Strategies supporting reduced hospitalization rates in a successful OCM practice.

Authors

null

Molly Mendenhall

Oncology Hematology Care, Cincinnati, OH

Molly Mendenhall, Amy Sheldrick, Karyn M. Dyehouse, Andrew S Guinigundo, David Michael Waterhouse

Organizations

Oncology Hematology Care, Cincinnati, OH, Oncology Hematology Care, Inc., Cincinnati, OH, OHC Hem Onc Care, Cincinnati, OH

Research Funding

Other

Background: Team-based implementation of care is a foundational tenant to reducing avoidable ER visits and hospitalizations. This care strategy supports the OCM mission of improving quality and reducing cost through practice transformation. Methods: Comprehensive care team: Physician, Advanced Practice Provider, Nurse Navigator, Financial Navigator, Phone Triage Nurse; Consistent Message: “Call Us Early – Call Us First” campaign. Verbal and written instructions at all staff member touch points, emphasizing patient responsibility to call before going to the hospital; Supporting infrastructure: 2-hour teaching visit with the entire care team prior to all new treatments; Triage Phone Unit, COME HOME (Barbara McAneny, M.D.) triage pathways – 38 symptom and 27 symptom f/u pathways modified; Blocked time-slots at all offices for same-day APP triage appts; Proactive ER and hosp f/u calls. Results: 2017 phone triage data: 9,841 total symptoms calls. 2,476 same day visits. 338 ER saves. 67 ER f/u calls (Nov/Dec 17’ only). OCM pt survey scores improved and internal Netpromoter scores remained stable. Conclusions: A comprehensive team-based patient navigation strategy, supported by consistent “Call Us First” messaging, symptom pathways and same-day patient access, resulted in decreased hospitalization without commensurate increases in ER visits or 24hr observation stays. Pt satisfaction was not impacted negatively.

Hospital Utilization Rates / 100 Pts

Apr 15’– Mar 16’Oct 15’– Sept 16’Jan 16’– Dec 16’Apr 16’– Mar 17’Jul 16’– Jun 17’
OHC Inpt Admits26.325.524.823.422.6
Admits, Practices in Risk Cohort26.826.225.425.825.9
OHC Unplanned Readmits < 30 Days of Discharge6.45.45.64.94.9
Unplanned Readmits < 30 Days of Discharge, Practices in Risk Cohort6.665.75.55.6
OHC ED Visits not Leading to Admits or Obsv Stay15.716.216.416.317
ED Visits not Leading to Admits or Obsv Stay, Practices in Risk Cohort18.318.318.218.518.6

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Abstract Details

Meeting

2018 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session A: Big Data Studies; Projects Relating to Equity, Value, and Policy

Track

Projects Relating to Equity, Value and Policy,Big Data Studies

Sub Track

Team-based Approaches to Optimizing Care Delivery

Citation

J Clin Oncol 36, 2018 (suppl 30; abstr 139)

DOI

10.1200/JCO.2018.36.30_suppl.139

Abstract #

139

Poster Bd #

N9

Abstract Disclosures

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