Tennessee Center for Patient Safety
TCPS Recognizes These Hospitals for Excellence in Complete Data Submission for 2017 Baptist Memorial Hospital-Calhoun Lonesome Pine Hospital Baptist Memorial Hospital-Collierville Milan General Hospital Baptist Memorial Hospital - Memphis Mountain View Regional Medical Center Baptist Memorial Hospital-Golden Triangle NorthCrest Medical Center Baptist Memorial Hospital-NE Arkansas Southern Tennessee Regional Health System- Baptist Memorial Hospital-Union City Lawrenceburg Bristol Regional Medical Center Southern Tennessee Regional Health System- CHI Memorial Hospital-Chattanooga Pulaski CHI Memorial Hospital-Hixson Sumner Regional Medical Center Henry County Medical Center University of Tennessee Medical Center Holston Valley Medical Center Wayne Medical Center Jackson-Madison County General Hospital Williamson Medical Center Livingston Regional Hospital
Center Staff • Chris Clarke, Sr. VP, Clinical and Professional Practices • Patrice Mayo, VP for Operations • Jackie Moreland, Clinical Quality Improvement Specialist • Rhonda Dickman, Clinical Quality Improvement Specialist • Janet Meadows, Clinical Quality Improvement Specialist • Jennifer McIntosh, Clinical Quality Data Manager • Amanda Chumley, Project Manager, PSO and TSQC • Teresa Benedetti, Executive Assistant 3
Tennessee Center For Patient Safety THA Board Strategic Aim: Zer Zero o Pr Preven enta table ble Har Harm 4
Leadership Commitment • Transparency and Accountability – Hospital-specific comparison data shared at THA Board meetings • Data posted on TCPS Report Distributor – Board level peer-to-peer presentations – CEO Leadership Scorecards
Tennessee Center for Patient Safety • Program Areas: – CMS Partnership for Patients • Hospital Improvement Innovation Network (HIIN) – Tennessee Surgical Quality Collaborative • Enhanced Recovery After Surgery – OB/ Maternal Care Programs with TDH • Early Elective Delivery, Breastfeeding Promotion, Safe Sleep – THA PSO Program
TCPS Strategies and Offerings • • AHRQ Culture of Safety Survey Professional peer networking and coalitions • TCPS Regional Education – Sepsis Coordinators Meetings coalition • Mentors program and peer – Care Transitions sharing coordinators coalition • Site visits to HIIN hospitals and – Pharmacy coalition health systems • – Patient and family advisors Medication Safety Summit • • Sepsis Collaborative and Tennessee Surgical Quality Consultations Collaborative • • Patient/Family Engagement SNAP Breastfeeding/OB initiatives • • Health Equity Summit THA Leadership Summit • Workplace Resilience Webinar Series
Core HIIN Topics • • Adverse Drug Events (ADE): Pressure Injuries – glycemic management, • Readmissions opioid safety, anticoagulant • Sepsis safety • Surgical Site Infections (SSI) • Catheter-Associated Urinary • Venous Thromboembolism (VTE) Tract Infections (CAUTI) • Ventilator-Associated Events (VAE) • Central-Line Associated Blood • Worker Safety Stream Infections (CLABSI) – Patient Handling Injuries • Clostridium difficile (C. diff ) – Workplace Violence Incidents • Falls with Injury • Culture • Methicillin-Resistant Staph • Patient and Family Engagement Aureus (MRSA) • Elimination of Disparities
Adverse Drug Events • Voluntary data collection and reporting by hospitals • No national standardized measures • CMS proposing new eCQM measures on harm – Hypoglycemia, opioid-related adverse events, hospital-acquired pressure injury, and acute kidney injury – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment- Instruments/MMS/PC-Currently-Accepting-Comments.html – Comment period extended to March 2, 2018
2018 Quality and Safety Priorities • Areas of focus based on performance gaps – Adverse Drug Events – opioids, anticoagulation, hypoglycemia – Sepsis – MDROs – MRSA and C-difficile • Request all THA members collect and report to THA on adverse drug event measures, falls and pressure injuries • Share hospital – specific data with THA Board on ADEs and other voluntary measures
2018 Quality and Safety Priorities • Cross-Cutting Strategies for Hospitals – Quality boot camp for hospital leaders – Infection control boot camp – UP campaign – Surgical ERAS/ISCR protocols – Workforce resilience webinars – Patient and family engagement – Health equity and addressing disparities
2018 Quality and Safety Priorities Partnership Programs • Tennessee Department of Health – Healthcare Infection Targeted Assessment and Prevention (TAP) strategy – Antibiotic Stewardship • Tennessee Departments of Health and Mental Health – “Tennessee Together” Opioids Plan • Collaborative on Prevention of Opioid Addiction • Enhanced access to treatment services
Opioid Epidemic Update
Governor’s Plan TN Together Prevention Treatment Law Enforcement Increases state funding to Limits initial prescriptions Provides over $25 million in address illicit sale and to 5-day supply state/federal funds trafficking of opioids Commission to address evidence-based Updates the controlled competencies for medical Extends peer recovery substance schedules to and health practitioner specialists to targeted, high- address fentanyl schools need emergency rooms analogues Collaborative to implement best practices around pain Expands TennCare access to Provides state troopers management recovery services with Naloxone Creates public/private Public awareness campaign treatment collaborative Treatment and recovery Education for elementary options tied to legal system and secondary schools and corrections Prevention of Neonatal Abstinence Syndrome
TDH Opioid Prevention – Provider/Prescriber Collaborative • Develop a multi-stakeholder collaborative to identify the most significant interventions to decrease opioid abuse and support evidence-based interventions for statewide quality improvement • Four focus areas identified at opioid conference last fall – Prescriber Education – Patient Education – Perioperative Pain Management – Emergency Department • Funding for 1 year in Governor’s budget proposal
Opioid Light ED Pilot • Enlist interested facilities in reducing opioids used to treat patients in Emergency Department • Baptist Memphis staff serving as expert faculty • Six-month pilot • Aim to reduce opioid use in the ED by 40% through use of five pain pathways • Multi-disciplinary hospital teams (physicians, pharmacists, nurses) • Developing toolkit and resources • Launch April 26th at THA Medication Safety Summit
Opioid Abuse Prevention Strategies • Perioperative Pain Management – Spread implementation of Enhanced Recovery After Surgery (ERAS) protocols with emphasis on reduction in opioid use for perioperative pain – Vanderbilt Colon ERAS project has decreased opioids by 50% with lower complications, shorter length of stay and lower costs – Goal to decrease post-operative opioid prescribing by 40% by 2019 – TSQC and TN ACS as possible leaders
Opioid Abuse Prevention: Perioperative Pain Management • Tennessee Surgical Quality Collaborative – 22 hospitals that participate in ACS NSQIP – ERAS project focus for 2017/2018 • AHRQ funded Improving Surgical Care and Recovery (ISCR) project – American College of Surgeons/ John Hopkins faculty – Open to ANY hospital at no cost – Cohort 2 starts in March focused on orthopedics – TCPS hosting regional meeting of hospitals April 19 th – Future cohorts on gyn surgery, bariatrics and emergency surgery
TCPS Resources for Hospitals • IHI Open School for Health Professions -Free access • TCPS Weekly Newsletter • TCPS Website http://www.tnpatientsafety.com • TCPS Report Distributor – Data feedback and comparisons – CEO Scorecards and Board data slides
Upcoming Events • Workforce Resilience Webinar Series with Dr. Bryan Sexton ─ Offered monthly • THA Medication Safety Summit ─ Thursday, April 26, 2018 • Breastfeeding Workshop ─ Friday, May 4, 2018
Upcoming Events • Sepsis Readmissions Summit ─ Wednesday, May 9, 2018 • Health Equity Conference ─ Thursday, May 17,2018
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