UCSF, Baystate Medical Center, and the University of Pennsylvania are leading the development of a new quality and safety focused network - the Hospital Medicine Reengineering Network (HOMERUN) - that aims to improve outcomes of patients on general medical wards. HOMERUN will draw on the experience of the Vermont-Oxford Neonatal Network and National Surgical Quality Improvement Projects (among others), and leverage the growth of hospitalists to help speed improvement in care across participating sites
What is HOMERUN?
HOMERUN is a collaborative quality improvement and implementation research network focused on three key missions:
- To use measures that matter to hospitalizes and their patients to improve quality and efficiency of care in the hospital and afterwards.
- To link improvement efforts to robust and timely evaluation, so that the pace of meaningful improvement is accelerated.
- To study how to ensure the uptake of effective improvements through implementation science.
These missions are possible because HOMERUN includes sites which represent national leaders in hospital medicine, care improvement methods and implementation science, as well as expertise in specific topic areas relevant to hospital medicine (e.g. thromboembolism prevention, readmission reduction, medication reconciliation, infection reduction).
Rationale for HOMERUN
Medical patients are the largest patient group in US hospitals, and more than half of these patients are cared for by hospitalists. As a result, hospitalists are the most important potential stakeholders in innovations which seek to improve the care of general medical patients. However, despite the importance of this group of doctors and patients, remarkably little attention has been given to them. In particular:
- Existing benchmarking approaches often focus on methodologies that are based on the lowest common denominator of available data (e.g., ICD codes). Benchmarking using only these data do not engage front line providers, and compel change slowly. In addition, benchmarking using these data do not explicitly collect data of importance to patients (such as functional status, or understanding of a care plan).
- Many publicly reported measures (e.g., Joint Commission quality measures for pneumonia) are actually geared toward emergency department care or the ICU. A hospital seeking to implement evidence-based practices on their medical wards currently has a very limited ability to support improvement in care transitions, reduction in venous thromboembolism, or reduction in hospital-acquired infections.
Plans for 2018
- Improving care transitions for medical patients: This program will collect and share information about the quality of discharge processes, as well as support ongoing real-time reviews of the causes of readmissions from the patient and provider perspective. The combination of these two data sharing programs will lead to better targeting of efforts to meet patients’ needs at discharge and after hospitalization.
For more information on the HOMERUN Project, please contact Dr. Michelle Schneidermann.