality

Vizient

Show Notes:

[00:31] New CDI guidelines

[01:21] Insight on major causes – and an example

[03:31] Benefit of early detection at hospital

[05:57] Issues with testing protocols, isolation practices and use of antibiotics

[09:21] A multi-faceted approach

Links | Resources:

Rick Beaver’s contact email: [email protected]

New CDI guidelines (IDSA and SHEA) Click here

CMS Hospital-Acquired Condition (HAC) fact sheet Click here

CMS Hospital-Acquired Condition (HAC) reduction program Click here

Information on Vizient’s Clinical Data Base (CDB) Click here

AHRQ tools to reduce HACs Click here

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Surgical site infections (SSIs) are persistent and challenging, no more so than following the COVID-19 outbreak. Now that elective surgeries are ramping up again, it is more important than ever to prevent SSIs, and that is the focus for this episode in our series addressing HACs.

Guest speaker:

Richard Beaver, B.S. Chem, MBB, CPHQ

Senior Consulting Director

Vizient

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Principal

Clinical Operations and Quality

Vizient

Show Notes:

[00:36] The upsurge in sepsis

[02:25] Limited SSI improvement in some cases

[03:39] A combination of causes

[04:50] Lack of compliance

[05:59] Prophylactic antibiotics

[08:35] Chlorhexidine

[10:33] Accurate metrics and analysis for key drivers of improvement

[11:35] 360-degree approach

Links | Resources:

Rick Beaver’s contact email: [email protected]

CMS Hospital-Acquired Condition (HAC) fact sheet Click here

CMS Hospital-Acquired Condition (HAC) reduction program Click here

Information on Vizient’s Clinical Data Base (CDB) Click here

AHRQ tools to reduce HACs Click here

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The outbreak of COVID-19 exacerbated the occurrence of Hospital-Acquired Conditions (HACs) in health care organizations, and bringing infection rates back down is a struggle. This series examines the steps we can take to reduce HACs, and on this episode, we focus on catheter-associated urinary tract infections, or CAUTIs.

Guest speaker:

Richard Beaver, B.S. Chem, MBB, CPHQ

Senior Consulting Director

Vizient

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Principal

Clinical Operations and Quality

Vizient

Show Notes:

[00:33] Occurrences of CAUTI

[01:11] Foley removal practice

[05:51] Other causes and managing the perineum

[08:25] Addressing the bundle components

Links | Resources:

Rick Beaver’s contact email: [email protected]

CMS Hospital-Acquired Condition (HAC) fact sheet Click here

CMS Hospital-Acquired Condition (HAC) reduction program Click here

Information on Vizient’s Clinical Data Base (CDB) Click here

AHRQ tools to reduce HACs Click here

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