September was a busy month for the Bree Collaborative. We finalized three of our reports for dissemination for public comment – Alzheimer’s Disease and Other Dementias, Opioid Use Disorder Treatment, and our re-review of the Total Knee and Total Hip Replacement Bundle. Now we want to hear from you! Information on submitting comments on all three of our topics below. Please send this announcement to colleagues, friends, or family who may also want to send us their thoughts.
Feedback on all three topic areas is due by 5pm Friday, October 27th. Our three workgroups will review comments before submitting a final draft for review and adoption by the Bree Collaborative.
Alzheimer’s Disease and Other Dementias
Alzheimer’s disease and other dementias are a growing concern in Washington State and around the country. The complex symptoms including in memory, cognition, and social functioning are difficult for patients themselves, their family members and friends, and the health care system at large. In many cases no clear guidelines exist to support the patient through diagnosis and increase in symptoms. This Report and Recommendations has six focus areas: diagnosis; ongoing care and support; advance care planning and palliative care; need for increased support and/or higher levels of care; preparing for potential hospitalization; and screening for delirium risk.
Opioid Use Disorder Treatment
Opioid overdose is a leading cause of death in Washington State. However, access to appropriate, evidence-based opioid use disorder treatment is not typically readily available due to lack of resources, lack of a referral infrastructure, lack of reimbursement, and other barriers. The workgroup’s goal is a health care system that identifies people with opioid use disorder and facilitates access to comprehensive, evidence-based treatment with the patient at the center of care. Recommendation focus areas include access to evidence-based treatment (e.g., medication assisted treatment, reduce stigma), referral information (e.g., inventory of medication treatment prescribers, supportive referrals and infrastructure), and integrated behavioral and physical health to support whole-person care (e.g., treatment of comorbid conditions).
Total Knee and Total Hip Replacement Bundled Payment Model and Warranty Re-Review
Bundled payment models align healthcare delivery, purchasing, and payment with an evidence-informed community standard for quality. The Bree Collaborative developed a bundled payment model for total knee and total hip replacement in November 2013 and elected to re-review and update this recommendation in 2017. The four cycles within the bundled payment model include standards for appropriateness, requirements for fitness for surgery, elements of best-practice surgery, and components of post-surgical care to return the patient to function as well as quality standards. The warranty is a stand-alone product that does not include quality standards other than accountability for complications.
For more information or to give additional feedback, please contact me at GWeir@qualityhealth.org or visit www.breecollaborative.org. Thank you in advance for your participation in this effort to improve health care quality, outcomes, and affordability in Washington State.
Ginny Weir, MPH
Program Director, Bree Collaborative