Premier HIIN Award Methodology
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Premier HIIN Award for Excellence in Patient Safety Across the Board!

Premier is excited to share the criteria for the Premier Hospital Improvement Innovation Network (HIIN) Award for Excellence in Patient Safety Across the Board!

This award recognizes hospitals that have demonstrated excellence in performance in the 13 patient safety adverse event areas (AEA) of focus AND with active participation in the HIIN program. Recipients will be publicly recognized during the June 19, 2018 Premier HIIN National meeting. Hospitals and Health Systems will also be featured on PremierConnect™ and receive a press kit for local media announcements.

Excellence in Patient Safety Across the Board refers to an organization’s commitment and execution at all levels to a culture of patient safety through hard-wiring evidence-based practices into day-to-day operations and actions to ensure delivery of safe, reliable care, free from harm for every patient, every time. Hospitals must meet both the performance and participation criteria in order to receive the award.

Excellence in Performance Criteria

The Premier HIIN will evaluate hospitals performance on the 13-core patient safety AEAs of the national Partnership for Patients (PfP) program. Excellence in performance with safety across the board (SAB) is determined by a hospitals average score with reporting and achievement across all applicable AEAs. Hospitals will receive one point per applicable AEA for reporting outcomes data and one performance point for either achieving the PfP program goals of a 20 percent reduction in each AEA or a 12 percent reduction in the readmissions AEA (Table 1). Hospitals that have very low baseline rates and are unable to demonstrate the 20/12 reduction goals can also earn one performance point by meeting or exceeding the national PfP or Premier HIIN benchmark in each AEA (Tables 4-5).  If hospitals have multiple outcome measures, Premier will select the best performing measure to represent the hospitals achievement for that AEA. Please note: Hospitals reporting manual data must submit all available 2017 data by March 30, 2018 for inclusion in the HIIN award analysis. 

Table 1. Patient Safety AEA Performance Scoring Criteria

Component Points per AEA Description
Reporting 1 Hospital provides services related to the AEA and is submitting outcomes measure data for at least 6 months of 2017
Performance 1
  • Reduction (harm) ≥ 20 percent: 1.0 point
  • Reduction (readmissions) ≥ 12 percent: 1.0 point
    • and/or
  • Hospital demonstrating sustained high 2017 YTD performance by meeting national HIIN or Premier HIIN benchmarks

Excellence in Performance Criteria

The Premier HIIN Award for Excellence in Patient SAB also recognizes high performing hospitals for actively participating in the Premier HIIN program. Hospitals demonstrate their excellence by dedicating time and efforts towards their organizations success as well as through their active contributions to the success of the Premier HIIN program. To receive the award, hospitals must meet at least 6 of the 11 participation criteria listed in Table 2.

Table 2. Active Premier HIIN Participation Criteria
Active Premier HIIN Participation
  1. Completion of Organizational Assessment Tool (OAT, version 3)
  2. Complete answering of Patient and Family Engagement (PFE) measures questions 1-5 (Yes/No)
  3. Participate in regularly scheduled coaching calls with HIIN Partner
  4. Participate in site visit(s) by HIIN Partner and/or PFE contractor
  5. Utilization of Premier HIIN PFP Performance Dashboard
  6. Confer NHSN and/or NDNQI data sharing rights to Premier, as applicable
  7. Manual data submission for any measure a hospital is not able to have electronic submission through Premier’s QualityAdvisorTM (QA) or Quality Measures Reporter® (QMR), NHSN or NDNQI
  8. Serve as a HIIN event speaker (webinar or in-person meeting)
  9. Attend Premier HIIN webinars
  10. Submit hospital success story to Premier HIIN
  11. Serve as a member of and/or engage in the Premier HIIN PFE-Partnership Council

Patient and Family Engagement (PFE) Measures Bonus Point Criteria

Hospitals are eligible to receive a bonus point if they demonstrate achievement of all 5 national PfP PFE measures criteria (Table 3).

Table 3. Patient and Family Engagement Measures Bonus Point Criteria

Point

Patient and Family Engagement Measures Bonus Point Criteria

1 Bonus Point

  1. Hospital has a planning checklist that is discussed with every patient that has a scheduled admission (i.e., scheduled surgery or scheduled childbirth) AND at admission hospital staff discuss the checklist with patient and family.
  2. Hospital conducts shift change huddles OR bedside reporting involving patients and family members in all feasible cases. (Minimally conducted on at least one unit- nurse shift change huddle or clinician report/rounding)
  3. Hospital has a designated individual(s), or an existing office or department that dedicates a percentage of time within their current role to lead and be accountable for PFE efforts AND appropriate hospital staff and clinicians can identify the individual(s), office or department responsible in the PFE role.
  4. Hospital has an active Patient and Family Advisory Council (PFAC) OR at least one patient or family representative from the community who serves on a patient safety or quality improvement committee or team.
  5. Hospital has at least one patient who serves on a governing and/or leadership board as a patient representative. If not, does hospital meet the intent of the measure criteria using any of the below alternative measures:
    1. Hospital asks for PFE and/or PFAC input on matters before the board AND includes a PFE and/or PFAC report into the board agenda OR includes PFE and/or PFAC activity as a topic in existing Quality/Safety reports presented to the board.
    2. Hospital has elected or appointed board member(s) to serve in a specific role, with a written role definition, representing the patient and family voice on all matters before the board.
    3. Board members are required to conduct activities that connect them closer to patients and families such as, visiting care units in the hospital two times per year and/or attending two PFAC meetings per year.

National PfP HIIN and Premier HIIN Achievement Benchmarks

Tables 4 and 5 reflect the National PfP HIIN and Premier HIIN achievement benchmarks. As previously noted, hospitals having very low baseline rates and that are unable to demonstrate the 20/12 reduction goals can also earn one performance point by meeting or exceeding the National PfP or Premier HIIN benchmark in each AEA. Please note: Hospitals reporting manual data must submit all available 2017 data by March 30, 2018 for inclusion in the HIIN award analysis.

Table 4. National PfP HIIN Achievement Benchmarks

National PfP HIIN Benchmarks

Adverse Event Area Measure HIIN Benchmark Data Source Method for Defining Benchmark
C. difficile NHSN CDC C. difficile SIR (ADE-8a) 0.793 CDC/NHSN 20 percent reduction from overall SIR
CAUTI NHSN CAUTI SIR – ICU, excluding NICU (UTI-2a) 0.787 CDC/NHSN 20 percent reduction from overall SIR
CLABSI NHSN CLABSI SIR – ICU, including NICU (BSI-2a) 0.791 CDC/NHSN 20 percent reduction from overall SIR
Falls Falls with Injury (NQF 0202) per 1,000 Patient Days (INJ-2c) 0.518 NDNQI Leading Indicators 20 percent reduction from overall rate
MDRO NHSN CDC Methicillin-Resistant Staphylococcus aureus (MRSA) Bacteremia SIR (MRSA-2a) 0.788 CDC/NHSN 20 percent reduction from overall SIR
Pressure Ulcers AHRQ PSI-03 PU rate, Stage 3+ per 1,000 Discharges (PU-2b) 0.322 AHRQ PSI-03 20 percent reduction from overall rate
Sepsis Sepsis Post-Operative Rate per 1,000 Surgical Discharges (SEP-2) 3.192 AHRQ PSI-13 20 percent reduction from overall rate
SSI ACS CDC SSI – Abdominal Hysterectomy SIR (SSI-4d) 0.800 CDC/NHSN 20 percent reduction from overall SIR
ACS CDC SSI – Colon Surgery SIR (SSI-4c) 0.802 CDC/NHSN 20 percent reduction from overall SIR
ACS CDC SSI – Total Hip Replacements SIR (SSI-5a) 0.817 CDC/NHSN 20 percent reduction from overall SIR
ACS CDC SSI – Total Knee Replacements SIR (SSI-6a) 0.807 CDC/NHSN 20 percent reduction from overall SIR
VAE NHSN Ventilator-Associated Conditions (VAC) Rate per 1,000 Ventilator Days (VAE-4b) 3.209 CDC/NHSN 20 percent reduction from overall rate
NHSN Infection-Related Ventilator-Associated Complications (IVAC) Rate per 1,000 Ventilator Days (VAE-4c) 1.196 CDC/NHSN 20 percent reduction from overall rate
VTE AHRQ PSI-12 Post-Operative Pulmonary Embolism (PE) or Deep Vein Thrombosis (DVT) Rate per 1,000 Surgical Discharges (VTE-6c) 3.162 AHRQ PSI-12 20 percent reduction from overall rate

*Please note: National PfP HIIN benchmarks are for the PfP program’s standardized and nationally-defined measures. These benchmarks were last updated by the PfP Performance Evaluation Contractor in October, 2017.

Table 5. Premier HIIN Achievement Benchmarks

Premier HIIN Benchmarks

Adverse Event Area Measure HIIN Benchmark Data Source Method for Defining Benchmark
ADE

 

Anticoagulant ADE (ADE-2) 2.41463 Premier HIIN Administrative Claims 20 percent reduction from HIIN Baseline
Glycemic Ctrl (ADE-4) 0.10538 Premier HIIN Administrative Claims 20 percent reduction from HIIN Baseline
Insulin ADE (ADE-4b) 2.4383 Premier HIIN Administrative Claims 20 percent reduction from HIIN Baseline
Opioid ADE (ADE-6) 0.72758 Premier HIIN Administrative Claims 20 percent reduction from HIIN Baseline
Naloxone reversal among acute inpatients with opioids administered (ADE-6b) 115.44018 Premier HIIN Administrative Claims 20 percent reduction from HIIN Baseline
Airway Safety AHRQ PSI-11 Postoperative Respiratory Failure (AIR-2) 0.50109 AHRQ PSI-11 20 percent reduction from HIIN Baseline
CAUTI (all units) NHSN CAUTI SIR – all tracked units (UTI-2d) 0.77804 CDC/NHSN 20 percent reduction from HIIN Baseline
CLABSI (all units) NHSN CLABSI SIR  – all tracked units (BSI-2d) 0.74443 CDC/NHSN 20 percent reduction from HIIN Baseline
Falls

 

Falls with Major Injuries (INJ-2b) 0.02577 Premier HIIN Administrative Claims 20 percent reduction from HIIN Baseline
Falls Prevalence (INJ-2d) 2.3025 NDNQI NQF 141 20 percent reduction from HIIN Baseline
Pressure Ulcers Pressure Ulcers Stages 3-4 CMS HAC (PU-2) 0.00781 Premier HIIN Administrative Claims 20 percent reduction from HIIN Baseline
Pressure Ulcers Stage 2 CMS HAC (PU-2c) 0.03305 Premier HIIN Administrative Claims 20 percent reduction from HIIN Baseline
Readmissions Unplanned 30-day Readmission Rate (READ-2b) 7.76591 Premier HIIN Administrative Claims 12 percent reduction from HIIN Baseline
All 30-day Readmissions Rate (READ-2) 9.31836 Premier HIIN Administrative Claims 12 percent reduction from HIIN Baseline
Sepsis Severe Sepsis or Septic Shock (SEP-3) 5.59306 Premier HIIN Administrative Claims 20 percent reduction from HIIN Baseline
VTE Potentially Preventable VTE (VTE-6) 1.90402 Joint Commission 20 percent reduction from HIIN Baseline
Post Ortho VTE (VTE-6b) 0.316 Premier HIIN Administrative Claims 20 percent reduction from HIIN Baseline

*Please note: Premier HIIN benchmarks last updated December, 2017


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