5/7/2014 0 Dis Disclo losur sures: s: The planners and - - PDF document

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The Indiana University School of Nursing Center for Professional Development and Lifelong Learning is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission of Accreditation.

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Dis Disclo losur sures: s: The planners and presenters of this activity disclose no conflicts

• f interest or relevant financial relationships related to this

activity No commercial support or sponsorship was received for this educational activity. In order to receive 1.0 contact hours for this activity, participants must attend the webinar and complete the electronic evaluation that will be provided via email after the webinar offering.

Orienting to Adobe Connect Room Orienting to Adobe Connect Room

On the left side of your screen, you will see several “pods” .

• “Q&A” is for submission of questions about the

presentation content. Dr. Case Di Leonardi will answer questions at the end of the webinar, but all questions may not be addressed depending on time.

• “Files” includes a copy of the powerpoint presentation as

well as the ROI worksheet for download/print /review.

• “Weblinks” At the end of the presentation, the evaluation

link will be found in a weblinks pod on your screen. This pod is not visible now.

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Not everything that can be counted cou counts ts. Some things that cou count cannot be counted.

Impact Outcome Content Process

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ROI Impact Outcome Content Process

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ROI Fiscal Outcomes Impact: Patient, Staff, Organizational Outcomes Outcome Performance Outcome Content Learning Outcome Process

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ROI Impact Outcome Content Process

Lindy & Reiter, 2006 Olson-Sitki, et al, 2012 Trevanier, et al., 2012 Return On I nvestm ent

benefits- costs X 1 0 0 = % ROI costs

Benefit/ Cost Ratio ( BCR) = Total Benefits Costs

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Measurability

Relevance to Stakeholders High Low Easy Difficult

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ROI Impact Outcome Content Process

The Process Piece

• What are the questions?
• How do they like it?
• They = participants, instructors, managers, all
• thers affected including interprofessional

personnel

• Where are the answers?
• Survey, oral, written, online,

quality/performance improvement data

• Responses to communications about the

learning activity or initiative

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The Content Piece

• What are the questions?
• Can the participants do the objectives after the

learning activity?

• Are staff members ready to implement the

initiative (access to info, supplies, equipment, protocol)?

• Where are the answers?
• Post test, demonstration, simulation, game,

round robin

• Mock/dry run performance

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ROI Impact Outcome Content Process

The Outcome Piece

• What are the questions?
• Are the participants doing the objectives of

the learning activity in practice?

• Are staff members performing their roles in

the initiative?

• Where are the answers?
• Observation, audits, documentation, manager
• bservation, quality/performance

improvement data

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ROI Impact Outcome Content Process

The question for the future is not “What do you do?” Or “How do you do it?” But rather, “What difference have you made?”

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Baseline Collected

• ver 3 months

After 3 months of simulation 3 months post- simulation

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• Wh

What at ar are th e the q e question tions? s?

• So

So w what?

• Wh

What or at organization tional al goals als ar are e aff affect cted ed?

• Wher

ere ar e are th e the e an answer ers? s?

• Inci

Incide dent nt repo ports, rts, i infecti ction c n contr ntrol r repo ports, rts, qua quality mo moni nito tori ring ng results, s, c core mea measur ures es an and HC HCAHP AHPS resu sult lts s

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ROI Impact Outcome Content Process

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Med E

Erro rors rs

LO

LOS

Falls

lls

Inf

Infecti ctions ns: C : CLAB ABSI, SI, C CAUTI, UTI, s surgical site te

Ho

Hosp spital A ital Acquir ired ed Condition itions

Staff T

Staff Turno rnover

Patient S

tient Satis tisfaction, action, HC HCAHP AHPS

Co

Core Mea Measur ures es

Staff Mo

Staff Morale le

NDNQI

NDNQI

Collab

llaboration tion

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Baseline Collected over 3 months After 3 months

• f simulation

3 months post- simulation

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Baseline Collected over 3 months After 3 months

• f simulation

3 months post- simulation

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Baseline Collected over 3 months After 3 months

• f simulation

3 months post- simulation

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Baseline Collected over 3 months After 3 months

• f simulation

3 months post- simulation

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Baseline Collected over 3 months After 3 months

• f simulation

3 months post- simulation

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The ROI Piece

• Wh

What at ar are th e the q e question tions? s?

• Was it

s it worth rth it? it?

• Ho

How w much much di did i d it c cost? st?

• Ho

How w much much di did i d it g gene nerate te a and/ d/or av avoid? d?

• Wher

ere ar e are th e the e an answer ers? s?

• Wage and

and salar salary of EVER

• f EVERYONE

NE

• Costs o

s of su supplie lies an s and eq equipmen ent t – for

• r

ed education ation an and f for imp r implemen ementation tation

• Patien

tient b t billin illing/ g/ac accounts s payable

• Institu

itute f e for r He Health althcare Improvemen ement t (I (IHI HI) ) imp improvemen ement s t storie

• ries
• Li

Lite teratur ture

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ROI Impact Outcome Content Process

Beecroft et al., 2001; Contino, 2002; Jones, 2008; RWJF, 2006 31

Baseline Collected over 3 months After 3 months of simulation 3 months post- simulation

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• COST o
• f t

training aining

• ALL personne

nnel l in involv lved (salar alary and and b bene nefit fits)

• Cost o
• f s

simulat lator and and all all materials als

• COST o
• f re

record rd ke keeping

• ALL personne

nnel l in involv lved (salar alary and and b bene nefit fits)

• COST - diff

ifferenc nce between cost of t this is t training aining and and c cost of p previo ious us ap approach ch

• BENEFIT -
• difference

e betw between een rate o te of su successful resu suscitation pr pre- e- and d po post- th this tr training

• BE

BENE NEFIT FIT? d diff fference in in cost o

• f r

resuscit itat atio ion? n?

• Not

t qu quanti tifi fiable i in $$ $$

• Lives s

s saved d – insurance ta tabl bles, bu but n t not a t a savi ving to to th the or e organizati tion

• n
• Staff me

ff membe mbers’ s’ confi nfidence

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• COST =

= di differ eren ence betw between een cost of th this tr training and c d cost of pr previous a appr proach

• BENEFIT =

= di differ eren ence betw between een rate o te of su successful resu suscitation pr pre- e- and d po post- th this tr training

• COST = $5

= $500 00 mor more per s r staff aff me memb mber = $5 = $500 00 X 1 178 = = $8 $89,000 000

• BENEFIT

BENEFIT = = Diff Difference PRE PRE = 1 = 10% = = 1/1 1/10 p patie tients and ts and PO POST = 18 = 18% = = 2/11 2/11 RO ROI

• For a cost

cost of

• f $

$89,000, our s successf ccessful r resusc scitation ra rate i increa ease sed 8%

• Staff

aff member c confid nfidence and and int interprofessio ional nal cooperat atio ion n incr increased (r (ratings)

• Possib

ible le s saving ngs o

• n supplie

lies us used in in resuscit itat atio ion

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Hard Data Soft Data The Cost

• f NOT

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CAUTI Prevention

– Many stakeholders “care” – Data is readily available – Bite off a piece that we can chew: nurse- driven protocol for catheter removal

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Compare costs:

– CAUTI pre-intervention with CAUTI post- intervention – Catheter days pre-intervention with catheter days post-intervention

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Baseline = 7 CAUTI/Quarter First quarter after full implementation = 1 CAUTI

Compare: 7 X $800 = $5,600 with 1 X $800 = $800 We saved $4,800!! BUT, how much did it cost us?

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Developing and Implementing Training Educator X 10 hours = $40 X 10 = $400 RN Training 20 RNs X 30-minute training session = 20 X ½ ($32) = $320 Training Costs = $720

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• 1. (4800-720) x 100 =

720

• 2. 4080 x 100 =

720

• 3. 5.7 x 100 = 570% ROI

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Compare costs:

– Traditional preparation of new grads – Savings generated from a decrease in new grad turnover and actual contract labor cost

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SAVINGS = $48,908,750

– Decreased turnover = $15,228,000 – Contract Labor Savings = $33,680,750

ADDITIONAL COSTS = $7,053,040

– Residency costs = additional $13,460 more per RN than traditional

• rientation

– 524 new grads X $13,460 more than traditional orientation = $7,053,040 ROI = Benefits – Costs X 100 = % ROI $48,908,750 - $7,053,040 = 5.93 X 100 = 593% $7,053,040 And savings of $10 - $50 per patient day 44 Costs

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Compare costs:

– Traditional preparation of new grads and 50% turnover – Residency preparation of new grads and 13% turnover.

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To Total C Cost Total C l Cost per per Resident sident Replac placement C ement Costs

Turnover

– Costs related to recruitment, – Replacement through

• vertime,

– Employee orientation – Lost productivity – Customer satisfaction

• Vendor fee
• Vendor training fee
• Resident salary post-
• rientation
• Catering
• Faculty salary
• Replacement cost

(during sessions)

46 Net Program Benefits = Benefits – Costs Benefits = (Cost of 50% turnover minus Cost of 13% turnover) minus Cost of 13% turnover Costs = Total Residency Costs (Could have used Difference between this residency and the old way) Net Program Benefits X 100 = % ROI Costs Net Program Benefits = $1,098,240 - $274,560 = $823,680 $823,680 X 100 = 884.7% ROI $93,100 47

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Costs Hard Benefits Soft

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