FHA MTC HIIN Lead Quarterly Virtual Meeting April 30, 2018
Today’s Agenda • Welcome and Overview for today’s HIIN Lead Virtual Meeting • HIINgagment and HIINaction Florida’s Success, Opportunities and Line of Attack • • WishHIIN List
Our Progress Most Recent To Date Relative Cost Harms Lives HIIN Goal Status (1) Data as of 04/02/2018 Harm Measure Month Reported Reduction Savings Prevented Saved ADE Anticoag (ADE-1a) 2018 02 (Feb) -32.78% Achieved $5,175,602 1,035 114 ADE ADE Hypo (ADE-1b) 2018 02 (Feb) 8.52% Worsening ($8,968,393) (1,794) (197) ADE Opioid (ADE-1c) 2018 02 (Feb) -12.85% Making Progress $3,663,375 733 81 CAUTI CAUTI Rate - All Units excl NICU (CAUTI-2a) 2018 02 (Feb) -15.23% Making Progress $149,337 149 15 CLABSI CLABSI Rate - All Units (CLABSI-2a) 2018 02 (Feb) -24.89% Achieved $4,044,600 238 43 Falls Falls with Injury (FALLS-1) 2018 02 (Feb) -13.82% Making Progress $6,413,644 495 MRDO MRSA Rate (MRSA-2) 2018 03 (Mar) -2.22% Making Progress $82,774 11 3 Pressure Injuries PrU Prevalence, Stage 2+ (PrU-2) 2018 02 (Feb) -15.23% Making Progress $3,904,459 230 SSI Rate, Colon (SSI-2a) 2018 03 (Mar) 6.35% Worsening ($868,326) (41) (1) SSI Rate, Abd Hyst (SSI-2b) 2018 02 (Feb) -20.40% Achieved $694,379 33 1 SSI SSI Rate, Hip (SSI-2d) 2018 02 (Feb) -24.48% Achieved $1,266,197 60 2 SSI Rate, Knee (SSI-2c) 2018 02 (Feb) -23.65% Achieved $962,726 46 1 c. difficile rate C. diff rate (CDI-1b) 2018 03 (Mar) -33.70% Achieved $15,566,962 1,557 100 Post-operative sepsis Post-Op Sepsis Rate (Sepsis-1a) 2018 02 (Feb) -8.09% Making Progress $653,976 38 10 Ventilator-Associated Condition VAC (VAE-1) 2018 02 (Feb) -12.50% Making Progress $4,163,830 198 77 Post-Op. Pulmonary Embolism or Post-Op VTE (VTE-1) 2018 02 (Feb) Making Progress $1,532,988 192 29 Deep Vein Thrombosis -18.63% All Cause 30-Day Readmissions All Cause 30-Day Readmissions (READ-1) 2018 02 (Feb) -0.93% Making Progress $16,452,889 1,063 Total $64,727,739 6,077 475 Source: HRET Improvement Calculator, effective date April 2, 2018
HIINgagement • Hospital Successes, Challenges and Asks
Florida Hospital Fish Memorial: Strategies for Reducing CDI and Post-Op Sepsis Veronica Pichardo PT Safety/PSO liaison Florida Hospital Fish Memorial Office of Clinical Effectiveness April 30, 2018
Lee Health: Certified Zero Award Marilyn Kole, MD, MBA Alex Daneshmand, DO, MBA Cora Murphy, MSN, RN-BC, CNL April 30, 2018
What is the Certified Zero Award Purpose: The award is part of Lee Health's efforts to support the creation and sustainment of highly reliable care- care that is dependable, high quality, and safe over a long period of time Zero Harm Together 9
Award Eligibility Children's Hospital Units: • CLABSI free for 12 consecutive months Lee Health Adult In-Patient Units: • CAUTI and CLABSI free for 12 consecutive months * Once recognized, units are re-eligible once they have met an additional 12 rolling months 10
How it Works Initiated: • March 2017 (Children’s Hospital) May 2017 (Adult campuses) What Units: • 1 Unit: Golisano Children’s Hospital & 13 Adult Units Each unit receives : • 1. Framed Certified Zero Award 2. Pizza luncheon (day/night) 3. Recognition of unit director, VP/ACMO, senior leaders Other recognition: Teaming Update, Medical Staff Matters, Nursing Matters, SafeLee Website 11
Certified Zero winners were asked: How did you achieve the Certified Zero? • Transparency on how many lines do we have. Do we really need each line? Addressing each line every day • Create a banner of how many days the team has achieved CLABSI or CAUTI free • Every morning, ask the physicians, can we pull the line without any repercussion • Physician-nurse rounding- It is important that the charge RN call the physician on service and review the plan of the care daily
Certified Zero Winners were asked: How did you make prevention important to the staff?? • Make it personal and create ownership • Create accountability and empowerment of the staff • Make it important and make it consistent- daily follow up • Having a questioning attitude with providers • Share results and engage the physicians
Certified Zero Winners were asked: How do you make harm visible? • Banner on the unit should be visible to everyone including patients and their families • Real-time feedback • Share safety story in huddles/meetings
Tracking log
First Recipients 16
CPCU Director: Beth Thacker 17
Thank You 18
What do YOU and YOUR TEAMS need to meet the 20/12 Goal?
HIINaction - UP Campaign January-March 2018 April-June 2018
GET UP Take Aways • Eliminate sitters-train staff to mobilize patients • Progressive mobility prevents harm-Optimize mobility in bed or chair • Interdisciplinary collaboration in mobility program • Decrease medication risk to mobilization • Appropriate/adequate supply of equipment is key • Paradigm shift-progressive mobilization instead of falls prevention • Start with small tests of change
GET UP Poster
WAKE UP Take Aways • Make it easy to do the right thing, but avoid “Uboxia” Airway assessed Labs reviewed Past medical history reviewed Pain discussed • Take advantage of PAT visits to discuss pain expectations • Do not allow “routine reversals” using naloxone – Where will the patient most likely be when the naloxone wears off? • Create hard stops for orders that contain both benzodiazepines and opioids – Did you know that situational delirium leads to dementia? Combine sedation level assessment with pain assessment • – If these two scores do not give you a clear picture, use end-tidal capnography as the umpire • Ask about their comfort level, prior to asking about pain, do they match? – Provide alternatives to ease anxiety and pain; What would you do at home? • Ensure that leadership is aware of the actual culture
HIIN SafeCulture Project Why Participate? • Measure with Ease (Survey Portal uses AHRQ’s HSOPS) • Improve Response Rates • Quick Access to Results & Analysis • Comparison to U.S. & FL hospitals May 7 th (2-3pm ET) (AHRQ 2018 National Benchmarks)
Patient and Family Engagement FHA Patient and Family Engagement (PFE) Learning Collaborative Providing hospitals with tailored resources, coaching calls, site visits, monthly newsletters, webinars and more. • 21% increase in HIIN hospitals reporting Patient and Family Advisory Councils • Coaching calls: providing support on PFAC sustainability, establishment, and expansion • Upcoming ‘Best Practice Webinar Series’ • Pending national research assessing the positive correlation of performance on PFE metrics and improved quality
Readmissions Discussion Forums May-August Jupiter – May 17 Orlando – May 23 Pensacola – June 15 Other areas - TBA Review the latest data Share individual hospital strategies to reduce readmissions Identification of common barriers This Photo by Unknown Action planning Author is licensed under CC BY-NC-SA
WOUND CARE TRAINING • FHA MTC small test of change • One day program—5-7 contact hours • Customizable program based on needs of interested hospitals and on the participant skill level (RN, LPN, Physical Therapist) • Designed for the inexperienced or novice provider • Primary focus on wound assessment and bariatric wound and skin care – Please complete the survey at the end of webinar.
OTHER ACTIVITIES IN THE WORKS • Team STEPPs training • Subject Matter Expert Resources • SCRIPT UP • Other ideas (group discussion – all lines OPEN)
• FHA Statewide Initiative • Provides real-time data on patients • Used in 18 other states • Results: • Prevented readmissions • Identified patients with opioid seeking behavior • Reduced non-emergency ED visits • Learn more: May 11, 2018 – 10 am ET FHA New Initiative: EDIE [Webinar] Emergency Department Information Exchange
Future Planning: Tell us about the resources you would you like FHA to offer… • Lean training • TCAB • Sepsis training for all provider types • Other ideas (group discussion)
Upcoming Events In-Person Meetings: – WAKE UP to Protect Patients from Oversedation June 12, 2018: FHA Corporate Office, Orlando, FL June 14, 2018: Sacred Heart Hospital, Pensacola, FL – SAVE THE DATES! May-August | Readmissions Discussion Forums May 17, 2018: Jupiter Medical Center, Jupiter, FL May 23, 2018: FHA Corporate Office, Orlando, FL Jun. 15, 2018: Pensacola, FL Other Areas to be Announced [Regional invitations and registration details coming soon] NHSN Training (to be announced for this Summer) – Check your HIIN INFO Upcoming – Wound Care Seminar (to be announced) Events Weekly Email for details Virtual Events: and registration May 1 | FHA HIIN - CDI in the Pediatric Population May 3 | FHA IVAC Bi-Monthly Webinar #2 May 3 | HRET HIIN NHSN CDI Surveillance Definition Review May 7 | FHA HIIN SafeCulture Offering: Informational Webinar May 8 | HRET HIIN Readmissions Sepsis Fishbowl Series: 2 May 8 | FHA HIIN Chasing Zero Infections MRSA Coaching Call
Contact Us We are here to help! HIIN@fha.org 407-841-6230 SAVE THE DATE! Next HIIN Lead Quarterly Virtual Meeting July 30, 2018 11am ET
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