Have you ever wondered how hospitals work together to improve patient care and safety? Hospital Engagement Networks (HENs) play a critical role in driving quality improvement across hospitals and health systems. In this comprehensive guide, we’ll cover everything you need to know about these important programs.
Buckle up for a fascinating tour through the world of HENs! By the end, you’ll understand what HENs are, how they operate, the impact they have on patient care, and what the future looks like for these networks. Let’s get started!
A Hospital Engagement Network (HEN) is a group or network of hospitals and healthcare providers working together to improve patient health outcomes. The goal is to reduce patient harm and avoidable readmissions through coordinated quality improvement initiatives.
HENs first emerged in 2008 through the Medicare Quality Improvement Organizations (QIOs), which brought together hospitals in various regions to focus on reducing specific types of patient harm.
The HEN model was expanded in 2011 through the Partnership for Patients initiative led by the U.S. Department of Health and Human Services (HHS). This made HENs a cornerstone of national efforts to improve patient safety in hospitals.
HENs are important because they provide a structured way for hospitals to collaborate, share best practices, and rapidly spread quality improvement innovations. By working together, HENs can tackle patient safety challenges and care transitions in a way that individual hospitals cannot.
- HENs are regional networks of hospitals working together to improve patient outcomes and reduce harm.
- They emerged in 2008 through Medicare QIOs and expanded nationally through the Partnership for Patients initiative.
- HENs allow hospitals to collaborate on quality improvement and spread innovations faster.
- Key focus areas for HENs include preventable harm, care transitions, and patient engagement.
- HENs face challenges like ensuring engagement and measuring impact, but remain a crucial strategy for improving care.
Partnership for Patients
In 2011, the Partnership for Patients initiative was launched by the U.S. Department of Health and Human Services (HHS). This ambitious program aimed to drastically reduce preventable hospital harms and improve care transitions.
The goals of the Partnership for Patients included:
- Reducing preventable hospital-acquired conditions by 40%
- Reducing 30 day hospital readmissions by 20%
- Saving up to 60,000 lives
- Avoiding millions of patient injuries
- Saving up to $35 billion in U.S. healthcare costs
To drive progress, the Partnership for Patients dedicated funding to create Hospital Engagement Networks across the country. These HENs were tasked with leading quality improvement and helping hospitals implement best practices to achieve the goals of the Partnership for Patients.
In total, about 3,700 hospitals participated in the first round of HENs from 2011-2015. HENs were seen as a key driver of change under the Partnership for Patients, providing coordination and collaboration to hospitals nationwide.
|Hospital-Acquired Condition||National Improvement 2011-2013|
|Adverse drug events||17%|
|Injuries from falls and immobility||6%|
|Surgical site infections||20%|
Table 1. National improvement on sample hospital-acquired conditions during the first phase of the Partnership for Patients program.
How HENs Work
Hospital Engagement Networks bring together groups of hospitals to work collaboratively on improving healthcare quality and patient outcomes. But how exactly do they operate?
HENs are structured as networks that can function at the national, regional, state, or hospital system level. They provide a forum for hospitals to work together on shared priorities through regular meetings, data monitoring, training programs, site visits, and more.
A major focus of HENs is facilitating peer learning through structured collaboratives. In these collaboratives, hospitals share best practices and lessons learned to rapidly spread quality improvement innovations.
For example, a HEN collaborative might bring together hospitals interested in reducing falls. Hospitals would share their interventions, tools, and experience implementing fall prevention programs. Struggling hospitals can get help and adopt validated practices from top performers.
HENs also promote the use of evidence-based care interventions to address preventable sources of patient harm. Some areas include:
- Surgical complications
- Healthcare-associated infections
- Obstetrical adverse events
- Patient falls
- Pressure ulcers
This peer learning and structured collaboration model allows HENs to tackle entrenched patient safety challenges that cannot be solved by hospitals working alone.
Measures and Data Collection
Hospital Engagement Networks utilize a standard set of process and outcome measures to track hospital progress on quality improvement. This data-driven approach allows hospitals to benchmark their results and focus their improvement efforts.
In the second phase of HENs from 2015-2018, hospitals reported on measures such as:
- Early elective deliveries
- Sepsis management
- Inpatient falls with injury
- 30-day readmissions
- Hospital-acquired conditions like pressure ulcers and surgical site infections
HENs aggregated this data to provide feedback and support to help hospitals hit target goals. Over 1,400 hospitals participated in the second round of HENs.
The Medicare Beneficiary Quality Improvement Project (MBQIP) now continues the HEN model through state-level hospital collaboratives engaging over 2,500 hospitals. MBQIP networks continue to publicly report hospital performance data as well.
Patient Engagement in Hospital Safety
Along with clinical outcomes, Hospital Engagement Networks are also focused on improving patient engagement in hospital safety. Research shows that actively engaging patients and families in the healthcare process can reduce preventable harm.
Strategies HENs promote to support patient engagement include:
- Open communication and hourly rounding by nurses
- Nurse bedside shift reports
- Teach back methods to confirm patient understanding
- Patient family advisory councils
- Post-discharge phone calls
- Providing direct feedback data to patients
Patients are also tapped to participate in some HEN collaboratives and share their stories and perspectives. This focus on patient activation brings an important voice to the table in the drive to improve hospital safety outcomes.
Challenges Facing HENs
While Hospital Engagement Networks play an important role, they also face some key challenges:
Ensuring consistent hospital engagement: With voluntary participation, not all hospitals may fully commit to collaborative initiatives. Larger hospitals with more resources are also sometimes more involved.
Measuring impact: Isolating the impact of HEN collaboratives can be difficult with many factors influencing hospital performance. Standard outcome measures help but don’t tell the whole story.
Sustaining funding: HENs require significant funding and staffing to coordinate networks and learning collaboratives. Some operate through grants or time-limited public funding.
Spreading innovations: While HENs facilitate sharing best practices, it can still be challenging to fully standardize changes across different hospital contexts and settings.
Despite these difficulties, experts believe Hospital Engagement Networks provide value and should remain an important strategy for improving patient safety. Ongoing focus on engaging hospitals, demonstrating results, and optimizing funding continues.
The Future of HENs
What does the future look like for Hospital Engagement Networks?
Many believe HENs will continue evolving as a frontline strategy for improving hospital quality:
- More targeted collaboratives: HENs may narrow focus to specific high-risk procedures, conditions, or regions.
- Specialty networks: Networks of children’s hospitals, cancer centers, or other specialty hospitals could form focused HENs.
- Alternative models: Options like accountable care networks, Medicaid collaboratives, or private sector models may emerge.
- New focus areas: HENs could move into new priorities like behavioral health, opioid use, social determinants of health, and more.
- Advanced analytics: Big data and artificial intelligence tools could enhance measurement, benchmarking, and spread of innovations.
While unknown, the HEN concept shows no signs of going away. Ongoing evolution and adaptation will be key to driving the next generation of improvement.
Hospital Engagement Networks play a vital role in bringing hospitals together to improve patient safety, quality, and health outcomes.
Through collaboratives, best practice sharing, and data-driven improvement, HENs enable hospitals to make progress on entrenched patient safety issues in ways that would be impossible alone.
While challenges like measuring impact remain, HENs have demonstrated their value. They will continue adapting to spearhead new innovations that provide patients with the safe, high-quality care we all deserve.
Frequently Asked Questions
Q: What is a Hospital Engagement Network (HEN)?
A: A Hospital Engagement Network is a network that develops learning collaboratives for hospitals to implement changes and innovations necessary to achieve the Partnership for Patients’ safety and care transitions goals.
Q: What is the Partnership for Patients initiative?
A: The Partnership for Patients initiative is a national initiative to improve patient safety and reduce healthcare-acquired conditions and hospital readmissions.
Q: How do HENs operate?
A: HENs operate at the national, regional, state, or hospital system level to develop learning collaboratives for hospitals to implement evidence-based interventions.
Q: What other forms of preventable patient harm do HENs address?
A: HENs are expected to address all other forms of preventable patient harm in pursuit of safety across the board.
Q: What measures do HENs use to track hospital progress on quality improvement?
A: HENs use appropriate process and outcome measures for each area of focus to track hospital progress on quality improvement.
Q: How many hospitals are supported by HENs?
A: HENs support approximately 3,400 hospitals during a 12-month period of performance.
Q: What is patient engagement in hospital safety?
A: Patient engagement in hospital safety involves strategies to support patient and family engagement in promoting safe care in the hospital.
Q: What are some strategies to support patient and family engagement in promoting safe care in the hospital?
A: Strategies include allowing patients and families to summon rapid response teams, interventions that explicitly include patient and family engagement, and the use of electronic medical records.
Q: What are some challenges faced by HENs?
A: Challenges include predicting the level of patient and family participation, and the emotional burden placed on patients and caregivers to ensure safety while hospitalized.
Q: What is the future of HENs?
A: HENs will continue to play an important role in improving patient safety and care transitions.