Evidence-Based Medicine Group (the fruit group) (the fruit group ) - PDF document

1 Evidence-Based Medicine Group (the “fruit group”) (the fruit group ) December 18, 2009

2

3

Participation 44 out of 45 blood banks = 98% participation rate! = 98% participation rate! •Participation Pledge •Baseline Data •Conference calls attendance •Website registration W b it i t ti 4

Blood Wastage Collaborative Website Tools for the following: •Collect monthly metrics y •Provide monthly reports comparing to state performance •Share best practices 5

Project Charter Reducing Discarded Platelet Units Champion: Barb Epke/Bill Minogue/Chip Davis Revised: 12/11/2009 Project Leader: Page Gambill/Donna Marquess Problem Statement Project Goal A significant number of apheresis platelet units are prepared per physician request and then not transfused. There is a short shelf life and Reduce platelet wastage by a minimum of p g y _____ % by July y y the units are often discarded. The result is fewer units available for patients 2010 across the participating hospitals in Maryland which compromises patient safety. There is also a financial impact due to the high product cost. Measurement Methodology Scope Unit = one unit of apheresis platelets (6 EU) U t o e u t o ap e es s p ate ets (6 U)  44 Blood Banks in Maryland % Waste = # platelet units wasted  Blood suppliers Total # of platelet units purchased (Do not include partial units as wasted.) Participating Organizations Benefits  Increased blood inventory available for patient care  44 Blood Banks out of 45 in Maryland  Cost credit for transferring out short dated platelets  2 Blood suppliers  Reduction in costs to acquire additional platelet products Reduction in costs to acquire additional platelet products Phase Date Comp Milestones Define 07/22/09 • Pre work completed - prior to 07/22/09 Measure • Sign off on project charters - 07/22/09 Analyze • Conference call follow-up – 8/21/09 • Kickoff – 9/22/09 Improve • Collect baseline data and launch interventions – 10/15/09 6 Control • Create Collaborative Website -11/02/09

State Blood Wastage Results Platelets Platelets % Wasted for State Baseline Year Baseline Year vs. Current Year Average % Wasted g % 9.00% 9.00% = 7.09% 8.00% 7.00% 6.00% 5 00% 5.00% 4.00% 3.00% Baseline Year 2.00% Current Year 1 00% 1.00% 0.00% Baseline Year Month-Year T Total Units Wasted l U i W d Total Units Collected/ Purchased % Wasted

State Blood Wastage Results Platelets Platelets Cumulative Units Saved for State Cumulative $s Saved for State Sep 09 Current Sep 09--Current Sep 09--Current 140 70000 120 60000 100 50000 80 40000 60 30000 40 20000 20 10000 0 0 Sep-09 Oct-09 Sep-09 Oct-09 Sep ‐ 09 Oct ‐ 09 Predicted units wasted 286 287 Actual units wasted 227 231 Cumulative units saved Cumulative units saved 59 59 115 115 Cumulative $s saved $29,938 $58,355 8

State Blood Wastage Results Plasma Plasma % Wasted for State Baseline Year Baseline Year vs. Current Year Average % Wasted g % 7.00% 7.00% = 5.12% 6.00% 5.00% 4.00% 4.00% 3.00% 2.00% Baseline Year 1.00% 1.00% Current Year Current Year 0.00% Baseline Year Baseline Year Month-Year Total Units Wasted o a U s as ed Total Units Thawed % Wasted 9

State Blood Wastage Results Plasma Plasma Cumulative Units Saved for State Cumulative $s Saved for State Sep 09--Current Sep 09--Current 5 500 0 Sep-09 Oct-09 -5 0 Sep-09 Oct-09 -10 -500 -15 -20 -1000 -25 -1500 -30 -35 -2000 -40 Sep ‐ 09 Oct ‐ 09 Predicted units wasted 339 319 Actual units wasted 373 283 Cumulative units saved Cumulative units saved ‐ 34 34 2 2 Cumulative $s saved ($1,866) $110 10

Total Units Saved for State: 2 Months Total Units Saved for State: 2 Months • Platelets = 115 units Platelets 115 units • Plasma = 2 units • Allo Red = -19 units Allo Red = -19 units • Auto Red = -39 units Total Units Saved = 59 units = 59 units 11

Total $s Saved for State: 2 Months Total $s Saved for State: 2 Months • Platelets = $58,355 Platelets $58,355 • Plasma = $110 • Allo Red = ($4 557) Allo Red = ($4,557) • Auto Red = ($13,800) Total $s Saved = $40 108 = $40,108 12

Next Steps for Blood Wastage Collaborative • BWWG will – make quarterly reports on the state aggregate blood wastage data to MHQCC to MHQCC – coordinate quarterly follow-up calls with all participants to discuss best practices and data submitted – schedule an in-person conference in Spring 2010 schedule an in person conference in Spring 2010 • Website enhancement— “Craig’s List” for expired products – allows blood banks to post soon-to-be expiring inventory and to access to see what is available during emergent situation ***BWWG recognizes the importance of regulatory/liability issues, g p g y y , and is in the process of investigating these issues. 13

14

15

Recaps and Updates • Statewide Hospital Hand Hygiene Campaign adopted by Council on June 10, 2009 • Letter from Secretary Colmers requesting recommendations from the MHCC HAI Advisory Committee on Statewide Hospital Hand Hygiene Initiative • Creation of Governance Structure – Steering Committee – Expert Panel – Work Group Work Group • Launch of the Maryland Hospital Hand Hygiene Collaborative -Kick-off meeting - Nov. 3, 2009 -Program resources developed and disseminated - Nov 2009 -Webinar series 1) Standardized observer training - Nov 18, 2009 2) Data submission and web reporting - Dec 2, 2009 2) Data submission and web reporting Dec 2, 2009 -Regular communication with and among hospital participants 16

Program Builds on Existing Strengths and Structures g •Department of Health and Mental Hygiene Governing body •Maryland Patient Safety Center & Maryland Hospital Association Experience with Hospitals •Delmarva Foundation Logistical Coordination of Statewide Collaboratives •MHCC HAI Advisory Committee Expert Panel •Johns Hopkins Medicine J h H ki M di i Program and Implementation Experience 17

Maryland Hospital Hand Hygiene Collaborative Kick-Off Meeting - Nov 3 2009 Kick-Off Meeting - Nov. 3, 2009 Participation: Participation: 200+ attendees from over 40 acute care and specialty care hospitals 18

Press Coverage Participation as of 12/10: 44 out of 47 acute hospitals p = 94% participation ! 19

20 Kick-Off Meeting Agenda

Collaborative Website http://www.marylandpatientsafety.org/html/collaboratives/hand hygiene http://www.marylandpatientsafety.org/html/collaboratives/hand_hygiene Resources -Toolkit -link to observer training li k t b t i i -link to data submission and web reporting -FAQs -Webinar recordings 21

Webinar 1: Standardized Observer Training Participation: 97 attendees 22

Webinar 2: Data Submission and Web Reporting handstats org handstats.org Participation: 77 attendees 23

Two Forms of Data Submission mobile device vs. desktop PC 24

Feedback Reports for Individual Hospitals Hospital Level Graphs Service Level Graphs Unit Level Graphs p  Performance over time  Benchmarking against  Benchmarking against other services/units  Compliance by Health Care Worker type 25

Feedback Reports for MHQCC Hand Hygiene Compliance across State Hand Hygiene Compliance the State (Jan '10--current) 90.00% 70.00% 80.00% 60.00% 70.00% 50.00% 60.00% 40.00% 50.00% 30.00% 40.00% 20.00% 30.00% 10.00% 20.00% 0.00% 2010 Feb Mar Apr May Jun Jul Aug Sep Oct 10.00% Jan 0.00% State Average 26

Ti Timeline li • Monthly data submission—starting from Jan 2010 • Continued Engagement with Hospitals – Quarterly “Learning Sessions” y g – Monthly Sharing Calls – In-Person Conference in Spring 2010 p g 27

28

Potential “Fruit*” Seeds • Red Bag Trash • Expand Hand Hygiene beyond Acute Care Expand Hand Hygiene beyond Acute Care Hospitals • Checklist • Checklist – BSI – SSI SSI – VAP • Safety Dashboard • Explore Projects in Collaboration with Payors p j y * Short term, quick wins 29

Discussion Discussion