OHA Sepsis Hospital Letter of Commitment
To:
Re: Request to Participate in the Ohio Hospital Association Sepsis Collaborative
Date:
We have reviewed the collaborative information for participation in the Ohio Hospital Association
(OHA) Sepsis initiative. We understand the work is being coordinated by The Research and
Educational Foundation of The Ohio Hospital Association (REF of OHA).
The signature at the end of this letter indicates the facility’s commitment to participate in the Sepsis
project and to complete the Sepsis project expectations. It is understood that this commitment includes:
baseline and monthly submission of data, monthly conference calls, and ongoing participation in the
performance improvement project.
It is understood that this type of work is not without effort. Based on the experience of OHA in leading
similar collaborative projects, the healthcare facility's commitments necessary to maximize the
potential for success are outlined below.
Participating Healthcare Facility Commitments:
1. Will identify a team leader responsible for ensuring the ongoing meeting of the team and
development of meaningful agendas. This person will be responsible for assuring achievement of
commitments.
2. Will identify hospital multidisciplinary team members to lead internal processes and facilitate
mentoring. Frontline staff will be active participants in project development, testing and
implementation using frontline defect analysis to identify, test and refine practical strategies.
3. Will submit the required outcome and process measures on a monthly and quarterly basis to the
OHA. It is acknowledged that timely data submission is of utmost importance to achieving
expectations. This data in aggregate format will be shared among project participants and the
leadership team partners for benchmarking purposes to promote improvement. It is understand that
submitted data will be held in confidence and will be kept in accordance with HIPAA policies.
4. Will:
 Help identify and recruit appropriate content experts and staff to ensure effective innovative
practice development
 Establish an interactive process to share data throughout the network to allow for tracking of
team outcomes
 Identify resources/data analysis methodology (based on topic of participation) to assist in
working with hospitals to:
155 East Broad Street, Floor 15
Columbus, Ohio 43215-3620
www.ohanet.org
614.221.7614
614.221.4771 fax
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o Identify and mitigate sepsis. The goal is to understand the common causes associated
with patients in early stages of sepsis and implement appropriate care as early as
possible and continued management of the patient
Incorporate patient centered, patient and family engagement, and safe care into methodologies
Meet regularly with team to develop strategies for improvement and reporting progress.
Commit to meeting with other hospitals and OHA throughout the project.
Define hospital specific milestones based on gap analysis and peer-reviewed literature and
develop an effective implementation model
5. Outreach activities will include but are not limited to:
 Assist OHA to develop metrics, evidenced based practices/road maps/bundles/toolkits to share
locally and nationally
 Assist OHA in writing case study articles
 Share lessons learned with other hospitals as appropriate
As an organization, we understand that OHA will provide us the following to assist in implementation
of the sepsis agreement:
 Outcomes data using existing data sources
 Project Coordinator will serve as a reference and support to our organization
 A database to enable timely data collection and submission
CEO/Senior Executive Champion
____________________________________
Point of Contact (Project Team Leader)
Name of facility
___________________________________
Point of Contact Email
Address of Facility
Point of Contact Phone Number
Date
Return this signed commitment letter to:
Rosalie Weakland
Ohio Hospital Association
155 East Broad St, Suite 301
Columbus, Ohio 43215-3620
(Rosalie.Weakland@ohiohospitals.org or phone 614.221.7614, ext 132)
OR
FAX TO:
614-358-2741
Attn: Rosalie Weakland
155 East Broad Street, Floor 15
Columbus, Ohio 43215-3620
www.ohanet.org
614.221.7614
614.221.4771 fax