5/7/2014 0 Dis Disclo losur sures: s: The planners and - PDF document

5/7/2014 0 Dis Disclo losur sures: s: The planners and presenters of this activity disclose no conflicts of interest or relevant financial relationships related to this activity No commercial support or sponsorship was received for this educational activity. In order to receive 1.0 contact hours for this activity, participants must attend the webinar and complete the electronic evaluation that will be provided via email after the webinar offering. The Indiana University School of Nursing Center for Professional Development and Lifelong Learning is accredited as a provider of continuing nursing education by the 1 American Nurses Credentialing Center’s Commission of Accreditation. Orienting to Adobe Connect Room Orienting to Adobe Connect Room On the left side of your screen, you will see several “pods” . “Q&A” is for submission of questions about the • presentation content. Dr. Case Di Leonardi will answer questions at the end of the webinar, but all questions may not be addressed depending on time. • “Files” includes a copy of the powerpoint presentation as well as the ROI worksheet for download/print /review. “Weblinks ” At the end of the presentation, the evaluation • link will be found in a weblinks pod on your screen. This pod is not visible now. 2 1

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5/7/2014 6 Not everything that can be counted cou ts . counts Some things that cou count cannot be counted. 7 Impact Outcome Content Process 8 3

5/7/2014 ROI Impact Outcome Content Process 9 ROI Fiscal Outcomes Impact: Patient, Staff, Organizational Outcomes Outcome Performance Outcome Content Learning Outcome Process 10 Return On I nvestm ent Benefit/ Cost Ratio ROI benefits- costs X 1 0 0 = % ROI ( BCR) = costs Total Benefits Costs Impact Lindy & Reiter, 2006 Olson-Sitki, et al, 2012 Trevanier, et al., 2012 Outcome Content Process 11 4

5/7/2014 12 Relevance to Stakeholders Measurability High Low 3 1 Easy 4 2 Difficult 13 The Process Piece • What are the questions? • How do they like it? • They = participants, instructors, managers, all others affected including interprofessional personnel • Where are the answers? • Survey, oral, written, online, quality/performance improvement data • Responses to communications about the learning activity or initiative ROI Impact Outcome 14 Content Process 5

5/7/2014 The Content Piece • What are the questions? • Can the participants do the objectives after the learning activity? • Are staff members ready to implement the initiative (access to info, supplies, equipment, protocol)? • Where are the answers? • Post test, demonstration, simulation, game, round robin • Mock/dry run performance ROI Impact Outcome Content 15 Process The Outcome Piece • What are the questions? • Are the participants doing the objectives of the learning activity in practice? • Are staff members performing their roles in the initiative? • Where are the answers? • Observation, audits, documentation, manager observation, quality/performance improvement data ROI Impact Outcome Content 16 Process The question for the future is not “What do you do?” Or “How do you do it?” But rather, “What difference have you made?” 17 6

5/7/2014 18 Baseline 3 months Collected post- over 3 months simulation After 3 months of simulation 19 • Wh What at ar are th e the q e question tions? s? • So So w what? • Wh What or at organization tional al goals als ar are e aff affect cted ed? • Wher ere ar e are th e the e an answer ers? s? • Inci Incide dent nt repo ports, rts, i infecti ction c n contr ntrol r repo ports, rts, quality mo qua moni nito tori ring ng results, s, c core mea measur ures es and HC an HCAHP AHPS resu sult lts s ROI Impact Outcome Content 20 Process 7

5/7/2014  Med E Erro rors rs  LO LOS  Falls lls  Inf Infecti ctions ns: C : CLAB ABSI, SI, C CAUTI, UTI, s surgical site te  Ho Hosp spital A ital Acquir ired ed Condition itions  Staff T Staff Turno rnover  Patient S tient Satis tisfaction, action, HC HCAHP AHPS  Co Core Mea Measur ures es  Staff Mo Staff Morale le  NDNQI NDNQI  Collab llaboration tion 21 Baseline Collected over 3 months post- 3 months simulation After 3 months of simulation 22 Baseline Collected over 3 months post- 3 months simulation After 3 months of simulation 23 8

5/7/2014 Baseline Collected over 3 months post- 3 months simulation After 3 months of simulation 24 Baseline Collected over 3 months post- 3 months simulation After 3 months of simulation 25 Baseline Collected over 3 months post- 3 months simulation After 3 months of simulation 26 9

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5/7/2014 The ROI Piece • Wh What at ar are th e the q e question tions? s? • Was it s it worth rth it? it? • Ho How w much much di did i d it c cost? st? • Ho How w much much di did i d it g gene nerate te a and/ d/or av avoid? d? • Wher ere ar e are th e the e an answer ers? s? • Wage and and salar salary of EVER of EVERYONE NE • Costs o s of su supplie lies an s and eq equipmen ent t – for or ed education ation an and f for imp r implemen ementation tation • Patien tient b t billin illing/ g/ac accounts s payable • Institu itute f e for r He Health althcare Improvemen ement t (I (IHI HI) ) imp improvemen ement s t storie ories • Li Lite teratur ture ROI Impact Outcome 30 Content Process Beecroft et al., 2001; Contino, 2002; Jones, 2008; RWJF, 2006 31 Baseline Collected over 3 3 months post- months simulation After 3 months of simulation 32 11

5/7/2014 • COST o of t training aining • ALL personne nnel l in involv lved (salar alary and and b bene nefit fits) • Cost o of s simulat lator and and all all materials als • COST o of re record rd ke keeping ALL personne nnel l in involv lved (salar alary and and b bene nefit fits) • COST - diff ifferenc nce between cost of t this is t training aining and and c cost of p previo ious us ap approach ch • BENEFIT - - difference e betw between een rate o te of su successful resu suscitation pr pre- e- and d po post- • th this tr training • BE BENE NEFIT FIT? d diff fference in in cost o of r resuscit itat atio ion? n? • Not t qu quanti tifi fiable i in $$ $$ • Lives s s saved d – insurance ta tabl bles, bu but n t not a t a savi ving to to th the or e organizati tion on • Staff me ff membe mbers’ s’ confi nfidence 33 COST = = di differ eren ence betw between een cost of th this tr training and c d cost of pr previous a appr proach • • BENEFIT = = di differ eren ence betw between een rate o te of su successful resu suscitation pr pre- e- and d po post- th this tr training COST = $5 = $500 00 mor more per s r staff aff me memb mber = $5 = $500 00 X 1 178 = = $8 $89,000 000 • • BENEFIT BENEFIT = = Diff Difference PRE PRE = 1 = 10% = = 1/1 1/10 p patie tients and ts and PO POST = 18 = 18% = = 2/11 2/11 RO ROI • For a cost cost of of $ $89,000, our s successf ccessful r resusc scitation ra rate i increa ease sed 8% • Staff aff member c confid nfidence and and int interprofessio ional nal cooperat atio ion n incr increased (r (ratings) • Possib ible le s saving ngs o on supplie lies us used in in resuscit itat atio ion 34 The Hard Soft Cost Data Data of NOT 35 12

5/7/2014 CAUTI Prevention – Many stakeholders “care” – Data is readily available – Bite off a piece that we can chew: nurse- driven protocol for catheter removal 36 Compare costs: – CAUTI pre-intervention with CAUTI post- intervention – Catheter days pre-intervention with catheter days post-intervention 37 38 13

5/7/2014 Baseline = 7 CAUTI/Quarter First quarter after full implementation = 1 CAUTI Compare: 7 X $800 = $5,600 with 1 X $800 = $800 We saved $4,800!! BUT, how much did it cost us? 39 Developing and Implementing Training Educator X 10 hours = $40 X 10 = $400 RN Training 20 RNs X 30-minute training session = 20 X ½ ($32) = $320 Training Costs = $720 40 1. (4800-720) x 100 = 720 2. 4080 x 100 = 720 3. 5.7 x 100 = 570% ROI 41 14

5/7/2014 Compare costs: – Traditional preparation of new grads – Savings generated from a decrease in new grad turnover and actual contract labor cost 42 43 SAVINGS = $48,908,750 – Decreased turnover = $15,228,000 – Contract Labor Savings = $33,680,750 ADDITIONAL COSTS = $7,053,040 – Residency costs = additional $13,460 more per RN than traditional orientation – 524 new grads X $13,460 more than traditional orientation = $7,053,040 ROI = Benefits – Costs X 100 = % ROI Costs $48,908,750 - $7,053,040 = 5.93 X 100 = 593% $7,053,040 And savings of $10 - $50 per patient day 44 15