west virginia success stories

WV Local Success Stories
Quality improvement endeavors can often feel overwhelming, but chances are, you can learn from the experiences that another physician, hospital or nursing home has had in a similar situation. Coupled with support from Quality Insights Quality Innovation Network, learning what has worked for others — and what didn't — is a valuable strategic planning component. 

We encourage you to read the success stories, contact us for more information, and also let us know if you have a Quality Insights' success storyto share.

Innovative Partnership Improves Medication Safety in West Virginia

For years, Quality Insights has partnered with hospitals, nursing homes and community agencies to improve medication safety and reduce unnecessary hospital readmissions in the Medicare population.  
Our continuing efforts to reduce cost, improve quality and improve the patient experience led to a new partnership – with emergency medical services. As part of a Community Paramedicine Special Innovation Project, Quality Insights is collaborating with the Kanawha County Emergency Ambulance Authority (KCEAA) in Kanawha County, West Virginia.

KCEAA is one of the most active emergency medical service providers in West Virginia. Through this community paramedicine initiative, the paramedics receive specialized training to provide interventions that support patients in their home setting. The end goal is improved patient activation, care coordination and patient safety.

For patients screened by case management at partnering hospitals, community paramedicine is offered as a post-discharge intervention. The community paramedic makes a home visit within 48 hours after discharge and continues phone support and home visits for 30 days. 

During the first visit, the paramedic conducts a medication inventory and reconciliation. “This approach has been particularly successful, because often healthcare professionals at the hospital or in the physician’s office are not aware of all the medications that the patient has at home,” said Quality Insights Network Task Lead Biddy Smith, RN, MSN. 

As part of conducting the inventory, the community paramedic will contact the patient’s primary care physician and the community pharmacist, if appropriate, to discuss any inconsistencies with the patient’s most recent medication discharge list. The paramedic then coordinates any corrections to the list and develops a revised medication schedule.

Sometimes the process includes making visits to the pharmacy on behalf of a patient. “This has been especially helpful when a patient is unable to fill a prescription due to lack of transportation,” explained Smith. 

After the medication list has been finalized, the community paramedic explains it to the patient, highlighting any high-risk medications such as anti-diabetic agents, anticoagulants or opioids. 

As a result of this collaboration, the KCEAA conducted medication reconciliation and education from September 2017 to September 2018. During that timeframe, paramedics identified 122 medication issues with 115 patients.  

“Typical medication issues include the inability to obtain medication, patients unsure of dosage or uncertainty of which medication regimen to follow,” explained Smith. “In these instances, the community paramedicine team worked with the patient’s healthcare provider to resolve issues.” One example is when a paramedic contacted a patient’s doctor to explain that a particular medication was not covered by Medicare. The doctor agreed to remedy the problem by prescribing a medication that Medicare does cover.

As this collaboration continues, it will pave the way to reduced costs and safer patients. “This effort serves as a great example of patient-centered collaboration across the continuum,” said Smith. “And we look forward to helping even more patients live healthier lives.”