Patient/Family Centered Safe Care
Putting Patients First
40/20 by ‘13
What Leaders Need to Know
About Patient/ Family Centered
Safe Care
Partnership for Patients (PfP)
The Partnership for Patients has set an ambitious
goal for all U.S. hospitals: reduce preventable allcause harm rates by 40% and readmissions by
20% in our organization by the end of 2013.
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Partnership for Patients: A Movement
Our hospital is part of a national movement for the triple aim to
Put Patients First and make patient care:
• safer
• more reliable
• less costly
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As part of PfP Our Hospital Pledges To:
• Make achieving the goals of Putting Patients First, harm
reduction and improved care transitions to reduce
readmissions a priority for our Board of Directors, senior
leaders, clinicians, and staff;
• Support clinicians and staff working for and with us and
engage patients and families in order to make care safer,
improve communication, and increase coordination by
implementing proven systems and processes; and
• Learn from and share with others our experiences with
Putting Patients First, making care safer and more
coordinated.
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Aim: To Reduce All Cause Harm
All preventable harm must be addressed to reach the
goal but these are the areas of focus to begin: (Hospital
can star their priorities)
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•
•
•
•
•
•
•
•
Adverse Drug Events (ADE) (includes Medication Reconciliation)
Catheter-Associated Urinary Tract Infections (CAUTI)
Central Line Associated Blood Stream Infections (CLABSI)
Injuries from Falls and Immobility
Obstetrical Adverse Events (First: Early Elective Deliveries)
Pressure Ulcers
Surgical Site Infections
Venous Thromboembolism (VTE)
Ventilator-Associated Pneumonia (VAP)
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Georgia Hospital Engagement Network
Putting Patients First: 40/20 by ‘13
Goals:
- Change culture to be
Patient Focused, Staff
Driven
- Reduce hospital acquired
conditions by 40%
- Reduce readmissions by
20%
- Increase patient/family
engagement
- Reduce all cause harm
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Safe Care Not Only Important to Our Patients….
but also to Hospital Success
Payment for care is now based on quality not volume
• Value Based Purchasing
– Medicare payment incentives/penalties to promote:
• Achievement and improvement of high quality care
• Annual Market update increased or reduced up to 2% by 2017
– Payment based on quality measures and Patient satisfaction (HCAPHS)
– Better scores higher payments, low scores lower payments
• Nonpayment for Hospital Acquired Conditions
– Higher payment withheld if condition not present on admission
• Payment penalties for excessive readmissions
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The Hospital's Reputation is Transparent
• Public Reporting of Quality and Patient Satisfaction Scores
• Patients/families using Social Media to discuss care
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Where We Are Today
Show Hospital's Quality Data
(You can obtain hospital data from the PHA web site. Contact
your Quality Director for instructions and password or contact
Faizah Muheb at fmuheb@gha.org)
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Our Hospital's Goals
• (Consult with your Quality staff for goals. Quality director can
consult with PHA staff for assistance in developing your
goals).
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The Costs If We Do Not Meet Our Goals
• Patients Will Be Harmed
• Provide VBP Report on hospital’s projected payment
• Provide data on HAC cost
(You can obtain hospital data from PHA web site. Contact your
Quality Director for instructions and password or contact Faizah
Muheb at fmuheb@gha.org. )
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In Order to Provide Patient/Family Centered Safe Care
Everyone Must:
Work Together to Promote:
-
Patient/Family focus and engagement
Boundarilessness, seamless care
Unconditional team work
Speed and agility of change
Decreased cycle time to improvement
Repetition, testing, and evolving in real time
Reliability, standardization and spreading what works
If you’re not working together, you’re not doing your job!
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Leaders Must Create A Patients First Culture
• Align Goals
• Align Behavior
• Align Processes
Hold everyone accountable and spread a culture of
accountability throughout the organization
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Rev 4.8.11
Leadership - Execution Framework
Evidence-Based LeadershipSM
Foundation
STUDER GROUP®:
Objective
Evaluation
System
Leader
Development
Aligned Goals
Implement an
organizationwide
staff/leadership
evaluation
system to
hardwire
objective
accountability
(Must Haves®)
Create process
to assist leaders
in developing
skills and
leadership
competencies
necessary to
attain desired
results
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Must
Haves®
Performance
Gap
Aligned Behavior
Agreed upon
tactics and
behaviors to
achieve goals
Re-recruit high
and Middle/solid
performers
Move low
performers up or
out
Standardization
Accelerators
Aligned Process
Processes that are
consistent and
standardized
Process
Improvement
PDSA
Lean
Six Sigma
Baldrige
Framework
Software
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Two Step Process
• The Why:
– When everyone sees their role and their importance in being
accountable for Safe Patient Care they become truly engaged
• The How:
– Evidence shows that partnering with and supporting staff with
tools and resources, especially RNs, leads to better patient
outcomes and higher patient satisfaction
– Let us know what tools and resources are needed to meet the
goals
– Hold everyone accountable for outcomes
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Aligning to Put Patients First
• Align Goals
– Clearly and frequently voicing the goals
– Executive Rounding (assessing how things are going, what
is working and resources needed)
• Align Behavior
– Manager Rounding
– Performance Evaluation
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Align Processes to Put Patients First (Include QI approach
tools your hospital uses)
• PDSA
• Reliable Systems Design
• Comprehensive Unit-Based Safety Program (CUSP)
• Daily Patient Goals
• Learning from Defects
• TeamSTEPPS
•
•
•
•
Huddles
Briefs/Debriefs
SBAR
CUS (Speaking Up)
• Lean/Six Sigma
• Other Quality Processes
– Hourly Patient Rounding
– Bedside Report
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Leader Actions Are Key to Success
•
•
•
•
•
•
We already have successes to celebrate!
Our Vision and goals include (add statements related to quality care)
Our Expectations are communicated to employees
Accountability is reinforced through rounding and listening
We provide support for the work – time and resources
Assess progress and measures through regular review at key
meetings
• Feedback to staff, highlight, celebrate and spread success
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Leading the Way to Patient/Family Safe Care
• What is your perception of Board and leadership commitmenthow can it be strengthened?
• What more can we do to create energy and urgency by defining
success and identifying clear goals and timelines
• How can the WILL to execute be demonstrated more?
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Your Partnership Is Key to Leading the Effort
• Our expectations are for a fast-moving, iterative work
environment- how can you help with that?
• Let me know of potential staff champions, physician and
community champions
• Improvement teams will be used and supported by leaders to
address focus areas of harm – give me ideas for team leaders
• We are tasking our quality teams to measure results quickly
and report them back to hospital staff and partners
• Communicate to executive leaders needs related to the
performance improvement skills and knowledge of staff
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Your Work in Putting Patients First
• Lead the Patients First movement in our hospital
• Become a partner with all senior leaders, physicians, other
leaders/managers, staff and patients to be relentless about
putting patients first
• Look for good candidates to involve as patient advocates
• Include our patients and their families in all of our
interactions regarding their care-rounding is mandatory if
you work here
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You Create the Environment to Put Patients First
• Evaluate and let the executive team know what additional
support and resources are needed for teams to improve care and
increase efficiency
• Create a Just Culture where errors and near misses are freely
reported, analyzed and learned from to prevent harm
• Hold all in the organization accountable for safe patient care
• Support an environment where everyone can speak up for Safe
Patient Care
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All Hands on Deck
Focusing on Our North Star – the Patient
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Renew Your Sense of Purpose
When we do what’s right for the patient
the numbers will follow…..
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Hospital Executive Team Takes the Putting Patients
First Pledge
We pledge to:
• Make achieving the goals of Putting Patients First, harm
reduction and improved care transitions to reduce readmissions
priority of our Board of Directors, senior leaders, clinicians,
and staff;
• Support and working each other in engaging patients and
families in order to make care safer, improve communication,
and increase coordination by implementing proven systems and
processes; and
• Learn from and share with others our experiences with Putting
Patients First, making care safer and more coordinated.
Learn. Act. Improve. Spread.
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