GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 +...
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Transcript of GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 +...
GEORGIA H
OSPITA
L ENGAGEMENT
NETWORK
COHORT 9
COACHIN
G
CALL
AUGUST 27, 2
014
CO
HO
RT
2 +
CO
HO
RT
3 +
CO
HO
RT
4 =
CO
HO
RT
“ 9”
FRAMING
• PATIENT STORY
• HEN UPDATES (Data Submission Document)
• Videos for Employee Education “Patient’s perspective”
• Re-Admissions
• PFE
• QIO Update
• LEAPT Spread• Worker Safety – Getting Started
Getting ready for September spread – Procedural Harm and Failure to Rescue
• Calendar Review – Upcoming Events
• HEN Regional Meetings
September 16, 2014 GHA
September 30, 2014 Macon
HEALTH DISPARITIES
A hospital story….
COHORT 2, 3, 4: READMISSIONS
2010 41456 41487 41518 41548 41579 41609 41640 41671 4169916.00%
16.50%
17.00%
17.50%
18.00%
18.50%
19.00% 18.69%
17.67%17.53%
17.13%17.38%
17.88% 17.78%
17.38% 17.49%
17.13%
Cohort 2, 3, & 4 Medicare 30 day All Cause Rate
Base line 2010 toJuly 2013 - March 2014
RateLinear (Rate)
20% Reduction = 14.96%
COHORT 2, 3, 4: READMISSIONS
Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-141850
1900
1950
2000
2050
2100
2150
2200
2250
2300
2143
2231
1985
20942070
2181
2223
1996
2120
Cohort 2, 3, 4The number of Individuals Readmitted
July 2013 - March 2014
NumLinear (Num)
SENSE OF URGENCY
What actions will you take to adjust your improvement process based on what you have heard?
What can the HEN do to support your efforts?
• Do Your PART campaign
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http://www.gmcf.org/AlliantWeb/Files/QIOFiles/Members/Important%20Message%20from%20Medicare-English.pdf
Updated patient letter from new QIO
FAILURE TO RESCUE: SPREAD
Bold Aims:
PSI-4 – decrease deaths per 1000 patients having developed specified complications of care during hospitalization to 10% by December 2014.
Reduce the number of unplanned transfers to a higher level of care by 20% by December 2014.
Reduce the number of patients who had a code blue where there was not a Rapid Response Team called first by 20% by December 2014
FAILURE TO RESCUE: SPREAD
The Institute for Healthcare Improvement's 5 Million Lives campaign, which is a continuation of its initial 100,000 Lives campaign, calls for the establishment of Rapid Response Systems.i In particular, the goal of RRS implementation is to reduce the number of medical errors by decreasing the number of unmet patient needs prior to cardiac arrest.ii RRSs are established to "respond to a 'spark' before it becomes a 'forest fire,'" thereby preventing failure to rescue.iii
FAILURE TO RESCUE: SPREAD
• Observable signs of deterioration develop within 6-8 hrs. of a cardiac arrest
• As many as 17% of cardiac arrests occur in patients being cared for in an inappropriate clinical settingiv
• Cardiac arrest was potentially avoidable in as many as 95% of these patientsiv
• FTR is potentially avoidable in as many as 60% of patients who were cared for in an appropriate setting.iv
FAILURE TO RESCUE: SPREAD
Key Learnings:
• Position to Spread best practices within our HENs and across the nation starting September 2014
Provide mentor support and monthly coaching calls/webinars
• Leadership buy-in and Champion to assist with spread throughout organization
• Formation of Rapid Response Team (RRT) – multidisciplinary team with skill sets to handle emergency care
• Standardize RRT protocols—(policy/procedure/protocol)
FAILURE TO RESCUE: SPREAD
Key Learnings:
• Education of entire hospital staff AND Patients and Families---when and who can call a RRT call (anyone and everyone); role of each department in RRT is KEY
• Analyze data and give feedback to entire hospital on regular basis; report card format is preferred
• Continuous education of staff , patients and families is necessary to increase utilization
FAILURE TO RESCUE: SPREAD
Rapid Test of Change:
• Drills and simulations
• RRT Call Simulations
• Code Blue Grand Rounds• Rapid Response Teams (RRTs)
• Implement RRT Policy
FAILURE TO RESCUE: SPREAD
Rapid Test of Change:
• Chart Review: Reconcile Patients with RRT calls with complications / mortality / unplanned transfers
• Educate staff to reinforce RRT activation criteria
• Post RRT- call huddles
• Hospitals are reviewing Rapid Response Team (RRT) activations and comparing to the Modified Early Warning System* (MEWS) scoring to determine feasibility of using the MEWS to identify patients who need an early intervention from a RRT or early response nurse.
“CAREGIVER SAFETY”WHERE TO START?
1. Establish - a Team of “stakeholders”
Suggest representatives from Occupational / Employee Health,
Human Resources, Risk Management, Nursing, Quality, ….
2. Complete - OSHA’s Self –Assessment Tool:
“How Safe is my Hospital?”
3. Evaluate - Employee Turnover, and Culture of Safety Survey
Results
4. First Step Suggestions -
Hospital Governing Board review of Worker Injury data
Safe Patient Handling / Use of Low Tech Devices16
17
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“HOW SAFE IS MY HOSPITAL FOR WORKERS?”
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“HOW SAFE IS MY HOSPITAL FOR WORKERS?”
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“HOW SAFE IS MY HOSPITAL FOR WORKERS?”
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“HOW SAFE IS MY HOSPITAL FOR WORKERS?”
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CALENDAR OF UPCOMING EVENTS
Next Cohort Coaching Call: October 22, 2014
HEN Fall Regional Meetings: September 16 (GHA)
September 30 (MACON)
Data Submissions:
July Data Due September 15:
ADE’s including INR, BG, and Opioids
Falls with injury
VTE-6 (due once a quarter)
HAI (if not submitting via NHSN)
EED if applicable
Workers Safety if applicable
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