Download Amalgamated Process - Hospital Quality Institute

WellTransitions®
Reducing Preventable Readmissions
Walgreens Mission and Vision
MISSION
To be the most trusted, convenient
multichannel provider/advisor of
innovative pharmacy, health and
wellness solutions, and consumer
goods and services in communities
across America…
A destination where health and
happiness come together to help
people get well, stay well, and
live well.
VISION
To be “My Walgreens” for everyone
in America, the first choice for health
and daily living
Transforming Community Pharmacy – Integrated
Healthcare Delivery System
A premier provider of healthcare
and wellness services
• 75,000 healthcare providers deliver
high-quality healthcare services
– Retail and specialty pharmacists
– RNs, LPNs, NPs, PAs
– Physicians and dentists
– Medical, dental, and radiology
technicians and assistants
– Dietitians
– Health and wellness coaches
– Health and fitness trainers
– Case managers and referral
coordinators
[photo TK]
Health System Pharmacies – Reflecting Growing
Access and Addressing Service Needs
100+ locations
• Planned expansion to 196
locations in 2013
• Premier locations include:
–
–
–
–
Teaching hospitals
Hospital networks
Children’s hospitals
Community hospitals
• Staffed by PharmDs and
pharmacists
• Locations include HIV/AIDS
Centers of Excellence
Comprehensive Portfolio of Health Systems
Management Solutions
Walgreens integrates
outpatient pharmacy into the
healthcare continuum
On-site outpatient
pharmacies
• Improves access to specialty
and limited-distribution
therapies
Employee access to
30d/90d Rx
• Improves MPR and patient
adherence
WellTransitionsTM
Specialty Pharmacy
• Reduce penalty for avoidable
readmission
Home Infusion Services
• Access to 340B solutions
340B solutions
• Coordinates post-discharge
care through the nation’s largest
network of retail pharmacies
Community-based
Take Care Clinics®
Rate of Medication Drop Off – Nearly 1 in 3 Patients
Don’t Fill
100%
50% - 70%
48% - 60%
25% - 30%
15% - 20%
Prescriptions
Brought to
Pharmacy
Picked up
Are Taken
Properly
Are Refilled
Source: IMS
WellTransitions Strategic Vision
• Assisting health systems with
avoiding readmission penalties
• Bridging the care gap
• Redefining role of the pharmacist
• Intervention based care model
• Collaboration efforts with
interdisciplinary healthcare teams
• Increasing access and extending
care through 8,000 community
locations
WellTransitions – Three Phased Approach
Hospital
Treatment
Post-discharge
Care
• Interventions 1-4
• Patient identified,
enrolled in program
• Generate medication
history
• Fill, alignment and
reconciliation of
discharge medications
• Bedside delivery of
medication and patient
consultation
• Interventions 5-7
• Pharmacist education
follow up initiated 48-72
hours after discharge
• Pharmacist clinical
therapy review
approximately 10 days
post-discharge
• Community integration
provided by pharmacist
at day 25 postdischarge
Aligned with health system core measures
Focused on reducing preventable readmissions
Coordinated effort to drive HCAHPS scores
Coordinated care with community providers
Integrates data points – EMR, ADT, alerts
Outcomes
Reporting
• Final Intervention
• Comprehensive
reporting capabilities
• Advanced data
analytics
• Measure clinical
outcomes and
economic effectiveness
• Real-time access
through secure web
portal
Pharmacist Driven Program to Increase Medication
Adherence
• Range of pharmacist-mediated
interventions utilizing evidence based
guidelines
• Ability to monitor adherence through
comprehensive analytics
• One-on-one pharmacy/patient
medication education and review
sessions
• Accurate patient profile and
comprehensive medication history
• Complement to other intervention
initiatives and activities
Bridging the Gap, Coordinating Care
Health
System
•
•
•
•
Offered as part of patient care services
If necessary, identifies and targets high risk patients
Integrated into daily workflow
Provides feedback and is an advocate of benefits
Walgreens
• Medication history provided at admission, medication review, alignment
• Ease of transition, follows patient in own environment, reviews medication
instructions
• Documents any change in therapy, alerts health system and community
provider to any issues
Loopback
Analytics
• Determines patient eligibility based on pre-select health criteria
• Collects and maintains data points (medical and pharmacy)
• Pushes tasks and communications based on role/responsibility and
severity
• Integrates data points – EMR, ADT, alerts
Community
Health
Providers
• Integrated into care continuum with two-way communications
• Educated on health status of patient
• Enhances patient/provider relationship with full view of medication history
External Dashboard - Example
©2012 Walgreen Co. All rights reserved
DeKalb Medical Center –
Early Version of WellTransitions
Program initiated January 2011 with DeKalb Medical (Main) and is
based on their process of improving core measure goals
• Patients in the care transition program had a lower 30-day
readmissions rate (5.6 percent compared to 10.6 percent) than patients in
the same hospital in the year prior to program initiation
• Unadjusted readmission rates
Duncan, I. DeKalb’s Comprehensive Medication Compliance Approach Cuts Readmissions. Healthcare Financial
Management Association (HFMA) Leadership e-Bulletin: February 2013 Issue. http://www.hfma.org/
Patient Satisfaction Results from DeKalb Medical
Patient Satisfaction (HCAHPS Scores) was a significant driver of the
decision to implement WellTransitions/bedside delivery.
There was a dramatic improvement in HCAHPS “Communication about medicines” domain
scores1
26% relative increase
in HCAHPS domain score
63% at
65th
percentile
50%
at first
percentile
ACHIEVED IN THE FIRST 90 DAYS
From the first percentile to the 65th percentile.
1. Stemphiak M., Bedside Delivery-an Easier Pill to Swallow. HHN (p2-3), August 2012