Health Quality Innovators (HQI) today announced the winners of its fourth annual Health Quality Innovators of the Year Awards. HQI leads the Health Quality Innovation Network, the Quality Innovation Network-Quality Improvement Organization for Kansas, Missouri, South Carolina, and Virginia and is a Hospital Quality Improvement Contractor assisting hospitals across the country.
This year’s awards demonstrate HQI’s commitment to improving health care by honoring organizations that are using innovative approaches or technologies to address COVID-19 and keeping patients, residents, and staff safe.
The 2020 Health Quality Innovators of the Year are:
In a time when six feet has never felt so far away, Dogwood Village of Orange County (Virginia) implemented a simple yet highly effective approach to close the perception of that distance. The nursing home uses a clear plastic barrier for residents who are at risk for having challenges with social distancing and/or wearing a mask (i.e.: dementia residents), be a fall risk or otherwise be in area where staff need to observe them. The clear barrier allows residents to see other people and engage in activities to keep their minds active and reduce unintended consequences of isolation such as mental, emotional, and medical decline. Keeping residents in view and interacting with staff also decreases the need for one-on-one supervision, which allows staff to spread their time more evenly with other residents.
A collaborative program developed at University of Virginia Health (Virginia) working with local long-term care facilities prevented COVID-19 infections and reduced mortality during an outbreak. UVA Health pulmonary/critical-care and geriatric and palliative medicine experts used telemedicine to provide access to testing, monitoring, and treatment of residents for the virus. When necessary, the team also facilitated transfers to the hospital and transfers back to nursing facilities when patients recovered. The team also worked closely with primary-care physicians to assist in decision-making and treatment of these patients. The first two facility outbreaks the UVA team worked with sustained lower mortality rates than previous outbreaks: 12% and 19% respectively, compared with a 28% mortality rate reported at a long-term care facility in Washington.
Blue Ridge Healthcare of Sumter (South Carolina) empowered its residents to do their part in preventing COVID-19 by providing “hands-on” education to help them understand the importance of hand washing before and after meals and during daily activities. Staff at the facility engaged residents with a fun visual tool, a Glo Germ Powder Kit, which uses black light to show everything that residents touch during a typical day. The visualization of “germs” successfully encouraged residents, especially those initially hesitant to using hand sanitizing wipes, to become proactive about hand hygiene. Staff at Blue Ridge Healthcare also lead by example with 100% in compliance with hand hygiene and personal protective equipment use.
Health Partners Inc. (Maryland) created an online diabetes prevention program to allow patients to receive coaching and training at home to help protect them from acquiring COVID-19. With only one other prevention program available in Charles County, Health Partners teamed up with the Charles County Health Department and PreventionLink to create the online program that targeted adults who are overweight, have borderline diabetes or prediabetes, have a family history of diabetes or have had gestational diabetes. The program included 26 one-hour sessions and provided participants with educational materials and weight scales. The goal was for participants to achieve a 5% weight loss. Health Partners is not designated as a safety-net clinic or a federally qualified health center, but they serve their whole community, regardless of patients’ ability to pay.
McPherson Medical and Surgical Associates (Kansas) implemented a telehealth program within 15 days to protect its high-risk patients and staff in response to the outbreak of COVID-19. McPherson Medical’s community service area had an above average rate of COVID-19 infections during the early stages of the epidemic. The program allowed them to hold 659 patient appointments via telehealth from March through May. The quick shift swiftly provided their patients with continued access to care while reducing potential exposure to staff and patients. McPherson Medical continues with its telehealth program and is reaching out to patients to better understand their needs and improve the program.
Abingdon Internal Medicine (Virginia) successfully adjusted despite COVID-19 to continue its chronic care management trial in partnership with the Appalachian College of Pharmacy. The agreement to collaborate occurred in February 2020 and the widespread onset of the virus begain in March. Abingdon adapted a new virtual approach using technology and online platforms to connect with patients in this rural, underserved area of Virginia where access to care can be challenging even without a pandemic. The practice overcame challenges of internet connectivity, wide-ranging patient technology skills and new practice workflows. Annual Wellness Visits and Chronic Care Management appointments were performed virtually and still occur, but they are now mixed with in-office visits depending on the patient’s health condition and preference to safety precautions.
Other Provider Types and Organizations
Prince George’s County Health Department (Maryland) created a program called “COVID Care” to support its residents particularly vulnerable to COVID-19 and those who have been exposed or tested positive for the virus. Prince George’s county has the highest rate of positive COVID-19 cases and deaths in Maryland. Those who qualify for COVID Care receive assistance from a community health worker to address needs including health insurance, medical and mental health care, social services, living situation, utilities, and food insecurity. Residents who test positive are eligible to receive COVID Care Kits, which include personal protective equipment, cleaning supplies, medical items such as a thermometer, and educational material. Those who are identified as food insecure also receive a two-week supply of food.
When COVID-19 forced free clinics to move to telemedicine, Rx Partnership (Virginia) reimagined an existing service into a program that allows patients to continue receiving their medication without the risk of in-person visits. Rx Partnership existing program, Access to Medication Program (AMP), helps patients at clinics without licensed pharmacies obtain low-cost generic medications by filling prescriptions at a central location and mailing medicine to the clinics. With the arrival of COVID-19, Rx Partnership reshaped AMP to begin sending prescriptions directly to patients’ homes. They have also facilitated the shipping of medically necessary pharmacy supplies and over-the-counter medicine. In total, Rx Partnership worked with 10 free clinics in Virginia to provide 38,725 30-day supplies of prescription medication to over 5,300 uninsured patients between mid-March and August 31, 2020.
The Quality Improvement Program for Missouri (Missouri) quickly responded to the COVID-19 pandemic by helping nursing homes understand a multitude of information being disseminated about the virus and implement action to keep residents and staff safe. QIPMO immediately increased the frequency of its statewide Administrator Support Group and DON Support Group meetings to understand and assimilate new guidance and regulations regarding COVID-19. The QIPMO team distilled information into manageable learning sessions and held open forums for nursing homes to ask questions and share experiences. These statewide virtual meetings focus not just on regulation but also on broader aspects affected by the pandemic such as staff and residents’ health and safety, both physically and mentally.