Did you know that HealthStream has partnered with the American Heart Association to deliver their full suite of ECC courseware?
HealthStream launched the comprehensive portfolio of online courses from the American Heart Association (AHA), the universally trusted and recognized world leader in emergency cardiovascular care (ECC) resources, in June 2012.
Since then, the AHA has updated these courses, and their Acute Stroke Online now offers CE Credit for Physicians, Nurses, EMTs and Physician Assistants! Whether your employees are updating their professional skills or being introduced to emergency cardiovascular response training for the first time, HealthStream provides AHA courseware to help you effectively achieve your training objectives.
Many online courses from AHA use a blended learning approach. Students learn cognitive skills through web‐based, self‐paced modules then practice and test the skills they have learned with an American Heart Association Instructor or Heartsaver® Skills Evaluator.
Benefits for Hospitals and Learners:
- Improve patient outcomes, by advancing prevention efforts and education
- Save time by completing certifications faster than classroom-based courses, as well as eliminating the wait for scheduled class times
- Reduce costs by freeing up limited instructor and classroom resources, decreasing or eliminating textbook expenses, and eliminating replacement staff to cover class time
- Interactive, self-paced courses vetted by AHA scientists and educators
- Courses are regularly updated and improved, using the latest AHA Guidelines for ECC and CPR
Acute Stroke Online is a web-based, interactive course that provides training on the symptoms, diagnosis and management of ischemic and hemorrhagic stroke and complications of stroke. Course content covers treatment from the field to the emergency department, as well as critical care and rehabilitation. Geared toward the experienced healthcare provider, this course is ideal for in-hospital, out-of-hospital and any healthcare provider who wants to improve his or her knowledge of stroke treatment. (1.5 CE Credits for Physicians, Physician Assistants, Nurses & EMS)
Stroke Prehospital Care Online is an online course that teaches emergency medical professionals about stroke, including: pathophysiology, risk factors, differential diagnosis, recognition, assessment, and management. This course is ideal for out-of-hospital EMS providers. (1.25 Credit Hours for EMS)
Heartsaver® First Aid Online Part 1 is a self-directed course that uses interactive lessons and videos to teach comprehensive first aid knowledge including first aid basics, medical emergencies, injury emergencies and environmental emergencies. This program is for anyone with limited or no medical training interested in learning basic first aid.
Heartsaver First Aid Online is a self-directed course that uses interactive lessons and videos to teach you comprehensive first aid knowledge. This program is for anyone with limited or no medical training who needs an AHA course completion card. You will learn:
- First aid basics
- Medical emergencies
- Injury emergencies
- Environmental emergencies
Heartsaver® CPR AED Online Part 1 is an online, self‐directed program that teaches learners critical skills and knowledge needed to respond to and manage a sudden cardiac arrest or choking emergency in the first few minutes until emergency medical services (EMS) takes over. This course provides an AHA course completion card upon completion of all three parts.
Heartsaver® First Aid CPR AED Online Part 1 is an online, self‐directed program. The program teaches comprehensive first aid skills and critical skills and knowledge needed to respond to and manage a sudden cardiac arrest emergency in the first few minutes until emergency medical services (EMS) takes over. This course provides an AHA course completion card upon completion of all three parts and is ideal for anyone interested in learning these skills.
Heartsaver® Bloodborne Pathogens Online is a self‐directed course designed to meet Occupational Safety and Health Administration (OSHA) requirements for bloodborne pathogens training when paired with site‐specific instruction.
BLS for Healthcare Providers Online Part 1 provides a flexible alternative to classroom training. Through case‐based scenarios, interactive activities and videos, this course teaches the concepts of both single‐rescuer and team basic life support. This course is for healthcare professionals who need to know how to perform CPR, as well as other lifesaving skills, in a wide variety of in‐hospital and out‐of‐hospital settings. This course provides an AHA BLS Provider Card upon completion of all three parts.
Structured and Supported Debriefing is an online tool designed to teach AHA Instructors how to facilitate an effective debriefing of their learners to enhance the learning and retention of their participants. This course is for any instructor who leads simulation or conducts debriefing sessions, including those following megacodes, Advanced Cardiac Life Support scenarios, and Pediatric Advanced Life Support skills sessions and scenarios.
Learn more here.
By Nicholas Dowd, Senior Consultant (HCAHPs and other Surveys), HealthStream
The commitment to excellence is truly a team effort at Avera Sacred Heart Hospital (ASHH). They have been involved in – and seek out – opportunities to collaborate with facilities from across the nation to share best practices and processes to improve overall quality. For example, they were active participants in the CMS Demonstration Project and have proactively participated in programs such as the QUEST initiative, the IHI 100k Lives Campaign and the 5 Million Lives Campaign. They are also currently participating in the CMS initiative “Partnership for Patients. ASHH sees participating in each of these collaboratives as means to improve evidenced-based care, patient perceptions of care and enhanced patient safety.
Their deep level of commitment to continuously improving quality is a unifying thread that runs throughout the hospital, touching every employee. This team effort starts with transparency of performance data. Performance data at the unit level is posted on the hospital’s intranet enabling all employees to see results. Using the “push” feature of HealthStream’s Insights Online product, leaders can schedule and post results via e-mail to those front-line staff that need that information to manage more effectively. Those data are also an integral part of the work of ASHH Patient Services Council and a variety of performance improvement teams at work on a daily basis.
The current areas of focus for the hospital include:
- Decreasing overall readmissions
- Evaluating and implementing best practice solutions to reduce hospital harm
- Maximizing use of the electronic medical record
Read the full success story here.
By Bo Hansen, Research Consultant (HCAHPS and Other Surveys), HealthStream
What Hospitals are Doing to Curb Readmissions
Following is information on transitional care models taking hold at hospitals across the country in efforts to curb readmissions:
Care Transitions Interventions
The Care Transitions Intervention, developed by Eric Coleman, MD, professor of medicine and head of the healthcare policy and research division at the University of Colorado, is a four-week program in which a transition coach teaches patients with complex conditions how to self-manage their medication and how to recognize red flags if their condition gets worse. The coach, who makes a single home visit and three follow-up phone calls, also coordinates with primary care and specialist providers, community organizations, home care agencies, skilled nursing facilities and clinics, making sure patients are active participants in their own care.
"Rather than providing the patients with a 'fish,' we are helping them learn to fish and thereby apply their newly acquired skills to the immediate transitions but also to future transitions," Coleman told FierceHealthcare.
The transition coaches explicitly focus on promoting those skills through activities such as role-playing. They "do not provide skill care but rather use simulation … to reinforce key skills" Coleman explained.
The model has been adopted by 750 organizations, 20 percent of which are hospitals. And out of the 47 communities under the Centers for Medicare & Medicaid Services' Community-Based Care Transitions Program, 34 are using Care Transitions Intervention, Coleman said.
The Care Transitions Intervention has been shown to cut 30-day readmissions by 20 to 50 percent--even six months down the line, according to Coleman.
The Transitional Care Model
The Transitional Care Model, designed by Mary Naylor, professor of gerontology and director of NewCourtland Center for Transitions and Health, and colleagues at the University of Pennsylvania, targets older adults with two or more risk factors, including a history of recent hospitalizations, multiple chronic conditions or medications and poor self-health ratings.
The model, although complementary to, is not care management, according to the researchers.
"The major goal of this model is to help the patient and family caregivers develop the knowledge, skills and resources essential to prevent future decline and rehospitalization," according to the Transitional Care Model website. "At the end of this episode of care, continuity is assured by excellent communication with the primary care providers continuing to follow patients who have made a commitment to their self-management goals."
Key to the model is the care coordinator called a "transitional care nurse," who ushers the patient through in-hospital planning and home follow-up. The role, which is different from traditional roles, incorporates the skills of a nurse, care manager and patient advocate, according to the website.
Within a day of enrollment in the program, the transitional care nurse assesses the patient's health status in the hospital. The transitional care nurse then visits the patient's home within 24 to 48 hours of discharge and then again once per week during the first month, followed by semi-monthly visits until discharge from the program, as well as offers phone support seven days a week. After the patient completes the program, the transitional care nurse prepares a summary for the patient and primary care provider and provides access to other care services, if needed.
U Penn's model, which partners with Aetna and Kaiser Permanente, cut readmissions by 28 percent within the first 24 weeks and by 13 percent within a year. It also has cut costs by 39 percent per patient, or nearly $5,000, within the year after hospitalization.
Project BOOST, led by the Society of Hospital Medicine (SHM), combines multidisciplinary leaders with existing process models for transitional care.
"It's really an aggregation of tools that help hospitals put into place interventions that have been shown in the literature to help reduce readmissions," Greg Maynard, clinical professor of medicine of University of California, San Diego and director of the Center for Innovation and Improvement Science, told FierceHealthcare.
BOOST mentors provide a site visit, where the mentor spends a full day with the QI team and C-suite. They coach sites for a year on how to get institutional support, help with a data repository and integrate tools into their own organizations.
"What sets Project BOOST and in general, the Society of Hospital Medicine and mentor implementation projects, aside from the rest [of care models] is they have experts in the both the content and quality improvement, coaching the improvement teams through each step of the process," Maynard added.
The mentoring also is supplemented with Web resources, webinars and a listserv with active community sharing about pharmacy interventions, follow-up phone calls, getting patients to see the primary care provider soon after they leave hospital and making appointments, as well as teach-back and other patient engagement strategies.
"What we've come to realize, of course, is that you can't just … have someone come into your hospital, grab the patient and think everything's fixed, nor can you just fix the inpatient side without regard to what happens once the patient leaves the hospital. What we're seeing across the country now is better partnership between the inpatient and outpatient settings," Maynard said about building bridges with skilled nursing facilities, community clinics, safety nets and social services.
Maynard hinted the next version of Project BOOST will help bridge the inpatient and outpatient resources.
"This is not just fixing one process; it's really a dozen related processes that go across disciplines. So to be successful, people will have to not get overwhelmed by this and keep chipping away at these processes with an eye toward trying to make them a more coordinated whole," he said.
Nearly 3,900 sites have downloaded the BOOST toolkit, as of February, and the mentoring program has been implemented at more than 100 sites, according to an SHM fact sheet. Project BOOST has resulted in a 21 percent drop in all-cause readmission rates, although Maynard noted updated data will be published soon.
Project BOOST also collaborates with Blue Cross Blue Shield Association of Michigan and the California Health Care Foundation.
Researchers at Boston University Medical Center created Project RED, short for Project Re-Engineered Discharge, which combines components that have been proven to cut readmissions and yield high patient satisfaction.
With 38 million hospital discharges taking place each year, the discharge process plays an important role in transitional care.
Among the best practices that Project RED uses is language assistance, in which RED promotes "complete implementation guidance and is adapted to address language barriers, cross cultural issues and disparities in health care communication and trust," according to the website.
RED also encourages following up on appointments, making sure the patient not only has a primary care provider but also that the patient knows when and how to get there. Providers organize post-discharge outpatient services and medical equipment, help with medication management, lay out a discharge plan and write a discharge summary. To support patients, providers also expedite the discharge summary and offer telephone support if problems arise.
Another publicized aspect of the model is a Virtual Discharge Advocate, otherwise known as "Louise." To cut down the time it takes for nurses to deliver RED, the virtual patient engagement system shows video animations that instruct patients on their medications and other discharge information--which patients seem to like. According to the pilot study, nearly three-quarters (74 percent) of hospital patients said they prefer discharge instructions from a virtual nurse over human providers, noting that the computer goes at a patient's pace.
The model, supported by the Agency for Healthcare Research and Quality, the Blue Cross Blue Shield Foundation and the Patient-Centered Outcomes Research Institute, among others, has proven successful, lowering hospital utilization by 30 percent and saving nearly 34 percent in costs ($412) per patient who received intervention, according to a Project RED fact sheet
Read more: Project RED - FierceHealthcare http://www.fiercehealthcare.com/special-reports/project-red#ixzz281HLAW1c
Read more: Project BOOST - FierceHealthcare http://www.fiercehealthcare.com/special-reports/project-boost#ixzz281GnnnB5
Read more: Transitional Care Model - FierceHealthcare http://www.fiercehealthcare.com/special-reports/transitional-care-model#ixzz281GHuuhX
Read more: Care Transitions Intervention - FierceHealthcare http://www.fiercehealthcare.com/special-reports/care-transitions-intervention#ixzz281FXajM9
Read more: Transitional care models to combat readmissions - FierceHealthcare http://www.fiercehealthcare.com/special-reports/transitional-care-models-combat-readmissions#ixzz281EayZET
Data to assess the penalties have been collected and crunched, and Medicare has shared the results with individual hospitals. Medicare plans to post details online later in October 2012, and people can look up how their community hospitals performed by using the agency's "Hospital Compare" website.
CMS Incentives to Reduce Readmissions
In April 2011, the Center for Medicare and Medicaid Services (CMS) announced funding opportunities for acute-care hospitals with high readmission rates that partner with community based organizations (CBOs) or CBOs that provide care transition services to improve a patient’s transition from a hospital to another setting, such as a long-term care facility or the patient’s home. Created by Section 3026 of the Affordable Care Act, the Community-Based Care Transition Program (CCTP) provides funding to test models for improving care transitions for high risk Medicare patients by using services to manage patients’ transitions effectively. Participants will use process and outcome measures to report on their results.
CCTP supports the three-part aim of making health care safer, more reliable, and less costly for all Americans. This initiative is part of the Partnership for Patients, a public public-private partnership charged with reducing hospital-acquired conditions by 40 percent and hospital readmissions by 20 percent by 2013. The Department of Health and Human Services plans to invest up to $1 billion in Affordable Care Act funds in the Partnership to reduce millions of preventable injuries and complications.
Who can participate?
CMS invites CBOs, or acute care hospitals that partner with CBOs, to submit an application describing the proposed care transition intervention(s) and people with Medicare who are at high risk of readmission in their communities.
CBOs must provide care transition services across the continuum of care and have a formal organizational and governance structure, including formal relationships with hospitals, other providers, and consumer representatives. Preference will be given to Administration on Aging (AoA) grantees who partner with multiple hospitals and practitioners to provide care transition interventions or entities that provide services to medically-underserved populations, small communities and rural areas.
What will participation require?
CBOs will be required to provide care transition services across the continuum of care, which may include at least one of the following:
Care transition services that begin no later than 24 hours prior to discharge;
Timely and culturally and linguistically competent post-discharge education to patients so they understand potential additional health problems or a deteriorating condition;
- Timely interactions between patients and post-acute and outpatient providers;
- Patient-centered self-management support and information specific to the beneficiary’s condition; and,
- A comprehensive medication review and management, including—if appropriate—counseling and self-management support).
Applicants must explain how they will align their care transition programs with care transition initiatives by other payers in their communities, including Medicaid, Medicare Advantage, and private payers.
All awardees must agree to and sign terms and conditions governing their participation in the program prior to initiating their programs.
How long will CMS accept applications?
CMS will accept applicants and enroll participants on a rolling basis as funding permits. The program will run for 5 years (initiated April 2011). Participants will be awarded two-year agreements that may be extended annually through the duration of the program based on performance.
What does the application require?
Interested parties must submit a written proposal that addresses all of the evaluation selection criteria described in the solicitation on the CCTP web page at: http://go.cms.gov/caretransitions.
As part of the proposal, applicants must:
Identify community-specific root causes of readmissions, define the target population, and strategies for identifying high risk patien
- Specify care transition interventions and services that will address readmissions, including strategies for improving provider communications and improving patient activation;
- Describe how care transition strategies will incorporate culturally appropriate, beneficiary-centric, effective care transition approaches to reach ethnically diverse beneficiaries, and how other community and social supports will be incorporated to enhance beneficiaries’ post-hospitalization outcomes;
- Provide an implementation plan with milestones;
- Provide a clear budget proposal, including a per eligible discharge rate reflecting direct costs for care transition services; and,
- Describe prior experience with managing care transition services and reducing readmissions.
For application and additional information: http://www.innovations.cms.gov/initiatives/Partnership-for-Patients/CCTP/index.html?itemID=CMS1239313
[This blog post introduces HealthStream's new Accountable Care Organization (ACO)-focused white paper series. As the first of eight sponsored papers, it serves as an introduction to the ACO, its history, goals, and structure.]
In response to decades of rising healthcare costs without corresponding improvements in the quality of care, policymakers, providers, and payers across the country have been working on developing new models of care that potentially could “bend the cost curve” while rewarding for high quality and improved health status. A required model for the future, since the passage of the Patient Protection and Affordable Care Act (PPACA), is an Accountable Care Organization (ACO) that provides infrastructure and information technology solutions for moving from a disjointed, siloed “system” of delivery to one that is well coordinated and aligned to provide real value to patients, providers, and payers alike.
One Target of ACOs is Cost Containment
Healthcare costs have continued to increase and erode the ability to balance state and national budgets, as well as weaken the country’s position in the world. The Kaiser Family Foundation estimates that Medicare alone, currently 3.6 percent of the United States Gross Domestic Product (GDP), will grow to 4.2 percent of the GDP by 2018 and to 6.4 percent of GDP by 2030. The Commonwealth Fund National Scorecard on U.S. Health System Performance 2008 shows that U.S. healthcare spending per capita and as a percentage of GDP is respectively more than twice and 50 percent higher than the next industrialized nation. Concurrently, physicians’ and hospitals’ per unit of service revenue increases are not meeting their increased costs, and employers and payers are seeing utilization and technology use skyrocket, driving double digit premium and per member medical cost increases. The Congressional Budget Office has estimated that potential savings to Medicare from promoting ACOs could amount to $5.3 billion between 2010 and 2019, although net savings would not begin to realize until 2013. The savings would be realized as providers reduce volume and intensity of services delivered to their patients. The potential savings to Medicaid and the Commercial market are still being reviewed and formulated but early estimates show savings in the $50 to $100 billion range over the same time period.
Let’s Define an Accountable Care Organization (ACO)
The premise behind an ACO is that providing evidence-based, quality care will decrease costs and improve patient health status. While there is no single, well-accepted definition of an Accountable Care Organization (ACO), there is a general agreement that it creates a closer working relationship among hospitals, physicians/groups, insurers, employers, and individuals, where all players share the risk and assume accountability for health status outcomes. This white paper, Accountable Care Organizations 101, is the first in a series of eight. It includes such information as:
What is an Accountable Care Organization (ACO)?
- How Did We Get Here?
- Where is the Accountable Care Organization (ACO) Headed?
- Target of Cost Containment
- What’s the Market Place Saying about Accountable Care Organizations?
The successful ACO will require substantial changes in organizational goals, management, information platforms, operating activities, and staffing compared to today’s typical hospital system or physician practice. As in healthcare generally, the ability to appropriately staff, educate, motivate, and manage people will be critical. And, as with all new opportunities, success will not come without numerous challenges. It remains to be seen whether or not ACOs will become economically sustainable healthcare delivery systems that truly improve quality and reduce costs.
Download the white paper.
A Guest Blog By HealthStream Partner Michael Cohen, Healthcare Management and Employee Development Consultant
One of the responsibilities of a leader, especially in healthcare, is to create a learning culture where employees are at the very least technically competent and ideally at the cutting edge of their respective disciplines. With strong leadership, employees are never permitted to rest on their laurels regardless of age or length of employment. Nobody is permitted to practice OJR (on-the-job-retirement).
Because the technology is constantly advancing, employees’ skills must also continuously improve or they will soon lag behind. And leaders provide employees a great service when they insist on state-of-the-art skill sets. Once acquired, skills can never be taken away from someone. Skills are also portable. They can be taken from one job to another. A person becomes more employable with up to date knowledge and skills.
At the end of every annual performance appraisal, leaders should informally negotiate with employees a stretch learning objective that gets them out of their comfort zone:
“This time next year, what skill or knowledge will you acquire and how will you apply it to the benefit of the customers we serve? How will I know you have achieved this goal? What resources do you need from me to facilitate your success?”
Also, many continuing education programs are evaluated in the most superficial way by simply asking employees whether they liked the speaker and program content. The Buddha said, “To know and not to do is not to know.” Once you place a resource in employees’ hands, you should ask:
“What did you learn and how/when will you demonstrate this newly acquired knowledge or skill?
And if the program is mandatory, there should be serious consequences for failure to attend or learn the lesson by other means.
In a learning culture, leaders play the role of teacher, coach and mentor. They set up new employees for success by creating a comprehensive departmental new employee orientation process. Nobody is allowed to eat their young. Finally, leaders hold themselves accountable for their own professional development. They serve as role models for continuous quality improvement.
Learn more about HealthStream partner Michael Cohen and his services.
* * * * *
HealthStream's partner Precyse, a leader in health information management (HIM) technologies and services, leading up to the AHIMA 2012 Annual Conference and Exposition, released the following open letter from Chris Powell, President of Precyse, to all healthcare colleagues regarding the announced ICD-10 final rule. The open letter, answering a critical question at this hour: "How do we reinvigorate our planned ICD-10 implementation roadmaps?" is available below. AHIMA attendees are encouraged to visit Precyse (Booth #236) or HealthStream (Booth #437) to continue the ICD-10 conversation.
On August 24, the CMS published a rule finalizing the compliance deadline for converting to the ICD-10 system of diagnostic and procedural coding to Oct. 1, 2014 from Oct. 1, 2013. HHS said the extra time would allow healthcare organizations - especially small organizations - adequate time to get prepare for the changeover.
"By delaying the compliance date of ICD-10 from October 1, 2013, to October 1, 2014, we are allowing more time for covered entities to prepare for the transition to ICD-10 and to conduct thorough testing," HHS said in the rule. "By allowing more time to prepare, covered entities may be able to avoid costly obstacles that would otherwise emerge while in production."
Precyse has not stopped preparing for the implementation of the new coding rules and stands ready to support and meet the needs of nearly 1,000 clients - many who rely on our management, staffing and technology solutions - through their training and implementation process. Because Precyse not only supports, but actually operates, entire HIM and coding departments for some of these clients, here are our recommendations:
1. Documentation. Increase your clinical documentation training programs for physicians and other caregivers. You should develop processes, guidance and support for improved clinical documentation under ICD-10. Improved documentation skills – even minor changes such as more specificity in their notes – create obvious financial and non-financial rewards: fewer claims denials, reduced RAC audit exposure, improved case mix index, and improved cash flows. Most important for all of us, patient care is improved when downstream clinicians can review more complete chart notes and better data is available for analytics and comparative studies. Target high volume specialties in your organization most impacted by ICD-10 and train these specialists in proper documentation while training the coding team on accurate coding; then, move to the next specialty for training.
2. Training and Development. Act now to invest in the training of your coders AND those who will use the data. Improve the basic skills of your coders in ICD-9 areas that will also be required in ICD-10. The transition to ICD-10 has pushed healthcare to appropriately invest in training our coders as skilled knowledge workers. As part of our own ICD-10 preparations, Precyse assessed the coding skills of nearly 300 coders on our staff to evaluate their ICD-10 readiness. We found additional training needs related to anatomy, physiology and pathopharmacology, as well as opportunities to improve their understanding of coding system logic and principles. So Precyse invested in and developed a comprehensive and multifaceted training program that can be delivered via virtual webinars and our online Precyse University, while developing individual training plans for every coder. This investment has paid off for Precyse clients handsomely, yielding a better case mix index for hospitals, improved coding compliance audit results, increased coder retention, and attracting new coder recruits who are eager to develop and perfect their skills. So we recommend that you perform side-by-side ICD-9 and ICD-10 coding, assessing the documentation and coding gaps and target training based on these findings.
3. Build a strong foundation for process improvement. Assess the flow of your information across your organization and develop a plan to address gaps through process improvement and technology. Invest in automated systems that streamline the entire clinical documentation process. ICD-10 was never just about re-training medical coders–it was and is about having better data about patients and their treatments, affording vast opportunities for improvement in how data are captured and processed. This leads to a more complete and useful set of codes, which is crucial in a fully automated electronic medical record environment. Today, inefficient, labor-intensive workflows abound, whether involving clinical information inputs such as dictation and transcription; service approvals, coding, physician queries, and other myriad facets involved in billing for services; or abstracting and analyzing quality indicators to improve patient care. We also recognize the promise of future innovations such as automated speech recognition, Computer Assisted Coding using Natural Language Comprehension™ (NLC), and clinical decision support tools – but know that realizing their full promise tomorrow requires that we improve how current users interact with and use their systems today. Those of us in the health care information management/information technology community must use our skills to innovate for clinicians. We must develop workflow platforms and applications that allow health care providers to do their jobs more efficiently and effectively. We do not want to add more time and complexity to an already burdensome process.
About Precyse ICD-10 Training via HealthStream
Precyse has developed specific learning tracks, available through the HealthStream Learning Center, to meet all of your ICD-10 training and education needs. Designed by some of the most experienced coders, clinicians, and HIM professionals in the industry, the Precyse method dissects the system and provides education to each of the over 40 impacted populations. From coders and physicians to case managers, nurses, and administrative staff, the Precyse ICD-10 Training Solution Suite will prepare your facility and staff for this transition so that they are productive and successful on day one.
Benefits of Precyse ICD-10 Training
Maximize Reimbursement Potential
Decrease denials and rejections
Reduce queries and delays in billing
Be ready for the ICD-10 deadline on October 2014
Improve coding, billing, and reporting compliance
Ensure documentation and coding success on Day 1
Decrease Training Expense
Streamline training process
Offer specific education for each of the impacted populations
Standardize training across the organization
Four core ICD-10 training tracks plus multiple specialty tracks to address the needs of all of your impacted professionals
Precyse Animation Library illustrates anatomy and procedures in cutting-edge animations
Precyse Arcade offers 100+ games to increase learning
HIM & Coding Managers
Click here to learn more about Precyse ICD-10 training
By Donna Sue Snyder, Director, Human Resources, HealthStream
I posted earlier this year about the internal implementation of our new system for employee performance evaluation, the HealthStream Performance Center. This is the solution HealthStream has designed to meet the exacting demands for managing talent management in healthcare, and we wanted to put it to the test for HealthStream’s annual performance review process. Now that we’ve used it, I want to share our initial impressions and the feedback we have received about using this system.
Feedback About Our Performance Evaluation Process
Once the evaluation process was complete, we prepared a survey and used it to collect feedback, from employees and managers, to assist us in improvements in the evaluation process. Following is a sample of the positive comments concerning the process and the product:
Positive Reviews of the HealthStream Performance Center
Here are some of the things that employees and their managers told us:
- “I liked being able to comment on my interpretation of my accomplishments before my manager”
- “The previous process only allowed us to react to manager comments”
- “Shorter time involved, clear process”
- ”Good advance training”
- “Ease of use”
- “HPC is very intuitive”
- “Ability to make unlimited comments was very good”
- “Paperless and transparent between employee and manager”
- “Ease of access”
Surveys to Make Performance Evaluations Even Better
We also asked our employees and managers for feedback, which we plan to use to further improve the process. As a human resources professional, I found that it was a pleasure being able to receive candid comments that will assist us in making the necessary improvements to ultimately institute a better process. This will work in the same way that we reach out to our clients for feedback on all the services we provide to them. In most cases, and ours is no different, there are and will be future comments concerning improvements that can be made to the process within HealthStream, just as there are necessary improvements to be made for our clients in their workplaces. The survey helped us identify many of the changes that we need to make in order for the Performance Center, which is already a strong and effective tool, to become even better as we move forward within our own company and with our clients.
A Tool for Healthcare Career Pathing and Succession Planning
Now that we have tested and tried our new product, we can begin to use this tool for ongoing monitoring of performance. The next step is for us to start collecting data for performance measures throughout the next evaluation period. As mentioned in my previous communication, we will also now begin to use this tool for Career Pathing and Succession Planning. Next, we will populate the data library with information, which will in turn allow our managers to mentor and coach their employees in the best direction and assist them to make better use of their valuable time and resources.
An Asset for Talent Management in Healthcare, Now in Use at HealthStream
The HealthStream Performance Center, according to our feedback survey, has already become an asset for our managers and employees. We look forward to updating you again soon, as we continue to use this performance management tool to our best advantage. We anticipated great satisfaction from our employees and our managers, and we are satisfied, based on the survey results, that we have achieved a good level of satisfaction. We also anticipated a secure and reliable information sharing and gathering process, and our survey feedback indicates success. Having anticipated and experienced an improved Talent Management process, we definitely will continue to utilize this powerful tool. What’s best about the experience is that we have already begun to experience improvements and satisfaction in managing the company’s most valuable resources, our employees. Stay tuned for further updates!
Learn More about the HealthStream Performance Center.
By Cristina Hession, Associate Product Manager, HealthStream
The Impending Hospital Leadership Gap -- Harvard Business Publishing and HealthStream Can Help
By 2050, the number of United States citizens 65 years and older is expected to increase 138% over what it was in 2000. As the U.S. population ages and the labor force shrinks, labor shortages and leadership gaps are expected in many industries. The healthcare industry is no exception, even as the number of elderly persons requiring care increases and the number of available caregivers per patient drops dramatically. According to the Center for Workforce Studies of the Association of American Medical Colleges, roughly 40% of doctors are 55 and older, and approximately 33% of nurses are 50 and older. A Nursing Management Aging Workforce Survey conducted by the Bernard Hodes Group found that about 55% of nurses expressed an intention to retire within the next decade. While doctors and nurses continue to enter healthcare professions from medical and nursing schools, the current flow of new professionals will not be enough to replace those on the eve of retirement.
Growing Chronic Illness Needs Require Advanced Skills, More Caregivers, and More Leaders
To compound this challenging situation, individual illnesses are becoming progressively more complex and requiring more care. Chronic diseases such as obesity, cancer, diabetes, and cardiovascular disease are currently on the rise, requiring those suffering from such illnesses to receive care from numerous providers in multiple settings. While the U.S. healthcare system was primarily built to treat injuries and acute care illnesses, the rise in chronic illnesses requires providers to develop new competencies in order to continue delivering high quality care. These increased cases of chronic illness combined with new technology, new regulations, information management systems, and care outside of the hospital require healthcare providers to develop important non-clinical competencies such as leadership, teamwork, and collaboration. They will also need to establish processes for successful patient hand-offs from one clinician to the next. Now more than ever, nurses and doctors must work together to coordinate care across teams of professionals, using a broader portfolio of soft skills- including negotiation, strategy, and decision-making to achieve positive patient outcomes.
HealthStream People Development and Training Solutions Help Hospitals Succeed
HealthStream is already partnering with over 50% of the nation’s hospitals to help forge the path forward into a new age of patient care. The HealthStream Performance and Competency Centers are paving the way for healthcare providers to adopt an expanding set of competency and performance standards in a variety of settings. The HealthStream Learning Center, with a content library of over 6,000 courses, enables tailored skills development and remediation based on the outcomes of performance reviews and competency assessments. With transitions of care figuring prominently in today’s healthcare arena and an impending leadership shortage in the coming years, the development of leadership competencies is now more important than ever.
Develop Healthcare Leaders and Managers with Harvard ManageMentor Training
Partnering with Harvard Business Publishing, HealthStream is now offering Harvard ManageMentor, a collection of 44 action-oriented management essentials developed under the guidance of global experts and leaders, as well as Stepping Up To Management, a program designed to help newly-promoted managers realize immediate success in their new role. With individual course topics ranging from Decision Making to Process Improvement, to course bundles on Communication, Conflict Management, and Performance Management, Harvard Business Publishing provides a very timely skills development opportunity for the situation now faced by our providers. In moving toward a measurement and education system that reflects the dynamic healthcare landscape, HealthStream enables its network of facilities and providers to keep pace with rapidly changing concepts of quality care.
Learn More about Stepping Up to Management and ManageMentor from Harvard Business Publishing.
By Robert J. Ogden, Senior Consultant (HCAHPS & Other Surveys), HealthStream
At the end of the HealthStream HCAHPS survey interview, patients have an opportunity to make a comment about their recent hospital experience, using our Voice of the Patient enhancement. This feedback provides valuable qualitative information that supplements the quantitative data we gather.
Why Aren’t Patient Comments More Common?
Recently, one of our clients asked a client services manager why don’t more patients, if they are unhappy, voice their concerns or issues when they have a chance to make a comment at the end of their HCAHPS survey?
This is actually a very common question. If you are a hospital leader, nurse manager, service excellence coordinator, or someone else charged with improving your HCAHPS scores, you have probably heard that question before, or maybe asked it yourself.
Most Patients are Happy
When answering this question, there are several things to consider. First, it’s important to keep in mind that patients are very happy for the most part. Consider that on a scale of 0-10, more than 70% of patients rate their overall experience either a 9 or 10, and another approximately 20% rate their experience a 7 or 8. Less than 10% of patients rate their hospital experience a 6 or lower. So, while hospitals may be struggling to improve those last few points to differentiate themselves from the competition, the bar is set very high.
Unfortunately, it isn’t unusual to see some extreme responses to one end of the scale or the other, and then see the respondent indicate that they do not have an open-ended response. Some respondents may have a difficult time putting into words their thoughts or may be reluctant to have their thoughts recorded. Ultimately, I believe the reason most patients do not leave comments is because they are generally happy with the care they received and feel they have nothing outstanding to share.
We Wish We Could Ask for “Always.” We Can’t.
Another common question we get is why we can’t ask a patient why they did not give us an “always” or rate us a “9 or 10.” If only patients would tell us exactly why they did not rate us an “always” or a “9 or 10,” then we would know more precisely what the patient expects, right? While it would be nice if we could ask patients why they did not give us top box ratings, the CMS HCAHPS Quality Assurance Guidelines specifically prohibit asking patients questions like this to prevent introducing bias into the survey results.
Get More Comments by Explaining the Survey and Its Value
So what is a hospital to do to increase the number of comments from patients? I encourage hospital staff to inform patients that HealthStream may contact them by telephone to complete a short survey about their hospital experience. Your staff can inform patients of the survey upon admission, during discharge counseling with the patient and family, and prior to leaving the hospital. Make patients aware that if they are selected to complete the survey, they will be given an opportunity to make comments at the end of the survey. Encourage patients to make comments by letting them know how the hospital values their input.
What about your hospital? How do you let patients know they may be called to share their hospital experience? Do you encourage feedback from your patients?
Learn More about HealthStream's Patient Insights Survey/HCAHPS Services.
Learn More about HealthStream's Voice of the Patient Survey Enhancement.
By Kenneth W. Dion, PhD, MSN/MBA, RN, Vice President and Chief of Nursing Informatics, HealthStream
The word for today is disorientation. And no, I’m not talking about disorientation due to time-zone difference and jet lag. I’m talking about keeping left. As Sigma Theta Tau International moves to embrace its global nature, reflected in both its name and mission, American members like me, who have traditionally comprised the majority, must learn to embrace the cultures and traditions of our global membership. In my case, that means embracing the norms of the wonderful country that is my host for this research congress.
When I say, “Keep left,” I am not speaking politically. I mean, literally, KEEP LEFT! My Australian mates don’t drive on the wrong side of the road, they drive on the otherside of the road. I dare not drive here for fear of putting my life and the lives of my wonderful hosts at risk. This left-sided tendency is not restricted to driving. It holds true for just about anything. The “up” escalator is on the left, not the right, as we “Yanks” are used to. Slow traffic on the walking and bike trails around our host city of Brisbane, and the rest of the country for that matter, needs to move left. So, for those of you I have walked into or just confused, I extend my sincere apologies. I promise that I am working on staying left. And one last note for my friends from the Northern Hemisphere:—Yes, the water really does spin the other way as it goes down the drain. To the left!
A Focus on Nurse Residency and New Nurse Turnover
I knew from looking at the program prior to my arrival that the sessions were organized into tracks or themes. Little did I know that the theme I was interested in—nurse residency and new nurse turnover—would permeate my entire day. During the opening plenary session, Rhonda Griffiths, AM, RN, RM, Bed, MSc (Hons), DrPH, reminded us that policy must be based on valid and reliable evidence, not just the latest research article dragged onto the nursing unit, and that consensus that evidence is truly valid and reliable must be reached before that evidence can inform policy. The limited scholarly research in my area of interest confirmed for me that more study is required before policy can be generated in this area.
Similar Nursing Issues, Global Significance
Following the morning plenary, I visited the poster presentations. Just as there are presentation tracks at this congress that are relevant and timely, so, too, is the diversity of posters. I have no doubt there was at least one poster in the session that any attendee could relate to his or her area of research. My theme for this day—nurse residency and new nurse turnover—continued in the poster session. I found work that aligned with my research interest and confirmed that my interest is of global importance.
I had the honor of moderating a session sponsored by the Sigma Theta Tau International Foundation for Nursing. During this session, I learned about fantastic work being done by nurse scholars that found its genesis in a small research grant funded by the Honor Society of Nursing, Sigma Theta Tau International (STTI), as well as research that received continued funding through STTI, which increased its validity and reliability. The thread continued to weave its way through my day.
Conference Photo: Recipients of Leadership Education Grants
I am proud to serve on the foundation’s board. One of the most rewarding parts of that service is meeting nurse scholars and future nurse scholars who have benefited from a foundation Leadership Education Grant. These grants allow members who might not otherwise be able to attend events, such as this congress, to come learn, network and, above all, contribute to nursing scholarship. The first-ever networking event for recipients of these grants was held at this congress. This event allowed not only me but also the sponsors of these grants to meet these truly deserving recipients...
Kenneth W. Dion, PhD, MSN/MBA, RN, founder and chief executive officer of Decision Critical, Inc., a software company that specializes in learning and competency management products for acute-care hospitals, is now vice president and chief of nursing informatics of HealthStream, following HealthStream’s recent acquisition of Decision Critical. Dion is also president of the board of trustees of the Foundation of the National Student Nurses’ Association and serves on the board of directors of Sigma Theta Tau International Foundation for Nursing.