Georgia Hospital Engagement Network
Patient and Family Centered Safe Care
Putting Patients First
11/20/2013
1
Continuing Our Positive Net Forward Energy
Celebrating Our Success
State of the GA HEN
11/20/2013
3
Go Georgia!!
We Have Saved So Far….
Over 10,000 Patients from Harm
Over $55 Million!
11/20/2013
4
Georgia’s Improvement Measures Up
11/20/2013
5
Georgia Success Stories
Great Partnerships = Great Results!!
11/20/2013
7
Implementing Evidence Works!!!
11/20/2013
8
Glycemic Control – Under Control!
INR - Pocket of Excellence
11/20/2013
10
Decreases Need to Be Spread and Sustained
11/20/2013
11
Culture Change in Periop Areas Leads to Lower SSIs
11/20/2013
12
Success Then Plateau ….Change is holding at 7.7%
Georgia’s readmission rate
per 1,000 beneficiaries
ranks in the middle of the
country
Reducing Readmissions -- 2011 – 2012
Progress is being made!
Moving Forward in 2014
Success Needs to Spread
and Accelerate!!!
Moving Forward in 2014
Safety Across the Board
for
Patients and Staff
Safety will not happen without
intentional strategy
Safety is not in addition to..
it is the strategy
Focus 2014: Safety Strategy
•
•
•
•
•
•
•
Safety Ownership & Accountability for All
Leaders (at all levels) change things!
All voices heard
Align all topics where they intersect
Rapid cycle reduction of all harm
Adopt first, amend second
Standardized tools locally implemented
11/20/2013
19
Net Forward Energy!!!!
All Teach, All Learn
The Answer Is In This Room!
11/20/2013
20
Leaders Make Change Happen!!!
11/20/2013
21
2014 GHA Board of Trustees
Patient Quality and Safety Commitment
• Your accomplishments resulted in Georgia being one
of only six recipients of the Leading Edge Advanced
Practice Topics funding.
• With third-year funding comes a greater emphasis on:
– patient and family engagement
– eliminating health disparities
– enhanced rapid cycle improvement to reduce Catheter
Associated Urinary Tract Infections (CAUTI) and
readmissions.
11/20/2013
22
Georgia Hospitals Recommit to Goals and Focus Areas
• Safety Across the Board
• Meeting 40/20 Goals
• Reduce Catheter Associated Urinary Tract Infections
(CAUTI)
– Address the hospital’s culture, criteria, care, competency
and communication in reducing CAUTIs.
• Concentrate on patient and family engagement
• Reduce Readmission
– Use of the 12 point bundle of project RED shown to reduce
readmissions which includes, patient education, medication
management, and follow-up.
11/20/2013
23
Georgia Hospitals Recommit to Goals and Focus Areas
Enhance Patient and Family Engagement (PFE)
in Eliminating Health Disparities
•
•
•
•
•
•
Prior to admission, hospital staff provides and discusses a discharge planning checklist with every
patient who has a scheduled admission, allowing questions or comments from the patient or family
(e.g., the planning checklist may be similar to the CMS Discharge Planning Checklist)
Hospital conducts shift change huddles and does bedside reporting with patients and family
members in all feasible cases.
Hospital has a person or functional area, that may also operate within other roles in the hospital,
that is dedicated and proactively responsible for patient and family engagement and systematically
evaluates
PFE activities (e.g., open chart policy, PFE trainings, establishment and dissemination of PFE
goals).
Hospital has an active PFE Committee OR at least one former patient who serves on a patient
safety or quality improvement committee or team.
Hospital has at least one or more patient(s) who serve on a governing or leadership board and
serves as a patient representative.
11/20/2013
24
Focus 2014: Increasing the Voice of the
Patient and Family
11/20/2013
25
Focus 2014: Readmissions
11/20/2013
26
Focus 2014: Readmissions Goal
To Reach Our Goal - 9%
9,000 individuals
11/20/2013
27
Focus 2014: Ramp Up Readmissions
• All 12 components of Project RED
• 4 Basic Principles of Patient Centered
Care
11/20/2013
28
Focus 2014: CAUTI
11/20/2013
29
Focus 2014: Stop CAUTI!!
•
•
•
•
•
•
Rapid cycle change to further decrease unnecessary urinary
catheter utilization including nurse removal process
Focus on ED and OR utilization
Adopt then adapt
Urinary catheter focus during rounding and bedside handover
Observation and inquiry every day to assess necessity
Fully engage staff, patients and families in this work
HAI Affinity Group webinar : CAUTI: A Hospital Success
Story, January 22, 11 -11:45 am
11/20/2013
30
Focus 2014: New Safety Topics
• OB Adverse Events
– Postpartum Hemorrhage
– OB Trauma with/without instrumentation
• ADEs
– Opioid Safety
• HAI
– Focus on SSI
– VAE (IVAC, Possible, Probable VAP)
11/20/2013
31
Focus 2014: Expanded Data Requests
• New HAI Data Submission for 2014
–All inpatient CLABSI and CAUTI
–Additional SSI: Hip and knee prosthesis
–VAE: IVAC, Possible, probable VAP
• ADE – Opioid Safety
• Monitor SCIP: VTE:1 and VTE:2 from
Core Measure data
11/20/2013
32
GAPP /LEAPT : Innovation to Improve Safety
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Atlanta Medical Center
Chatuge Regional Hospital
Crisp Regional Medical Center
DeKalb Medical Center
Doctors Specialty Hospital
Effingham Health System
Floyd Medical Center
Habersham Medical Center
Midtown Medical Center
Newton Medical Center
Northside Medical Hospital
South Georgia Medical Center
Spalding Regional Medical Center
St. Mary's Healthcare System
Ty Cobb Regional Medical Center
Union General Hospital
University Hospital
Topics
• Sepsis
• C. difficle with antimicrobial
stewardship
• Procedural Harm
• Failure to Rescue
• Culture of Worker Safety
Call to Action on Sepsis from GAPP
Action Required Now to
Save Lives!!!!
Learn. Act. Improve. Spread
Fighting Sepsis:
Actions You Can Take Today to Save Lives
Implementing the Surviving Sepsis Campaign Bundles can reduce the
mortality from severe sepsis an septic shock.
• Identify local champions and form a multidisciplinary committee to support
bundle implementation:
– Consider the ED, Inpatient Staff, ICU, Administration, pharmacy,
pediatrics, nursing and infection prevention, etc.
• Educate your staff and present the evidence.
• Break it down into manageable pieces and pick an area of focus:
– Measure lactate at time of triage for patients who meet SIRS criteria
– Reduce time to antibiotics
– Administer at least 30ml/kg fluid bolus within three hours
11/20/2013
35
Fighting Sepsis:
More Actions You Can Take Today
• Time is critical!
• Prioritize pts with SIRS criteria from triage
• Create protocols and order sets which empower nurses and
reduce delays
• Don’t let a prolonged search for source delay the
administration of antibiotics
• Track your data and provide feedback to providers
• Let staff know how they are doing & celebrate success
11/20/2013
36
Fighting Sepsis:
More Actions You Can Take Today
• Implement ‘Code Sepsis’ to emphasize the importance of
immediate treatment.
• “Say Sepsis” - use the word sepsis early.
• Utilize your EHR to create sepsis alerts and order sets
– e.g., Link lactate order with blood culture orders so you
have to opt out of the lactate measurement
• Create posters with your sepsis protocol and post them
prominently
• Educate families on red flags–make them a member of the
team.
11/20/2013
37
Preparing for 2014 HEN Kickoff : Feb. 6
Request
•
•
•
•
•
Analyze data, identify units for improvement
Have Staff Complete the Staff Safety Assessment
Give feedback back to the staff
Prioritize work on each unit
Bring results with you to kickoff
11/20/2013
38
Let’s Celebrate the
First 2 Years
In appreciation
Executive Quality Advisory Committee
•
•
•
•
•
•
•
•
•
David Andrews, Patient Advocate,
Georgia Regents Medical Center
Sheila Bennett, Chair, Floyd Medical
Center
Susan Bowen, Shepherd Center
Montez Carter, Good Samaritan
Nicole Franks, MD, Emory
University Hospital Midtown
Freya Gilbert, Columbus Health
Roy Gilbreath, M.D., DeKalb
Medical
Babs Hargett, Emory Healthcare
Angie King, St. Francis Hospital
•
•
•
•
•
•
•
•
Steve Mayfield, Medical Center of
Central Georgia
Mindy McStott, Tift Regional Medical
Center
Norma Jean Morgan, Effingham Health
System
Heidi Nelson, University Hospital
Teri Newsome, Habersham Medical
Center
Mary M. Pizzino, Effingham Health
System
Sherry Sweek, Southeast Georgia Health
System
Tina Thomas, Ty Cobb Regional
Medical Center
Sharing Our Success Nationally
NAME
Angie King
Susan Bowen
Teri Newsome
Freya Gilbert
Nancy Curdy
Bernard Roberson
Norma Jean Morgan
Mary Pizzino
Brandon Reece
HOSPITAL
St. Francis Hospital
Shepherd Center
Habersham Medical Center
Columbus Regional Health
Dekalb Medical
Georgia Regents Medical Center
Effingham Health System
Effingham Health System
Floyd Medical Center
2013 Leaders
Circle Award
Winners
Congratulations!!
Let’s Celebrate Our
Work!
Thank You for Making
Patients Safer!