IHI Readmission and Length of Stay Study
NeuroPoint Alliance (NPA) and the Institute for Healthcare Improvement (IHI) with the support from the Neurosurgery Research and Education Foundation (NREF) launched a pilot test from January to July 2017 for eight Quality Outcomes Database (QOD) registry participating centers that functioned as the QOD Spine Surgery Learning Community (SSLC). Participating QOD centers included Atlantic Neurosurgical Specialists, Carolina Neurosurgery and Spine Associates, Goodman-Campbell Brain and Spine, Norton Healthcare, Semmes-Murphey Brain and Spine, the University of California at San Francisco, the University of Utah and Vanderbilt University. For the purposes of this project, the pilot teams created a series of process and outcome measures.
The objectives of the project include the testing of change theories that emerged from the research and development stage from October through December 2016. Between January and June 2017, the pilot site teams tested four primary change ideas from the drive diagrams:
- Preoperative discharge planning
- Screening for comorbidities and risks prior to surgery
- Assessing pain and satisfaction at discharge
- Postoperative calls two to five days after discharge
At the conclusion of the pilot in July, the IHI project team offered several key recommendations to NPA leadership that are focused on sustaining existing changes among the SSLC participants:
- Expand the target population
- Spread promising practices to other QOD sites
- Extend testing to new areas of focus from the project driver diagram
- Reliably collect real-time data for designated improvement measures
For the changes that were shown to be successful, on a small scale, at the SSLC sites, the NPA leadership team will conduct larger scale testing and implementation. Successful implementation of improvement concepts will ultimately depend on the capacity and capabilities of local teams to embed improvement activities into their quality management infrastructure.
NPA’s surgeon leadership team for this study was directed by Anthony L. Asher, MD, FAANS, and Mohamad Bydon, MD, FAANS. They are considering the next stages to support the pilot sites in sustaining their early gains while planning for further dissemination of effective improvements through manuscripts and toolkits.
For questions about the IHI study, contact NPA.