Sickle Cell Disease

Pediatric Respiratory
February 21, 2018
Vancomycin
February 21, 2018
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Sickle Cell Disease

Sickle Cell

There are several metrics that comprise the Sickle Cell Management solution. They are made up of overall, process, and medication metrics utilized to improve patient care.

Overall

  • Length of Stay (LOS vs GMLOS) – average Length of Stay per encounter (in days) and Benchmark LOS (Geometric Mean Length of Stay). Adult benchmarks come from CMS and are based on Medicare Severity (MS) DRG. Length of Stay measures can also be filtered by process and medication measures.
  • Mortality – the number of patients who died in-hospital divided by the total number of discharged patients. Mortality measures can also be filtered by process and medication measures.
  • Readmissions – the number of patients discharged from a hospital system and readmitted to the same hospital system within 30 days of discharge divided by the total number of discharged patients. Planned readmissions, same-day-readmits, and discharges to other acute hospitals are excluded. Readmissions can also be filtered by process and medication measures.
  • Discharge Dispositions – the eight most common discharge dispositions by patient volume

  • Process Measures

  • Order Set Utilization – percentage of encounters with the Sickle Cell Crisis order set utilized, broken down by Total (Overall), Emergency Department, Admission, and Nursing.
  • Case Management Consult ordered – Sickle Cell encounters where a Case Management consult ordered within 24 hours.
  • Sickle Cell Discharge Instruction Utilization – percentage of encounters where of using the smart text D/C instructions specific to Sickle Cell crisis.
  • Patients with Completed Follow Up visit within 7 days of Discharge– percentage of encounters where the patient had a follow up visit scheduled within 7 days. We will present two rates one for Follow Up rates and one for No Shows.
  • Packed Red Blood Cell administrations – percentage of encounters where the patient had Packed Red Blood Cells (PRBC) administered and the total PRBC administered for each encounter.
  • ED/Urgent Care Visits within 30 days of Discharge– percentage of encounters where within 30 days of discharge the patient utilized ED or Urgent Care services.

  • Medication Measures

  • Total IV Opioids – The number of patients who were administered IV opioids during the Sickle Cell encounter.
  • Patient Controlled Analgesics (PCA) Utilization – The percentage of total IV opioid patient encounters where a PCA was utilized during the encounter for pain management.
  • Narcan Administrations – the number of Narcan administrations that occurred each month for the Sickle Cell population.
  • IV to Oral Opioid Transition Prior to Discharge – the percentage of total IV opioid patients that transitioned to PO Opioids prior to discharge. To qualify the patient can not be on both IV and PO concurrently the day of discharge.
  • IV Opioid Utilization – average days of IV opioids for all opioid administrations, average days of PRN opioids administrations only (any PCA/scheduled admin), average days PCA and/or scheduled IV opioids.

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    Benefits of Fusion Solution Include:

    Process, Medication, Length of Stay, and Readmission measures help an organization realize if clinical interventions and pathways are helping to improve the overall care of a costly patient population. Appropriate patient education and pain management are paramount to keeping the Sickle Cell disease population healthy.

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    Patient Cohort - All patients with an inpatient, ED or urgent care visit for sickle cell

    Step 1: Assess

    • Collaboratively set goals and objectives to deliver required outcomes for finalization for the program.
    • Identify and assess criteria for calculating a Return on Investment for the program.

    Step 2: Examine and analyze approximately 30 relevant data points

    • Workflows analysis for data points include – clinical documentation, flowsheets, Best Practice Alerts, Medication Administrations, Navigators, Smart forms, ADT
    • Identify discrete data points to examine for data inconsistencies.
    • Optimize the workflow for process improvement based on Best Practices.
    • Define the necessary documentation standards to reduce data inconsistencies.
    • Order sets and groups to provide for the right care at the right time.

    Step 3: Orchestrate, Blend & Synthesize

    • Coordinate EHR optimization to help Physicians, Specialists, Care Providers and Care Mangers.
    • Enable & organize to unlock the current data infrastructure based on data elements to implement a governed approach to analytics based on established project/program objectives and goals

    Step 4: Optimize (user behavior analytics from above icon group)

    • Help validate the workflows and train end users during the acceptance and transitory phase to help drive adoption.
    • Suggest and recommend further refinement, if needed, based on specific organizational needs.

    Step 5: Adopt

    • Provide Visualizations from extended data analytics infrastructure to help sponsors and committees drive the outcome objectives and goals.
    • Provide analytics for Clinical Efficiency teams to help derive the most value from adherence to shared baseline protocols (clinical guidelines for acute or chronic disease management), if applicable
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