FEBRUARY 2016 IS SSI PREVENTION AUDIT MONTH: WHAT YOU NEED TO KNOW TO PARTICIPATE

Transcription

1 FEBRUARY 2016 IS SSI PREVENTION AUDIT MONTH: WHAT YOU NEED TO KNOW TO PARTICIPATE

2 Welcome to our francophone attendees Bienvenue à nos participants francophones Conseillère en sécurité et en amélioration Safety Improvement Advisor Gina Peck

3 Today s Speakers Dr. Curtis Smecher VP, Quality and Patient Safety BC Anesthesiologists Society Dept Head, Anesthesiology Abbotsford Regional Hospital and Cancer Center Virginia Flintoft, MSc BN, Manager Safer Healthcare Now! Central Measurement Team Carla Williams Patient Safety Improvement Lead Safer Healthcare Now!

4 SSI Prevention Audit is New this year! The Event has been planned in partnership with: Alberta Health Services-Surgery Strategic Clinical Network Atlantic Health Quality & Patient Safety Collaborative BC Patient Safety & Quality Council Health Quality Ontario Saskatchewan Ministry of Health- Patient Safety Unit

5 Overview Why focus on SSI Prevention and measurement? Why should I participate? What is SSI Prevention Audit? Who may participate? How do I participate? Where can I find resources for the SSI Audit?

6 Why Focus on SSI Prevention?

7 James 71 years old retired barber I worked hard all of my life Family: A Brother Brian 3 Sisters Janet, Louise, Mary 2 Sons: Jesse, Roy 6 Grandchildren: Elizabeth (18), Margaret (18), Allen (13), Nicholas (12), Brenda (8), Thomas (6) Well prior to his first surgery

8 My Introduction to James by a colleague: James You have a patient next week who s risk assessment is 50% That s a 50% chance of death or a Major cardiac event. 50/50 Chance of leaving the hospital alive.

9 Medical Background Well until 3 years ago: Ruptured AAA, with a Stent Repair Stormy post-op course including Cardiac Arrest Infected Aortic Graft Too sick to remove graft Plan: long term Antibiotics Sacral Plexopathy with parapelegia wheelchair dependant Living in Residential Care James More Recently: A number of Urosepsis events Ureteric Obstruction due to inflammation around infected graft Poor Kidney Function Anemia of Chronic Disease Chronic infection Poor Kidney Function Prior Cardiac Arrest Parapelegic Chronic Anemia Huge operation with large anticipated blood loss

10 The Operation James 1. Route his blood flow from his Left Axillary Artery to his Femoral Artery (Ax-Fem Bypass) 2. Connect the two Femoral Arteries (Fem-Fem Crossover) 3. Remove his Aorta and Aortic Grafts from his Kidneys to his Iliac Arteries

11 The Operation 1. James was given a 50/50 Chance 2. The Operation took about 8 hours 3. The OR went very well 4. He lost most of his blood volume, which was replaced from the Blood Bank: PRBC, Plasma, Platelets James

12 The Operation James His Aorta and grafts were heavily infected. It was a very dramatic presentation. The OR staff (who have seen it all ) were impressed that James had survived the infection at all, much less 3 years. Infection by: Drug Resistant Pseudomonas

13 Now James James is doing amazingly well. He is finding more movement of his legs His Kidney function is improving He is getting stronger every day

14 Surgical Site Infections SSI s happen to real people People with real lives People with Families People with Communities James SSI s are not about statistics, they are about real people

15 How many people? James SSI s are the most common Healthcare Associated Infection among Surgical Patients 2-5% of all Surgeries (1.3 M in Canada) 26-65,000 patients yearly And at what cost?

16 James Dollars: $350,000 to 1 Million Canadian?

17 Resources: 11 Days increased LOS 60% more ICU time 5x more likely to be readmitted James 60% Preventable 2x the mortality

18 Personal Cost James: His health Years of his life being unwell Almost, his life James Jesse, Roy Their Father Brian, Janet, Louise, Mary Their Brother Elizabeth, Margaret, Allen, Nicholas, Brenda, Thomas Their Grandfather

19 But, SSI s are not about statistics, they are about people We need statistics to improve how we treat people like James

20 Join the SSI National Audit Nationally and Provincially It is important to know how we re doing Where are we having problems Where do we need to put effort in Where will we get (need) the biggest improvement for people like James Locally How do you stack up? We all think we re doing a good job, but without measuring, we don t really know Where do you need to improve?

21 How many problems like James can we avoid?

22 National SSI Prevention Audit Call to Action Virginia Flintoft, MSc, BN and Alexandru Titeu, BA (Hons) January 7, 2016

23 What is the SSI Prevention Audit? The Canadian SSI Prevention Audit is designed to establish a national perspective of the adoption and implementation of established process measures for preventing SSI. It is hoped that the results will be used to inform and drive local and systemic improvement efforts

24 Why Should I Participate? Identify areas of excellence and areas for improvement Measurement is critical to improve the delivery of safe and effective healthcare

25 Who may participate? All organizations at which surgery is performed are encouraged to use measurement to support SSI Prevention quality improvement efforts throughout the month (and throughout the year!). Safer Healthcare Now! has made available a SSI Prevention Audit tool to support collection of measures related to SSI Prevention pre, peri, and post-operative processes. 25

26 How Do I Participate? 26

27 How to Register Visit the Canadian Surgical Site Infection Prevention Audit webpage to get started tyinstitute.ca/en/event s/ssiaudit/pages/defa ult.aspx 27

28 STEP Register to participate in SSI Prevention Audit month There is no cost to register! By registering you are committing to auditing your SSI processes and submitting your data during the month of February. Regardless of whether you are currently or have never used the SSI Prevention Quality Audit tool, we would like all organizations to register. Registration allows the SHN Central Measurement Team to contact you with information on how to access your site/unitspecific SSI Prevention Quality Audit tool(s). All SSI audit data collected for February and submitted before the second week of March will be included in the analysis (even if you have not registered). 28

29 Registration 527&state=step2direct&eve nt=

30 STEP Determine the audit areas Consider which care areas you would like to audit and how you might wish to group/analyze the audit results. For example, would you like to collect and analyze audit data from multiple units?, across multiple sites?, across a region? Drill down Roll up

31 STEP ❸ Choose a sampling approach No specific sample size Base sample size on patient volumes and resources available

32 Example of a Sampling Strategy Average Monthly Population Size "N" < 20 Minimum required sample "n" No sampling; 100% of population required > % of population size

33 Patient Safety Metrics - Introduction Features: Free, cloud-based data collection and reporting tool Available in English and French User friendly and simple to navigate Accessible from website with login details Tracks >100 process and outcome measures over 14 interventions Provides real time reporting and export of data to CSV/Excel Reduces burden of data collection, entry and analysis Roll Up or Drill Down Reports (i.e. Unit Organization Health Region Province National) with automated Run Charts Capacity to customize measures and reports Provides real time reporting and export of data to CSV/Excel

34 Computer generated barcode identifies your audit area/unit 34 34

35 Need this entered on every page So we may contact you if there is an error 10 s Date is required on every form units 35

36 36

37 SSI Infection PRE-OP Score SSI PRE- OPERATIVE SCORE (14) 37 37

38 SSI Infection PERI-OP Score SSI PERI-OPERATIVE SCORE (15) 38 38

39 SSI Infection POST-OP Score SSI POST- OP SCORE (16) 39 39

40 SSI Infection Score SSI INFECTION SCORE (17) 40 40

41 Data Collection (Audit) tool- BE AWARE! DO Colour inside the line - fill in bubble completely (Sharpie is best) Avoid stacking forms when filling in bubbles to avoid bleed through Use the void bubble for entry errors avoid scratch out Print new form each time - avoid photocopying Avoid using 3-hole punch on forms Keep form free from extra markings Fax without a cover sheet Fax form in FINE RESOLUTION - check setting on fax machine 41

42 SSI Audit Form Instructions (4 pages)

43 Accessing Instructions from PSM

44 STEP ❹ Access your audit tool You can: Use a previously generated SSI Prevention tool(s) OR Have the Central Measurement Team assist to generate your SSI Prevention tool(s) OR Generate the SSI Prevention tool(s) yourself, using the Patient Safety Metrics System 44

45 Accessing or Creating a Form from PSM

46 STEP Complete the audit Detailed instructions are available at: tute.ca/en/events/ssiaudit/p ages/default.aspx 46

47 STEP Submit your results Submit your results to the Patient Safety Metrics system Using a high resolution setting, fax your audit tool to the number found at the top of the audit tool 47

48 Resources Patient Safety Metrics System: SSI audit details Methodology FAQ s Instruction booklet Register for the audit 48

49 What then? Post Audit results March 24,

50 Questions? 50

51 We are here to help! For Audit forms, Data Questions and SSI Content CPSI Central Measurement Team Virginia Flintoft Alexandru Titeu Anne MacLaurin amaclaurin@cpsi-icsp.ca CPSI Patient Safety Intervention Lead Carla Williams cwilliams@cpsi-icsp.ca 51

52 We looking forward to your participation in the Canadian SSI Prevention Quality Audit Month! Thank you for attending! 52