FHA MTC HIIN Lead Quarterly Virtual Meeting April 30, 2018 Todays - - PowerPoint PPT Presentation

FHA MTC HIIN Lead Quarterly Virtual Meeting April 30, 2018

• Welcome and Overview for today’s HIIN Lead Virtual Meeting
• HIINgagment and HIINaction
• Florida’s Success, Opportunities and Line of Attack
• WishHIIN List

Today’s Agenda

Our Progress

Source: HRET Improvement Calculator, effective date April 2, 2018

Data as of 04/02/2018 Harm Measure Most Recent Month Reported To Date Relative Reduction HIIN Goal Status (1) Cost Savings Harms Prevented Lives Saved ADE Anticoag (ADE-1a) 2018 02 (Feb)

• 32.78%

Achieved $5,175,602 1,035 114 ADE Hypo (ADE-1b) 2018 02 (Feb) 8.52% Worsening ($8,968,393) (1,794) (197) ADE Opioid (ADE-1c) 2018 02 (Feb)

• 12.85%

Making Progress $3,663,375 733 81 CAUTI CAUTI Rate - All Units excl NICU (CAUTI-2a) 2018 02 (Feb)

• 15.23%

Making Progress $149,337 149 15 CLABSI CLABSI Rate - All Units (CLABSI-2a) 2018 02 (Feb)

• 24.89%

Achieved $4,044,600 238 43 Falls Falls with Injury (FALLS-1) 2018 02 (Feb)

• 13.82%

Making Progress $6,413,644 495 MRDO MRSA Rate (MRSA-2) 2018 03 (Mar)

• 2.22%

Making Progress $82,774 11 3 Pressure Injuries PrU Prevalence, Stage 2+ (PrU-2) 2018 02 (Feb)

• 15.23%

Making Progress $3,904,459 230 SSI Rate, Colon (SSI-2a) 2018 03 (Mar) 6.35% Worsening ($868,326) (41) (1) SSI Rate, Abd Hyst (SSI-2b) 2018 02 (Feb)

• 20.40%

Achieved $694,379 33 1 SSI Rate, Hip (SSI-2d) 2018 02 (Feb)

• 24.48%

Achieved $1,266,197 60 2 SSI Rate, Knee (SSI-2c) 2018 02 (Feb)

• 23.65%

Achieved $962,726 46 1

• c. difficile rate
• C. diff rate (CDI-1b)

2018 03 (Mar)

• 33.70%

Achieved $15,566,962 1,557 100 Post-operative sepsis Post-Op Sepsis Rate (Sepsis-1a) 2018 02 (Feb)

• 8.09%

Making Progress $653,976 38 10 Ventilator-Associated Condition VAC (VAE-1) 2018 02 (Feb)

• 12.50%

Making Progress $4,163,830 198 77 Post-Op. Pulmonary Embolism or Deep Vein Thrombosis Post-Op VTE (VTE-1) 2018 02 (Feb)

• 18.63%

Making Progress $1,532,988 192 29 All Cause 30-Day Readmissions All Cause 30-Day Readmissions (READ-1) 2018 02 (Feb)

• 0.93%

Making Progress $16,452,889 1,063 Total $64,727,739 6,077 475 ADE SSI

• Hospital Successes, Challenges and Asks

HIINgagement

Florida Hospital Fish Memorial: Strategies for Reducing CDI and Post-Op Sepsis

Veronica Pichardo PT Safety/PSO liaison Florida Hospital Fish Memorial Office of Clinical Effectiveness

April 30, 2018

Lee Health: Certified Zero Award

Marilyn Kole, MD, MBA Alex Daneshmand, DO, MBA Cora Murphy, MSN, RN-BC, CNL April 30, 2018

What is the Certified Zero Award

9

Purpose:

The award is part of Lee Health's efforts to support the creation and sustainment of highly reliable care- care that is dependable, high quality, and safe over a long period of time

Zero Harm Together

Award Eligibility

10

Children's Hospital Units:

• CLABSI free for 12 consecutive months

Lee Health Adult In-Patient Units:

• CAUTI and CLABSI free for 12 consecutive months

* Once recognized, units are re-eligible once they have met an additional 12 rolling months

How it Works

11

• Initiated:

March 2017 (Children’s Hospital) May 2017 (Adult campuses)

• What Units:

1 Unit: Golisano Children’s Hospital & 13 Adult Units

• Each unit receives :
• 1. Framed Certified Zero Award
• 2. Pizza luncheon (day/night)
• 3. Recognition of unit director, VP/ACMO, senior leaders

Other recognition: Teaming Update, Medical Staff Matters, Nursing Matters, SafeLee Website

Certified Zero winners were asked:

How did you achieve the Certified Zero?

• Transparency on how many lines do we have. Do we really need

each line? Addressing each line every day

• Create a banner of how many days the team has achieved

CLABSI or CAUTI free

• Every morning, ask the physicians, can we pull the line without

any repercussion

• Physician-nurse rounding- It is important that the charge RN call

the physician on service and review the plan of the care daily

Certified Zero Winners were asked:

How did you make prevention important to the staff??

• Make it personal and create ownership
• Create accountability and empowerment of the staff
• Make it important and make it consistent- daily follow up
• Having a questioning attitude with providers
• Share results and engage the physicians

Certified Zero Winners were asked:

How do you make harm visible?

• Banner on the unit should be visible to everyone including

patients and their families

• Real-time feedback
• Share safety story in huddles/meetings

Tracking log

16

First Recipients

17

CPCU Director: Beth Thacker

Thank You

18

What do YOU and YOUR TEAMS need to meet the 20/12 Goal?

HIINaction - UP Campaign

January-March 2018 April-June 2018

• Eliminate sitters-train staff to mobilize patients
• Progressive mobility prevents harm-Optimize mobility in

bed or chair

• Interdisciplinary collaboration in mobility program
• Decrease medication risk to mobilization
• Appropriate/adequate supply of equipment is key
• Paradigm shift-progressive mobilization instead of falls

prevention

• Start with small tests of change

GET UP Take Aways

GET UP Poster

• Make it easy to do the right thing, but avoid “Uboxia”

Airway assessed Labs reviewed Past medical history reviewed Pain discussed

• Take advantage of PAT visits to discuss pain expectations
• Do not allow “routine reversals” using naloxone

– Where will the patient most likely be when the naloxone wears off?

• Create hard stops for orders that contain both benzodiazepines and opioids

– Did you know that situational delirium leads to dementia?

• Combine sedation level assessment with pain assessment

– If these two scores do not give you a clear picture, use end-tidal capnography as the umpire

• Ask about their comfort level, prior to asking about pain, do they match?

– Provide alternatives to ease anxiety and pain; What would you do at home?

• Ensure that leadership is aware of the actual culture

WAKE UP Take Aways

HIIN SafeCulture Project

Why Participate?

• Measure with Ease

(Survey Portal uses AHRQ’s HSOPS)

• Improve Response

Rates

• Quick Access to

Results & Analysis

• Comparison to U.S.

& FL hospitals

(AHRQ 2018 National Benchmarks)

May 7th (2-3pm ET)

Patient and Family Engagement

• 21% increase in HIIN hospitals reporting Patient

and Family Advisory Councils

• Coaching calls: providing support on PFAC

sustainability, establishment, and expansion

• Upcoming ‘Best Practice Webinar Series’
• Pending national research assessing the positive

correlation of performance on PFE metrics and improved quality

FHA Patient and Family Engagement (PFE) Learning Collaborative Providing hospitals with tailored resources, coaching calls, site visits, monthly newsletters, webinars and more.

May-August Jupiter – May 17 Orlando – May 23 Pensacola – June 15 Other areas - TBA Review the latest data Share individual hospital strategies to reduce readmissions Identification of common barriers Action planning

Readmissions Discussion Forums

This Photo by Unknown Author is licensed under CC BY-NC-SA

• FHA MTC small test of change
• One day program—5-7 contact hours
• Customizable program based on needs of

interested hospitals and on the participant skill level (RN, LPN, Physical Therapist)

• Designed for the inexperienced or novice provider
• Primary focus on wound assessment and bariatric

wound and skin care

– Please complete the survey at the end of webinar.

WOUND CARE TRAINING

• Team STEPPs training
• Subject Matter Expert Resources
• SCRIPT UP
• Other ideas (group discussion – all lines OPEN)

OTHER ACTIVITIES IN THE WORKS

FHA New Initiative: EDIE Emergency Department Information Exchange

• FHA Statewide Initiative
• Provides real-time data
• n patients
• Used in 18 other states
• Results:
• Prevented readmissions
• Identified patients with
• pioid seeking behavior
• Reduced non-emergency

ED visits

• Learn more:

May 11, 2018 – 10 am ET [Webinar]

Future Planning: Tell us about the resources you would you like FHA to offer…

• Lean training
• TCAB
• Sepsis training for all provider

types

• Other ideas (group discussion)

In-Person Meetings: – WAKE UP to Protect Patients from Oversedation June 12, 2018: FHA Corporate Office, Orlando, FL June 14, 2018: Sacred Heart Hospital, Pensacola, FL – SAVE THE DATES! May-August | Readmissions Discussion Forums May 17, 2018: Jupiter Medical Center, Jupiter, FL May 23, 2018: FHA Corporate Office, Orlando, FL

• Jun. 15, 2018: Pensacola, FL

Other Areas to be Announced [Regional invitations and registration details coming soon] – NHSN Training (to be announced for this Summer) – Wound Care Seminar (to be announced) Virtual Events: May 1 | FHA HIIN - CDI in the Pediatric Population May 3 | FHA IVAC Bi-Monthly Webinar #2 May 3 | HRET HIIN NHSN CDI Surveillance Definition Review May 7 | FHA HIIN SafeCulture Offering: Informational Webinar May 8 | HRET HIIN Readmissions Sepsis Fishbowl Series: 2 May 8 | FHA HIIN Chasing Zero Infections MRSA Coaching Call

Upcoming Events

Check your HIIN INFO Upcoming Events Weekly Email for details and registration

We are here to help! HIIN@fha.org 407-841-6230 SAVE THE DATE! Next HIIN Lead Quarterly Virtual Meeting July 30, 2018 11am ET

Contact Us