Innovation Driving Change
MHVC is pleased to introduce this new section of our website featuring creative approaches and activities within our MHVC region, as well as important national best practices initiatives that our network can incorporate into the integrated delivery systems and drive outcomes and improve patient care.
MHVC Announces Innovation Fund Awards
Nineteen win competitive grants
In June 2017, MHVC announced a new funding opportunity for MHVC contracted partners and Tier 1 Community Based Organizations (CBOs) through the Innovation Fund Pilot Project Program. Providers and CBOs throughout MHVC’s seven-county region submitted proposals for collaborative pilot projects to address social determinants of health and develop outcomes-driven models of care. After extensive review, Innovation fund contracts have been awarded to 12 contracted partners and 7 new Tier 1 CBO partners, totaling $3,158,726.
“We are excited by the spirit of innovation and new partnerships being formed across the Hudson Valley,” said Marlene Ripa, MHVC Network Director. “We are confident that our provision of funding and continued technical assistance will result in successful projects with the ability to demonstrate a return on investment within a year or two.”
The funding is also consistent with the New York State Department of Health’s CBO Value-Based Purchasing Roadmap. “The state recently distributed a webinar focused on CBO VBP, and we were encouraged to see that our ongoing CBO integration strategy is very much aligned with what was outlined in the webinar and roadmap,” continued Ripa.
Below is a list of the nineteen organizations that have been awarded Innovation Funding for the project period October 1, 2017 through September 30, 2018:
Planned Parenthood Mid-Hudson— Newburgh-focused project
Project Name: Health Benefits of asthma education, screening, diagnosis/treatment, AAP, and rescue medication in the Newburgh Housing Authority homes
St. John’s Riverside Hospital—Yonkers-based project
Project Name: Decreasing Potentially Avoidable ER Visits through patient incentives, increased CBO involvement & Increased Health Home Enrollment
Yonkers Public Library—Yonkers-based project
Project Name: Offering Support Services for Library Patrons
Arms Acres—Hudson Valley region
Project Name: "Bridging the Gap": Certified Recovery Peer Advocates Engaging SUD Patients in Crisis
Hudson River Healthcare—Hudson Valley region
Project Name: Engaging Behavioral Health (BH) Clients through Nontraditional Strategies
Hudson Valley Care Coalition—Yonkers-based project
Project Name: Development of Sustainable Engagement Models that Target Hard to Reach Members of the Westchester Community
CANDLE of Rockland—Rockland-based project
Project Name: LGBT/Q Cultural Competency Training for Providers of Primary Care
Cornerstone Healthcare—Newburgh-focused project
Project Name: Using Shared Data to Target High-Risk Populations and Reduce ED Utilization-Homeless engagement
Rockland Paramedics—Rockland County
Project Name: Community Paramedicine Health Gap Services
Westchester Jewish Community Services—Yonkers-based project
Project Title: DBT-Informed Response to Care in Yonkers
MHA of Orange County—Newburgh-based project
Project Name: Standardized Care Management Education, After-hours Response to Individuals Enrolled with a Care Management Agency and/or in Need of Care Management Services that Present at an Area Hospital, and Community Education on the Role of Care Management
United Hebrew Geriatric Center—Westchester-focused project
Project Name: Transitional Post-Acute support
Human Development Services of Westchester—crisis-related program in Mamaroneck
Project Name: The Living Room: Crisis Day Respite Hospital Diversion Program of HDSW
Maternal Infant Services Network—Newburgh-focused project
Project Title: The Power of Health: Engaging Youth and Teens in Primary Care and Prevention
Student Assistance Services—Yonkers-based project
Project Title: Wonders of Wellness (WOW) Engagement of Youth in Preventive Care
Nyack Hospital—Rockland County-based program
Project Title: Nyack Hospital Community Paramedicine Collaboration
Project Name: Building Transition in Care Partnerships to Benefit Pulmonary Patients and Reduce Readmissions
Meals on Wheels of Rockland—Rockland-focused project
Project Name: Engagement with Clinical providers & Training of MOW staff to conduct Health Status Monitoring
TOUCH of Rockland & Orange Counties—Rockland-based Stanford Model project addressing food insecurity
Project Name: Medical Case Management and Medical Nutrition Therapy for people living with Type 2 Diabetes
May the (Quality) Force Be With You: Collaborative has Laser-Focus on Process
Workshop uses fun to focus on efficiency and adds patient experience
Although he has a simple question, Dr. Peter Shamamian, FACS, knows the answer is extremely complex. Shamamian, Vice President and Chief Quality Officer of Montefiore Health System and Professor of Surgery/Vice Chairman, Quality Improvement and Performance, is asking MHVC and Montefiore hospitals: As we move forward to provide the highest level of care in our expanding network, how do we ensure that everyone goes in the same direction?
In order to start the discussion and share ideas, Shamamian’s team created the Montefiore Health System-Quality Collaborative, a group of over 200 participants representing 12 hospitals, including MHVC partners Montefiore Mt. Vernon, Montefiore New Rochelle, Nyack, St. John’s, St. Joseph’s, St. Luke’s Cornwall, and White Plains. The Collaborative convened for the first time in June 2017, and meets quarterly for full-day sessions coordinated by the Network Performance Group (NPG). There are 50 people in the group, including physicians, health economists, nurses, data abstraction experts, and other specialized areas. The Montefiore Institute for Performance Improvement (MIPI) is within the NPG, providing robust offerings, including a year-long course on performance improvement, consulting with other groups, and data analysis. The team also offers post-collaborative coaching.
The St. Luke’s team won lightsabers for their efficient production process.
“Our goal is to develop approaches to improvement so we can ensure that all care delivery in our system provides safe and quality care using data analytics and performance improvement,” said Shamamian. The Quality Collaborative uses the Institute for Healthcare Improvement (IHI) Model for Improvement since it has proven results and is user-friendly. The Collaborative workshops incorporate didactic exercises and breakout sessions, and have focused on three projects of importance to network hospitals: Catheter-associated urinary tract infections (CAUTI), heart failure readiness, and Emergency Department (ED) throughput time.
In addition to these three focus areas, the Quality Collaborative has now expanded its scope to include patient experience metrics. Dr. Steven J. Choi, FAAP, Assistant Vice President and MIPI Director, gave the keynote on December 8th about how patient experience is the foundation for quality. He introduced concepts of change management and highlighted the importance of patient experience.
Marcello Khattar, Director of Patient Experience for Montefiore’s Moses Campus, participated in the new Patient Experience workgroup. “It is exciting that the Collaborative agreed that this is a priority and the time to start working on this is now,” Khattar said. “Our goal was to get the process started and we chose the collaborative path, to include the patient voice in the experience and to be patient-centric in everything we do.”
“We serve diverse populations in many counties, so this is a great forum to bring together all of the critical clinical, administrative, and operational members of the leadership teams,” said Dr. Choi. “We talk about how to improve, but Lean processes and improvement science tools alone do not make a recipe for success -- we need to change the culture and behaviors within the organization, and that is often harder than the the actual plan to change health care delivery.” This change will easily take five years, or closer to ten years in a large system.
In addition to change management and improvement methods, an organization needs to understand and invest in leadership. “The greatest leaders are those who can achieve results for the organization while investing in the development of people within their organization,” said Dr. Choi. “In order to be a leader, you must behave the way you want others to behave.”
During the exercises, Dr. Choi’s team facilitated an introduction to Lean principles using an entertaining simulation exercise. Each hospital team was asked to assemble Lego-block Star Wars “stormtrooper” figurines. The simulation demonstrated that applying Lean processes led to significantly improved efficiency in production work. The winning team, from St. Luke’s Cornwall Hospital, was most efficient, reducing production time from 12 to 2 minutes, and was rewarded with Star Wars-style lightsabers.