Driving Safer Careqioprogram.org/sites/default/files/editors/141/QINNCCNationalLANC… · 2/08/2016...
61
1 National Learning & Action Network Sharing Knowledge, Improving Health Care Series August 2, 2016 Driving Safer Care
Transcript of Driving Safer Careqioprogram.org/sites/default/files/editors/141/QINNCCNationalLANC… · 2/08/2016...
1
National Learning & Action Network
Sharing Knowledge, Improving Health Care Series
August 2, 2016
Driving Safer Care
2
Welcome and Reminders
• Cathy Maffry, from the QIN NCC, will be monitoring our WebEx CHAT board
•
Brianna GassQIN NCC
Please be prepared for sharing and open discussion!
• Slides and a recording from today’s session can be found on: http://qioprogram.org/national-learning-action-network-series-august-2016
3
Agenda
• Continuing Education Details • Speaker Presentations
• Melissa Dorsey, MHA, Centers for Medicare & Medicaid Services
• Carole Moss, Nile’s Project• Dr. Jason Newland, St. Louis Children’s Hospital &
Washington University• Facilitated Discussion• Wrap-up
4
Purpose of the Series
Audience: Patients, community and health care providers, local partners, federal partners and Quality Improvement Organization Program partners (*registration required)
Purpose: Offer virtual training events focused on health care quality improvement and hot topics in health care delivery transformation, and connect these national themes with related local services, resources and support available through the QIO Program
Expectations: Participants will gain knowledge that is directly applicable to their work in health care quality improvement and acquire information that can be easily shared among their own community, organization, or team
Topics: Topics will be aligned with the CMS Quality Strategy goals
5
Learning Outcome
• The purpose of this session is to prepare healthcare quality improvement professionals to implement effective and safer care strategies by exploring promising practices that prevent antibiotic-resistant infections.
• We expect that this experience will help participants demonstrate and promote successful delivery of care practices and identify opportunities for improvement, all of which may promote advances in care that impact the Medicare beneficiaries served by the work of the QIO Program.
6
Things to Consider
Will you commit to being… • Attentive• Active participant• Actionable
Show your commitment by clicking the green “check”!
7
Now Offering Continuing Education Credit
• Continuing education credit is available for:– Physicians & Physician Assistants––––
Registered Nurses & Nurse PractitionersDietitiansPharmacists & Pharmacy TechniciansCertificate of Attendance
8
CE Information
Physicians:This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of AKH Inc., Advancing Knowledge in Healthcare, CRW & Associates and Telligen. AKH Inc., Advancing Knowledge in Healthcare is accredited by the ACCME to provide continuing medical education for physicians.
AKH Inc., Advancing Knowledge in Healthcare designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physician Assistants:NCCPA accepts AMA PRA Category 1 Credit™ from organizations accredited by ACCME.
Pharmacists:AKH Inc., Advancing Knowledge in Healthcare is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.AKH Inc., Advancing Knowledge in Healthcare approves this knowledge-based activity for 1.0 contact hour (0.1 CEU). UAN 0077-9999-16-078-L04-P; UAN 0077-9999-16-078-L04-T. Initial
Release Date: 8/2/2016
9
CE Information
Registered Nurses:AKH Inc., Advancing Knowledge in Healthcare is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.This activity is awarded 1.0 contact hour.
Nurse Practitioners:AKH Inc., Advancing Knowledge in Healthcare is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider Number: 030803.This program is accredited for 1.0 contact hour which includes 0 hours of pharmacology. Program ID #21610-6.
This program was planned in accordance with AANP CE Standards and Policies and AANP Commercial Support Standard
Dietitians:AKH Inc., Advancing Knowledge in Healthcare is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR). Registered dietitians (RDs) and dietetic technicians, registered (DTRs) will receive 1.0 continuing professional education unit (CPEU) for completion of this program/material. CDR Accredited Provider #AN008. The focus of this activity is rated Level 2. Learners may submit evaluations of program/materials quality to the CDR at www.cdrnet.org.
10
Disclosure of Financial Relationships & Commercial Support
• The faculty have the following relevant financial relationships to disclose:
Melissa Dorsey, MHA: Nothing to discloseBrianna Gass, MPH: Nothing to discloseCarole Moss: Nothing to discloseDr. Jason Newland: Consultant for RPS Diagnostics
•
•
AKH Inc. , CRW & Associates and Telligen do not have any relevant financial relationships to disclose.No commercial support was received for this activity.
11
Disclosure of Financial Relationships & Commercial Support
DisclosuresIt is the policy of AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of its continuing education activities. The author must disclose to the participants any significant relationships with commercial interests whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflicts of interest are resolved by AKH prior to accreditation of the activity and may include any of or combination of the following: attestation to non-commercial content; notification of independent and certified CME/CE expectations; referral to National Author Initiative training; restriction of topic area or content; restriction to discussion of science only; amendment of content to eliminate discussion of device or technique; use of other author for discussion of recommendations; independent review against criteria ensuring evidence support recommendation; moderator review; and peer review.
Disclosure of Unlabeled Use and Investigational Product This educational activity may include discussion of uses of agents that are investigational and/or unapproved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Disclaimer This course is designed solely to provide the healthcare professional with information to assist in his/her practice and professional development and is not to be considered a diagnostic tool to replace professional advice or treatment. The course serves as a general guide to the healthcare professional, and therefore, cannot be considered as giving legal, nursing, medical, or other professional advice in specific cases. AKH Inc. specifically disclaim responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through participant's misunderstanding of the content.
12
Method of Participation
• You must participate in the entire activity to receive credit.
• A statement of credit will be available upon completion of an online evaluation/claimed credit form.
• The link to the online evaluation will be provided after completion of the activity.
• If you have questions about this CME/CE activity, please contact AKH Inc. at [email protected].
13
Who’s in the Room?
What entity or type of organization do you represent?
•••••••••
CMSHome Health AgencyHospitalNursing Home / Skilled Nursing FacilityPatient, Family or Caregiver RepresentativePharmacy / PharmacistProvider / PracticeQIN-QIOOther (please specify in the comments field)
14
Session Goals
By the end of today’s call you will be able to…
•
•
•
•
Describe at least three ways that deaths are caused by antibiotic resistant infections.
Describe at least three ways that deaths cause by antibiotic resistant infections, bacterial disease, and sepsis can be prevented.
Identify at least two resources that can be utilized by providers to drive safer care.
Explain how you can be participant in the appropriate use of antimicrobials in infection control, in vaccinations, and in the food you eat.
15
Centers for Medicare & Medicaid Services (CMS)
Melissa Dorsey, MHAExcellence in Operations Subject Matter Expert & Contracting Officer Representative for the Quality Innovation Network National Coordinating Center
16
CMS Quality Strategy
Better Care Healthier People
Smarter Spending
Foundational Principles• Enable Innovation• Foster learning
organizations• Eliminate disparities• Strengthen infrastructure
and data systems
17
Make Care Safer: Objectives
18
•••
Make Care Safer: Objectives
Improve support for a culture of safetyReduce inappropriate and unnecessary carePrevent or minimize harm in all settings
19
•
Today’s Speakers
Commonalities:Reducing harm
• Prevent HAIs
Patient Safety Journey• Where is the work going?
20
Nile’s Project
Carole MossMother & Founder
Nile’s Project
Antibiotic ResistanceHospital SuperbugsSepsisBe Aware, Be Prepared
•••••••
Nile’s Project
Nile Calvin MossNile’s ProjectLessons LearnedNile’s LawActionOur Call to Action Personal Stories
•••••••
Nile’s Project
Inspire a Culture of Safety AwarenessEducationPreventionActionRevolution of ChangeBecome a part of the solution
Inspiring a New Culture of Truly Safer Care
••
•
Nile’s Project
Antibiotic Resistance Executive Order – Combatting Antibiotic ResistanceTed Talk – Maryn McKenna
Antibiotic Resistance
We Were Unaware … So We Were Not Prepared
Each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die each year as a direct result of these infections.
• http://www.cdc.gov/vitalsigns/protect-patients/• www.cdc.gov/drugResistance
TED Talk – Maryn McKenna
• What do we do when antibiotics don’t work anymore? (type your response here)
•
•
••
•
Ted Talk – Maryn McKenna
What do we do when antibiotics don’t work anymore? What year did the antibiotic Vancomycin arrive and become available for public use?What year did vancomycin become resistant ?How can you do your part to reduce your use of antibiotics?How can we reverse the escalating reality of a world without antibiotics?
Nile’s Project
Community outreach, education, awareness, preventing patient harm, action, concerts
Nile’s Law
California: SB1058 SB158
Google My Hospital 411 Infection Map
••••
•
Lessons Learned
Hospital acquired infections are preventableNeed to make the CDC mandatory with enforcement Antibiotic resistance is caused by overuse and misuseNile would be here today had the professional taken his symptoms seriouslyRapid testing and rapid accurate treatment
•
••
Lessons Learned (Sepsis)
254 million people die from Sepsis in the United States each yearSepsis symptoms look like those of the fluPatients need to be aware
••••
New Culture of Change
The reason we are all here todayPay for performance AccountabilityPublic involvement
Be the New Revolution of Change (Providers)
• “If you see something#… Say something”• Providers anonymous tip lines
– Twitter - #tellusaboutyourinfection #slamSuperbugs– Facebook - Medical Error Transparency Plan
• Do your research• ProPublica National Surgeon’s Scorecard
– https://projects.propublica.org/surgeons
• ConsumerReports – Medical Board Website Ratings– https://consumersunion.org/wp-
content/uploads/2016/03/Chart-website-review-CR-blobs-all-states-FINAL-4.pdf
Be the New Revolution of Change (Beneficiaries)
••••
Work to Be Done
Infection PreventionEnvironmental CleaningSepsis PreventionReduce the Use of Antibioitics
••
••
National Certification Training
Infection Prevention – CDC guidelines Sepsis Deep Environmental Cleaning and MonitoringRapid Diagnostics Antibiotic Resistance and Antibiotic Stewardship
Resources for Awareness
• MRSA: http://www.cdc.gov/mrsa/• CDC funding Efforts for preventing antibiotic resistance
http://www.cdc.gov/HAI/state-based/index.htmlCMS Previews Hospitals for the 5 star rating
• Creation of a superbug: https://www.statnews.com/2016/07/26/superbug-antibiotics-bacteria
• 5 steps to focus your team on preventing HAI’s: https://www.dotmed.com/news/story/31576
• C. diff: http://www.cdc.gov/HAI/organisms/cdiff/Cdiff_infect.html• HAIs: http://www.cdc.gov/hai/index.html• Patient Safety: http://www.cdc.gov/hai/index.html• Antibiotic Resistance: www.cdc.gov/getsmart/antibiotic-use/anitbiotic-
resistance-faqs.html • Sepsis: www.cdc.gov/sepsis
•
•
•
•
•
Resources
Evaluation for Sever Sepsis Screening Tool: http://survivingsepsis.org/SiteCollectionDocuments/ScreeningTool.pdf“Bundles” in Improvement Initiatives: http://www.ihi.org/resources/Pages/ImprovementStories/WhatIsaBundle.aspx Antibiotic Resistance and Food Safety: http://www.cdc.gov/foodsafety/challenges/antibiotic-resistance.htmlChallenges in Food Safety: http://www.cdc.gov/foodsafety/challenges/index.htmlFoodborne Illness Index: http://www.cdc.gov/foodsafety/diseases/index.html
Additional Resources
www.nilesproject.com
Carole MossNile’s Mom
Nile’s Project949.235.2925
Thank you!
44
Individual Reflection
What are your key takeaways?
What did you hear that you could apply to your efforts to address healthcare acquired infections?
45
St. Louis Children’s Hospital & Washington University
Jason G. Newland, MD, Med, FPIDSDirector, Antimicrobial Stewardship ProgramSt. Louis Children’s HospitalAssociate Professor of PediatricsWashington University
©The Children's Mercy Hospital, 2015
Preventing Deaths from Antibiotic Resistant Infections
Jason G. Newland MD, MEd@JasonGNewland
@sharpsgroup
Department of PediatricsDivision of Infectious Diseases
Disclosures
• Consultant for RPS Diagnostics
Department of PediatricsDivision of Infectious Diseases
CDC Threat Report•
•
•
23,000 Americans die annually from an antibiotic resistant infection2 million Americans are infected annually with an antibiotic resistant infection250,000 Americans suffer from C. difficile infection • 19,000 die from C. difficile infection
http://www.cdc.gov/drugresistance/threat-report-2013/
Department of PediatricsDivision of Infectious Diseases
Inadequate Antibiotic Therapy Increases Mortality
0102030405060708090
100
Ibrahim2000
Leibovici1998
Luna 1997 Alvarez-Lerma1996
Rello 1997
Mor
talit
y (%
)Adequate therapy Inadequate therapy
Bloodstream Infections1Ibrahim et al. Chest. 2000;118:146. 2Leibovici et al. J Intern Med. 1998;244:379. 3Luna et al. Chest. 1997;111:676.
Nosocomial Pneumonia/VAP4Alvarez-Lerma et al. Intensive Care Med.1996;22:387–394. 5Rello et al. AJRCCM. 1997;156:196–200.
Department of PediatricsDivision of Infectious Diseases
Current Headlines•
•
•
The superbug that doctors have been dreading just reached the U.S.• Washington Post- May 27, 2016
Antibiotic-resistant bacteria give urgent warning• San Diego Tribune- May 30, 2016
Common infections could become untreatable: Dangerous new antibiotic-resistant bacteria reach U.S.• Salon- May 30, 2016
Department of PediatricsDivision of Infectious Diseases
Inappropriate Antibiotic Use•
•
•
Approximately 30% of antibiotic use in hospitalized patients are inappropriate33% of antimicrobial prescriptions in outpatients are inappropriateLarge portion of antibiotic use in US has been dedicated to growth promotion in animals
Donskey C et al. Arch Intern Med 2003Fleming-Dutra KE JAMA 2016; 315
Department of PediatricsDivision of Infectious Diseases
High Reliability Organization Principles
#1 Preoccupation with Failure#2 Reluctance to Simplify#3 Sensitivity to Operations#4 Commitment to Resilience#5 Deference to Expertise
Department of PediatricsDivision of Infectious Diseases
Solutions•
••••••
Antimicrobial stewardship programs and actions in all healthcare settingsBetter diagnosticsKnow best lengths of therapyReduction of hospital acquired infectionsVaccinesDecrease antimicrobial use in agricultureNew antimicrobial development
Department of PediatricsDivision of Infectious Diseases
Call to Action•
•
••
Support the development of antimicrobial stewardship actions and programsEmpower your healthcare workers to be able to prevent infectionsVaccinateWash your hands Support farmers raising animals without or judiciously using antibiotics
55
Facilitated Discussion
Chat in your questions and comments.
Press *1 on your telephone key pad to enter the teleconference queue.
56
Call to Action
•
•
Become empowered! Do you know, really know, how to become involved in your healthcare? Your family’s healthcare? – Check out the resources on the QIO Program website.
Share the resources with others.Do you have a story to share? What worked? What are you challenges?
–
– Share your story with the QIN NCC in the next 2 weeks ([email protected]), and you could be featured on a future national LAN event.
57
Call For Future Topics
••
•
We want to hear from you!Do you have a need or desire to hear about a certain topic?Submit your ideas in chat or email us at [email protected]
58
9/6/16 - Save the Date!
• Join us for the Follow-up Event to today’s National Learning & Action Network (LAN) Call– Tuesday, September 6, 2016– 3:00-4:00 PM ET– Registration is required!
▪ Register at: https://qualitynet.webex.com/qualitynet/onstage/g.php?MTID=e214535436625222a91e279e47da95d2b
11/1/16 - Save the Date!
• Join us for the National Learning & Action Network (LAN) Call • The topic will be aligned with the CMS Quality Strategy goal to
promote effective prevention and treatment of chronic disease.
– Tuesday, November 1, 2016– 3:00-4:00 PM ET– Registration is required!
▪ Register at: https://qualitynet.webex.com/qualitynet/onstage/g.php?MTID=e0d3120ebfafa703b79a0dc47b4c04d30
59
60
Post-Event Assessment
• If you would like to claim CE credit for this live event, please complete the CE evaluation found at the end of the post-event assessment:
– Post-event assessment: https://www.surveymonkey.com/r/86MRVXY
• Contact Nikki Racelis ([email protected]) with any questions.
61
Thank you!
This material was prepared by Telligen, the Quality Innovation Network National Coordinating Center, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 11SOW-QINNCC-00866-06/20/16
