AHRQ Safety Program for Improving Surgical Care and Recovery. ACS Quality and Safety Conference New York City July 21, 2017

Transcription

1 AHRQ Safety Program for Improving Surgical Care and Recovery ACS Quality and Safety Conference New York City July 21,

2 Project goals To measurably improve patient outcomes in five surgical areas by increasing the implementation of enhanced recovery practices in hospitals, through the use of an adaptation of the comprehensive unit based safety program. In addition, it is anticipated to reduce healthcare utilization, and improve the patient experience. 2

3 How are we going to get there? Standardization Reduction in variation Patient & Mobility Multimodal Analgesia Optimal Nutrition Evidence-based SSI, VTE & Family Engagement UTI Bundles AHRQ Safety Program for Improving Surgical Care and Recovery

4 Learning from those who have gone before us AHRQ Safety Program for CLABSI AHRQ Safety Program for Surgery (SUSP) ACS NSQIP Build a Community Declare clear goals Leadership Surgeons Engagement Quality Data AHRQ Safety Program for Improving Surgical Care and Recovery

5 Implementation Model * *Transdisciplinary team (surgeons, anesthesiologists, nurses) 5

6 Participation overview Participation is open to all hospitals in the United States, Puerto Rico and the District of Columbia Five cohorts, organized by surgical procedure Colorectal (NOW!) Ortho (January 2018) Emergency General Surgery (January 2019) Bariatrics (January 2019) Gynecology (January 2020) Hospitals can participate in one or more cohorts Each cohort will last 12 months No fee to participate 6

7 Tools Clinical Implementation Guide Pathway Evidence reviews elearning modules (to assist with local adaptation) Patient Education Materials Intervention checklist Example order sets Pocket guide Posters Adaptive Baseline Data and Goal Setting Patient and Family Engagement Strategies Return on Investment Calculator Stakeholder Analysis Case Studies in Sustaining Enhanced Recovery Sharing Progress with Senior Executive Partners 7

8 ISCR tools: Implementation Guide 8

9 ISCR tools: Pathway Worksheet 9

10 Available Assistance (One on One) Implementation Support ACS Clinical Support National Project Team Via or telephone AHRQ Safety Program for Improving Surgical Care and Recovery

11 Peer and Expert Learning(Group) Coaching Calls National Leader Calls Ask ISCR Calls AHRQ Safety Program for Improving Surgical Care and Recovery

12 Face to Face Training Change management & Leadership Simulation-based training First hand experience managing implementation Understanding stakeholder perspectives Developing the value case for hospital leadership Team development Prioritization of resources 12

13 Performance Measurement Process measures Outcome measures (SSI, VTE, UTI, mortality) Utilization (length of stay and readmission) Patient Experience Reports will be available to monitor performance Available to hospitals with andwithout existing NSQIP subscriptions 13

14 Hospitals who have: Who should participate? No prior enhanced recovery implementation experience Tried to implement enhanced recovery, but efforts did not lead to significant improvements or program failed to sustain Completely implemented enhanced recovery in colorectal surgeries and would like to learn from others and share your experience Health systems looking to develop best practices systemwide 14

15 Recognition 15

16 PATIENT QUOTES It was a wonderful experience, they made my pain and stress go in a better way during my stay. I was amazed that I didn't experience any pains or discomfort when I woke up from the operation or even weeks later. I would like to thank all of you who participated in it. Every phase of my care was well-coordinated, contributing to a very pleasant hospital experience. Excellent communication. Nurses very attentive especially my pain management. 16

17 Where can we go together? Improve collaborative relationship between hospital leadership and clinical teams? Consistent prescribing of non-narcotic analgesic agents post surgery? SSI rate of 5% or less? Consistent and clear bowel prep recommendations for colorectal surgery? Opioid free analgesia in the operating room? Promote transdisciplinary collaboration amongst perioperative providers? Get patients back to work and family activities more quickly? Consistent administration of VTE prophylaxis no missed because of either confusion or patient refusal? Consistent feedback of performance data to all disciplines? Family members partnering with care team to help with postoperative mobility of their loved ones?

18 Join us! Colorectal surgery: Now Orthopedics: Fall