The Hospital Engagement Network Initiative: Key Takeaways

The Centers for Medicare and Medicaid Services (CMS) is continuously rolling out new strategies to help improve quality of care on a national level. One notable effort known as the Hospital Engagement Network initiative aimed to increase collaborations between different health organizations to streamline evidence-based care delivery.

While this initiative is no longer being overseen by CMS, there are some valuable lessons that stakeholders in the healthcare industry can take away from it. We’ll provide an overview of this program, the available results, and what facilities should consider moving forward.

What Was the Hospital Engagement Network Initiative?

This initiative was part of CMS’s Partnerships for Patients (PfP) program, which provided a framework for collaborative quality improvement among different public and private health organizations. The underlying goal of the program (rolled out in two phases) was to encourage different hospitals to share evidence-based protocols and quality improvement data with one another to help reduce the following areas of harm on a national scale:

• Adverse drug events (ADEs)
• Catheter-associated urinary tract infections (CAUTIs)
• Central line-associated bloodstream infections (CLABSIs)
• Injuries from falls and immobility
• Obstetrical adverse events
• Pressure ulcers
• Surgical site infections (SSIs)
• Venous thromboembolism (VTE)
• Ventilator-associated events (VAEs)
• Readmissions

Phase One

The first phase of this initiative ran from 2011-2015. CMS contracted 26 national, regional, and state health organizations to lead designated “hospital engagement networks,” collectively garnering participation from over 3,700 hospitals. The contracted organizations were tasked to build, educate, and guide local networks of hospitals in quality improvement programs to help CMS meet the following goals:

• Reduce preventable hospital-acquired conditions by 40%
• Reduce 30-day readmissions by 20%

Phase Two

The program was renewed for a second phase that ran from 2016-2020. CMS merged their efforts with other federal organizations, updating their original Hospital Engagement Network initiative to the newly named Hospital Improvement Innovation Network (HIIN) initiative.

In this phase, CMS contracted 17 health associations/organizations to lead HIINs and continue the quality improvement efforts from phase one. CMS set two modified goals to meet by 2019:

• Reduce preventable hospital-acquired conditions by 20%
• Reduce 30-day readmissions by 12%

Was the Initiative Effective?

The PfP program set ambitious goals, and the public availability of data from phase two is still quite limited. However, the results published from phase one indicate that the hospital engagement network initiative did lead to some improvements. Within the first three years, CMS estimated about an 8.8% reduction in national harm rates and 1.2% reduction in readmissions.

Some HENs also published their own results. In particular, the American Hospital Association (AHA) reported an estimated reduction of 127,000 patient-safety incidents and more than $1 billion in cost savings across their network. The HEN under the Joint Commission Resources (JCR) also observed significant reductions in several key areas of harm.

Program Downfalls

Despite these results, the PfP program has been critiqued by health experts due to the lack of consistency in how the various HENs/HIINs were executed and measured. The overall effectiveness of the program has been difficult to gauge, and results reported by CMS are somewhat controversial because hospital-specific outcomes aren’t clear. Essentially, much of the data from the PfP program doesn’t appear to have been rigorously analyzed or put to meaningful use.

Below is a broader summary of the notable pros and cons of the program:

Pros

• Promoted more communication between different health organizations and associations
• Provided tools and resources to hospitals that may typically not have funds to access
• Enabled hospitals to learn from one another and adopt more effective practices

Cons

• The quality and comprehensiveness of the program varied between HENs/HIINs
• Limited publicly available information explaining how each HEN/HIIN was led
• Lack of data validating how the initiative actually led to reported outcomes

3 Key Takeaways for Healthcare Facilities

Despite the controversial structure and results of the hospital engagement network initiative, there are some important lessons that facilities can take away from it moving forward.

1. Stay Involved With Your Local Networks

Despite the inconsistencies among different HENs/HIINs, evidence-sharing did lead to noticeable benefits for participating hospitals. While the program is no longer active, it’s not too late to get involved with hospital associations or organizations that were involved in PfP.

If you were a part of any HENs/HIINs, keep in touch with program leaders to learn more ways that your facility can continue this type of collaborative work. If you weren’t, consider joining AHA’s peer-networking forum, which was created for hospitals to sustain communication with one another beyond the program’s existence.

2. Track and Share Meaningful Data to Help Others

Although a goal of PfP was to promote data sharing among hospitals, a lack of data transparency ended up becoming a notable downfall of the program. Moving forward, facilities can learn from this by taking the initiative to share data that contributes to meaningful, wide-scale change.

If your facility has seen significant success from any quality improvement projects, find ways to disseminate these results and help other facilities learn from your efforts. Consider publishing your data in online medical journals or sending your providers/staff to present findings at conferences.

3. Seize Opportunities to Learn From Other Facilities

While there was a lack of consistency among HENs/HIINs, health experts did make an important program-wide observation — hospitals that were more involved within their networks reaped more benefits. Specifically, those that actively attended and engaged in learning events reported observing better patient outcomes by the end of the program period.

So, beyond sharing data with others, it’s important to keep an open mind, learn, and adapt to new practices that are being conducted at facilities delivering high quality care. If there are local meetings or opportunities to engage with other health organizations in your area, take advantage of them because you may discover new care strategies that could help your patients.

Learn More Ways to Collaborate and Improve Care Delivery

Now that you’ve learned about the hospital engagement network initiative, you may be seeking ways to translate the takeaways from this program into practice. Don’t miss out on IntelyCare’s other free guides, strategies, and tips designed to help you improve quality of care.