Hospital Team Sharing Call Medical Center of Central Georgia Carroll Hospital in Maryland
Georgia Hospital Engagement Network
description
Transcript of Georgia Hospital Engagement Network
Georgia Hospital Engagement Network
Hospital Acquired Condition Affinity Webinar Series
3/19/2014
Dr. Roy Soto
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Dr. Soto is an anesthesiologist at William Beaumont Hospital in Royal Oak Michigan. Following his residency training at UCLA, he joined the faculty of the University of South Florida in Tampa, and then the State University of New York at Stony Brook. In 2007 he was recruited to Beaumont Hospital to start an anesthesiology training program, and he currently is the Residency Program Director. He also serves as a Professor of Anesthesiology at the hospital's affiliated medical school, and his research interests include patient safety, enhanced recovery after surgery, care standardization, and service excellence/patient satisfaction
Re-evaluating Safe Perioperative Pain Management
National Procedural NO Harm Affinity Group
Roy Soto, M.D.
Case Presentation
• 52yo s/p posterior cervical fusion• BMI 34
• OR pain meds: 0.5mg hydromorphone• PACU pain meds: 2.5mg hydromorphone
• Hospital course: dead within 2hr of arrival on ward
Overview
• Assumptions• MHA pain management toolkit• MHA data measures
0
10
20
30
40
50
60
70
80
90
100
Any Pain Slight Moderate Severe Extreme
Pate
ints
(%)
1993 1999 2012
6
Pain is Poorly Controlled
2001
2012
Opioids Cause Harm
Hospital X
Pain Control Drives Satisfaction
HCAHPS/Hospital Compare
Pain Control Enhances Recovery
• ↓opioids/↑multimodal analgesia leads to– Earlier return of gut motility– Earlier enteral feedings– Earlier mobilization– Earlier removal of drains/catheters
Implementation
• Baseline data collection– Gap analysis– Outcome and process data
• Implementation of MOSS tool• Education
– Physician– Nursing– Patient
• Reassessment and refinement
Implementation
Implementation
Patient Education
Gap Analysis Tool
Michigan Opioid Safety Score
Process & Outcome Measures
A. MHA Derived measures (numerator/denominator)1. % pts readmitted within 30d/total number surg proc2. HCAHPS q13
B. Process Measures (numerator/denominator)3. # surg pts receiving opioids/total number surg proc4. # pts eval with MOSS/total number surg proc
C. Outcome Measures(numerator/denominator)5. # surg pts rec Narcan/# surg pts receiving opioids6. # RRT opioid calls/# surg pts receiving opioids
Process & Outcome Measures
Educational Product
• Powerpoint with voiceover– Surgeon– Anesthesia– Nursing
• Live presentations• +/- CME/CE• Patient print product
Dynamic Processes
Contact Information
• Michelle Norcross, MSA – Michigan Health & Hospital Association Keystone
Center Project Manager– 517-886-8357– [email protected]
• Roy Soto, MD– Beaumont Health System– [email protected]