Evidence-Based Medicine Group (the fruit group) (the fruit group ) - - PDF document

Evidence-Based Medicine Group (the “fruit group”) (the fruit group )

December 18, 2009

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Participation

44 out of 45 blood banks = 98% participation rate! = 98% participation rate!

• Participation Pledge
• Baseline Data
• Conference calls attendance

W b it i t ti

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• Website registration

Blood Wastage Collaborative Website

Tools for the following:

• Collect monthly metrics

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• Provide monthly reports

comparing to state performance

• Share best practices

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Reducing Discarded Platelet Units

Champion: Barb Epke/Bill Minogue/Chip Davis

Project Charter

Revised: 12/11/2009 Project Leader: Page Gambill/Donna Marquess

Problem Statement Project Goal

Reduce platelet wastage by a minimum of % by July

A significant number of apheresis platelet units are prepared per physician request and then not transfused. There is a short shelf life and

Measurement Methodology Scope

p g y _____ y y 2010 across the participating hospitals in Maryland Unit = one unit of apheresis platelets (6 EU)

the units are often discarded. The result is fewer units available for patients which compromises patient safety. There is also a financial impact due to the high product cost.

• 44 Blood Banks in Maryland
• Blood suppliers

U t

• e u t o ap e es s p ate ets (6

U) % Waste = # platelet units wasted Total # of platelet units purchased (Do not include partial units as wasted.)

• Increased blood inventory available for patient care
• Cost credit for transferring out short dated platelets
• Reduction in costs to acquire additional platelet products

Benefits Participating Organizations

• 44 Blood Banks out of 45 in Maryland
• 2 Blood suppliers

Reduction in costs to acquire additional platelet products

Phase Date Comp Milestones

• Pre work completed - prior to 07/22/09
• Sign off on project charters - 07/22/09
• Conference call follow-up – 8/21/09
• Kickoff – 9/22/09
• Collect baseline data and launch interventions – 10/15/09
• Create Collaborative Website -11/02/09

Define Measure Analyze Improve Control

07/22/09 6

State Blood Wastage Results

Platelets Platelets

Baseline Year Average % Wasted

9.00%

% Wasted for State Baseline Year vs. Current Year g % = 7.09%

5 00% 6.00% 7.00% 8.00% 9.00% 1 00% 2.00% 3.00% 4.00% 5.00% Baseline Year Current Year 0.00% 1.00%

Baseline Year

Month-Year T l U i W d Total Units Wasted Total Units Collected/ Purchased % Wasted

State Blood Wastage Results

Platelets

Cumulative Units Saved for State Sep 09 Current Cumulative $s Saved for State

Platelets

100 120 140

Sep 09--Current

50000 60000 70000

Sep 09--Current

20 40 60 80 10000 20000 30000 40000 Sep-09 Oct-09 Sep-09 Oct-09

Sep‐09 Oct‐09 Predicted units wasted 286 287 Actual units wasted 227 231 Cumulative units saved 59 115

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Cumulative units saved 59 115 Cumulative $s saved $29,938 $58,355

State Blood Wastage Results

Plasma Plasma

Baseline Year Average % Wasted

7.00%

% Wasted for State Baseline Year vs. Current Year g % = 5.12%

4.00% 5.00% 6.00% 7.00% 1.00% 2.00% 3.00% 4.00% Baseline Year Current Year

Baseline Year

0.00% 1.00% Current Year

Baseline Year

Month-Year Total Units Wasted 9

• a U

s as ed Total Units Thawed % Wasted

State Blood Wastage Results

Plasma Plasma

Cumulative Units Saved for State Sep 09--Current Cumulative $s Saved for State Sep 09--Current

• 10
• 5

5 Sep-09 Oct-09 500 Sep-09 Oct-09

• 30
• 25
• 20
• 15
• 1500
• 1000
• 500
• 40
• 35

Sep‐09 Oct‐09

• 2000

Predicted units wasted 339 319 Actual units wasted 373 283 Cumulative units saved 34 2

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Cumulative units saved ‐34 2 Cumulative $s saved ($1,866) $110

Total Units Saved for State: 2 Months Total Units Saved for State: 2 Months

• Platelets = 115 units

Platelets 115 units

• Plasma = 2 units
• Allo Red = -19 units

Allo Red = -19 units

• Auto Red = -39 units

Total Units Saved = 59 units = 59 units

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Total $s Saved for State: 2 Months Total $s Saved for State: 2 Months

• Platelets = $58,355

Platelets $58,355

• Plasma = $110
• Allo Red = ($4 557)

Allo Red = ($4,557)

• Auto Red = ($13,800)

Total $s Saved = $40 108 = $40,108

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Next Steps for Blood Wastage Collaborative

• BWWG will

– make quarterly reports on the state aggregate blood wastage data to MHQCC to MHQCC – coordinate quarterly follow-up calls with all participants to discuss best practices and data submitted schedule an in person conference in Spring 2010 – schedule an in-person conference in Spring 2010

• Website enhancement— “Craig’s List” for expired products

– allows blood banks to post soon-to-be expiring inventory and to access to see what is available during emergent situation ***BWWG recognizes the importance of regulatory/liability issues, g p g y y , and is in the process of investigating these issues.

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Recaps and Updates

• Statewide Hospital Hand Hygiene Campaign adopted by Council on June

10, 2009

• Letter from Secretary Colmers requesting recommendations from the

MHCC HAI Advisory Committee on Statewide Hospital Hand Hygiene Initiative

• Creation of Governance Structure

– Steering Committee – Expert Panel Work Group – Work Group

• Launch of the Maryland Hospital Hand Hygiene Collaborative
• Kick-off meeting - Nov. 3, 2009
• Program resources developed and disseminated - Nov 2009
• Webinar series

1) Standardized observer training - Nov 18, 2009 2) Data submission and web reporting - Dec 2, 2009 2) Data submission and web reporting Dec 2, 2009

• Regular communication with and among hospital participants

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Program Builds on Existing Strengths and Structures g

• Department of Health and Mental Hygiene

Governing body

• Maryland Patient Safety Center & Maryland Hospital

Association Experience with Hospitals

• Delmarva Foundation

Logistical Coordination of Statewide Collaboratives

• MHCC HAI Advisory Committee

Expert Panel J h H ki M di i

• Johns Hopkins Medicine

Program and Implementation Experience

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Maryland Hospital Hand Hygiene Collaborative Kick-Off Meeting - Nov 3 2009 Kick-Off Meeting - Nov. 3, 2009

Participation:

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Participation: 200+ attendees from over 40 acute care and specialty care hospitals

Press Coverage

Participation as of 12/10:

44 out of 47 acute hospitals p

= 94% participation !

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Kick-Off Meeting Agenda

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Collaborative Website

http://www.marylandpatientsafety.org/html/collaboratives/hand hygiene http://www.marylandpatientsafety.org/html/collaboratives/hand_hygiene

Resources

• Toolkit

li k t b t i i

• link to observer training
• link to data submission

and web reporting

• FAQs
• Webinar recordings

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Webinar 1: Standardized Observer Training

Participation: 97 attendees

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Webinar 2: Data Submission and Web Reporting handstats org handstats.org

Participation: 77 attendees

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Two Forms of Data Submission

mobile device vs. desktop PC

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Feedback Reports for Individual Hospitals

Hospital Level Graphs Service Level Graphs Unit Level Graphs p  Performance over time  Benchmarking against  Benchmarking against

• ther services/units

 Compliance by Health Care Worker type

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Feedback Reports for MHQCC

Hand Hygiene Compliance across the State

State Hand Hygiene Compliance (Jan '10--current)

60.00% 70.00% 80.00% 90.00% 50.00% 60.00% 70.00% 30.00% 40.00% 50.00% 10.00% 20.00% 30.00% 40.00% 0.00% 10.00% 20.00% 0.00% 2010 Jan Feb Mar Apr May Jun Jul Aug Sep Oct 26

State Average

Ti li Timeline

• Monthly data submission—starting from

Jan 2010

• Continued Engagement with Hospitals

– Quarterly “Learning Sessions” y g – Monthly Sharing Calls – In-Person Conference in Spring 2010 p g

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Potential “Fruit*” Seeds

• Red Bag Trash
• Expand Hand Hygiene beyond Acute Care

Expand Hand Hygiene beyond Acute Care Hospitals

• Checklist
• Checklist

– BSI SSI – SSI – VAP

• Safety Dashboard
• Explore Projects in Collaboration with Payors

p j y

* Short term, quick wins

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Discussion Discussion