2016/17 Quality Improvement Plan "Improvement Targets and Initiatives"

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1 2016/17 Quality Improvement Plan "Improvement Targets and Initiatives" Queensway-Carleton Hospital 3045 Baseline Road AIM Measure Quality dimension Objective Measure/Indicator Unit / Population Source / Period Organization Id Current performance Effective Reduce 30 day Percentage of acute % / All acute DAD, CIHI / July 777* readmission rates for hospital inpatients patients 2014 June 2015 select HIGs discharged with selected HBAM Inpatient Grouper (HIG) that are readmitted to any acute inpatient hospital for nonelective patient care within 30 days of the discharge for index admission. Target Target justification Our stretch target represents close to a 5% improvement over previous results.

2 Reduce readmission rates for patients with CHF Risk-Adjusted 30-Day All-Cause Readmission Rate for Patients with CHF (QBP cohort) % / CHF QBP Cohort DAD, CIHI / January 2014 December * The target is lower than our peer comparator rate and represents over 14% improvement from previous results. Reduce readmission rates for patients with COPD Risk-Adjusted 30-Day All-Cause Readmission Rate for Patients with COPD (QBP cohort) % / COPD QBP Cohort DAD, CIHI / January 2014 December * Our target represents the peer comparator crude readmission rated for COPD as presented through CIHI

3 data, and is a better than 10% improvement over our current performance. Reduce readmission rates for Stroke patients Risk-Adjusted 30-Day All-Cause Readmission Rate for Patients with Stroke (QBP cohort) % / Stroke QBP Cohort DAD, CIHI / January 2014 December * Our target represents a 13% improvement over last year's rates and is more aggressive than our peer comparator based on crude readmission

4 rates provided by CIHI for patients with stroke Improve Organizational Financial Health Total Margin (consolidated): % by which total corporate (consolidated) revenues exceed or fall short of total corporate (consolidated) expense, excluding the impact of facility amortization, in a given year. % / N/a OHRS, MOH / Q3 FY14/15 777* The target is a balanced budget.

5 Reduce unnecessary deaths in hospitals HSMR: Number of observed deaths/number of expected deaths x 100 Ratio (No unit) / All patients DAD, CIHI / 2014/15 777* Performance at QCH has recently been significantly better than the expected HSMR of 100. Our goal is to maintain this level.

6 Efficient Reduce unnecessary time spent in acute care Total number of ALC inpatient days contributed by ALC patients within the specific reporting period (open, discharged and discontinued cases), divided by the total number of patient days for open, discharged and discontinued cases (Bed Census Summary) in the same period. % / All acute patients WTIS, CCO, BCS, MOHLTC / July 2015 September * Although we continue to make efforts to move toward the LHIN target of 13.1%, we recognize that there are no new community capacities available to assist this effort. Maintaining the current level will be difficult in this reality. In addition, it should be noted that the "current performance" is based on information from July to September only, and our target is representing the entire year. Patient-centred Improve patient Would you % / ED patients NRC Picker / 777* Our target is to satisfaction recommend this ED to your friends and family? add the October 2014 September maintain our current level of satisfaction while

7 number of respondents who responded Yes, definitely (for NRC Canada) or Definitely yes (for HCAHPS) and divide by number of respondents who registered any response to this question (do not include nonrespondents). going through significant renovation in the Emergency Department. This is still greater than the provincial mean of 71.9%. Would you recommend this hospital (inpatient care) to your friends and family? add the number of respondents who responded Yes, definitely (for NRC Canada) or Definitely yes (for HCAHPS) and divide by number of respondents who registered any hi % / All patients NRC Picker / October 2014 September * Our target of 85% is difficult to attain, is within 1% of our previous results, and is better than the NRC 75th percentile 14/15 benchmark of 82% based on the same target population of Medicine, S

8 Safe Increase proportion of patients receiving medication reconciliation upon admission Reduce hospital acquired infection rates response to this question (do not include nond ) Medication reconciliation at admission: The total number of patients with medications reconciled as a proportion of the total number of patients admitted to the hospital CDI rate per 1,000 patient days: Number of patients newly diagnosed with hospital-acquired CDI during the reporting period, divided by the number of patient days in the reporting period, multiplied by 1,000. % / All patients Hospital collected data / most recent quarter available Rate per 1,000 patient days / All patients Publicly Reported, MOH / January 2015 December * Surgery, Mother/Baby and Rehab Although i we exceeded our previous target of 85%, this pertained to only Medicine and Surgery patients. The new target expands the Medication Reconciliation (Med Rec) program to all inpatients and 777* We h exceeded f our target for 2015/16, and are performing better than the current provincial mean of 0.26 cases per 1,000 patient days.

9 Timely Reduce wait times in the ED ED Wait times: 90th percentile ED length of stay for Admitted patients. Hours / ED patients CCO iport Access / January December * We will be working toward sustaining the results that were seen in the previous year, and have maintained this target with the knowledge that the target is better than the provincial average of 29.2 hours. We continue to face increases in Emergency visits of grater than 5% year over year, and occupancy rates of near 100%, both of which contribute to making this target a stretch target.

10 Change Planned improvement initiatives (Change Ideas) Methods Process measures 1)By year end, will have 25% of diabetes resource time allocated to inpatient care Manual statistical collection for diabetes resource person Goal for change ideas # inpatient diabetic consults per day 2 2)In year 1 of a 3 year plan, implement standardized discharge information specific to diabetes adopted from regional "diabetes management committee" Manual audit of charts of discharged diabetic patients % of diabetic patients who receive standardized discharge information in Quarter 4 of this fiscal year 50 3)Implement specific pre printed orders from the diabetes tool kit Review list of patients who have diabetes pre-printed orders based on scanned copies of the documents % of diabetic patients who have had pre-printed orders utilized in the fourth quarter of this fiscal year 75

11 1)Develop standardized process for discharge of patients whose LACE score is 11 or over Audit components of the standardized discharge process % patients with a LACE score of 11 or higher who receive the standardized discharge process. To be measured in Q )Develop standardized readmission review process Manual audit of charts of readmitted patients with Congestive Heart Failure (CHF) % of readmitted CHF patients for which there is a standardized readmission review completed 80 3)Ensure CHF patients are referred to the appropriate outpatient/community partners Manual review of charts of patient with CHF upon discharge. % of CHF patients referred to external resources 50 4)Implement medication discharge counselling for CHF patients with LACE scores 11+ Dedicated pharmacist collection of data related to each patient counselled 1)Determine specific needs Audit of the community referral component of the for referral to appropriate standardized discharge process community partners (such as Health Links, CCAC, other community partners etc) for COPD patients at high risk of readmission % of high risk CHF patients who receive medication teaching by a pharmacist prior to discharge % of patients with Chronic Obstructive Pulmonary Disease (COPD) who have LACE score of 11 or higher and are assessed for the need for referral to community resources 80 75

12 2)Follow up appointments made before patient leaves hospital Compare the number of discharged COPD patients to those who have a verified appointment booked % of discharged COPD patients who have an appointment booked (within 7-10 days) with the family physician prior to discharge 50 3)Ensure accurate referral to CCAC Rapid Response Nurse as part of the standardized discharge planning process Statistics available for monitoring the increase in referral rate through CCAC % increase in referral for COPD patients 10 4)Implement medication discharge counselling for COPD patients with LACE scores 11+ 1)Ensure education of staff who work in stroke unit Dedicated pharmacist collection of data related to each patient counselled % of high risk COPD patients who receive medication teaching by a pharmacist prior to discharge 80 Manager manually reports on attendance % of new staff working in stroke unit who receive full day stroke education 100 2)Sustain hospitalist model for rounding so that barriers are addressed in a timely fashion Attendance records will be collected for all rounds. A manual review for attendance of various members will be completed. % of rounds with hospitalists attending 90

13 3)Ensure accurate referral to CCAC Rapid Response Nurse as part of the standardized discharge planning process Statistics available for monitoring the increase in referral rate through CCAC % increase in referral for stroke patients 10 4)Follow up appointments made before patient leaves hospital Compare the number of discharged stroke patients to those who have a verified appointment booked % of discharged stroke patients who have an appointment booked (within 7-10 days) with the family physician prior to discharge 50 1)Develop, implement and sustain plans to achieve organizational efficiencies for operational and clinical performance by reinstating a vigorous review process of the 25th percentile as approved by Senior Management Review all financial accounts and compare to benchmark peers to determine whether our results fall into the 25th percentile. % of all departments not meeting 25th percentile who have analyzed results and put acceptable improvement plans in place 100 2)Review and improve processes for sitter and security guard usage on the inpatient units Financial accounting report Dollar reduction in cost of sitter/security guards 100,000

14 3)Review and improve processes for non-urgent patient transport Financial accounting report Dollar reduction in costs of non-urgent transport 75,000 1)Identify expertise required for staff in the specialty hip fracture unit and provide training. 2)2) Develop a model of care to support the post-op fractured hip patient unit with a Medicine MRP to reduce complications such as delirium/constipation frequently encountered in these patients Count of number of full time staff educated Annual HSMR analysis provided by CIHI Number of appropriate full time staff who receive training to provide care to hip fracture patients % Reduction in potentially avoidable deaths in the hip fracture population 75% 50 3)Develop criteria for admission of appropriate patients to the 4-bed hip fracture specialty unit. Occupancy is captured in decision support Mean % occupancy of 4-bed specialty unit 90

15 1)Develop standardized process for discharge of patients whose LACE (readmission risk) score is 11 or over Audit components of the standardized discharge process % patients with a LACE score of 11 or higher who receive the standardized discharge process. To be measured in Q )Determine specific needs Audit of the community referral component of the for referral to appropriate standardized discharge process community partners (such as Health Links, CCAC, other community partners etc.) for all patients at high risk of readmission % of patients with LACE score of 11 or higher who are assessed for the need for referral to community resources 75 3)Build on acute to subacute navigation project pilot with Bruyère Continuing Care (BCC) Collect data related to number of referrals sent versus those accepted 4)Implement a valid tool on Chart review on discharge of patient to count those with the Acute Care of the Elderly completed admission and discharge assessments of (ACE) unit to measure functional status changes in functional status % of referrals to Bruyère accepted 80 % patient who are assessed at admission and discharge 85 1)Improve the reception to triage time through the use of existing resources and EDM. Review data collected through Decision Support for time from reception of the patient to triage of the patient Average number of minutes from Reception to Triage 20

16 2)Continue regular Nurse Review Assistant Nurse Manager log to determine Manager Patient Rounding number of patients rounded per day in the ED to assess and improve patient satisfaction. # patients seen through Manager rounds per day 4 3)Implementation of the new Model of Nursing Care Completion of all components of implementation of the nursing model of care % of the full Model of Nursing care deployed by the fourth quarter of 16/ )Improve wait times for low-acuity, non admitted patients through process improvement and use of a physician who focuses on patients who are breaching the targeted wait times. Information tracked by the Decision Support Daily DART. # hours for length of stay for Canadian Triage and Acuity Score (CTAS) level 4, CTAS level 5 and non admitted patients 4 1)Implement revised visiting hours throughout the organization with identified care partner 2)Continue to engage Patient and Family Advisory Council Assess number of complaints registered to the patient ombudsman related to visiting hours policy. Count number of unique projects/program issues brought to the Patient and Family Council for input or feedback % reduction in number of complaints related to visiting hours policy # new agenda items for discussion at patient/family council in FY 2016/

17 3)Reduce the % of finance/billing related patient complaints 1)Develop a plan to spread Med Rec to Mom Baby unit and mental health Review of complaints data through Patient Ombudsman % of total complaints related to finance and billing 4 Plan will be completed for review in the fourth quarter % of plan approved 100 2)Ensure completion of Best Possible Medication History (BPMH) for admitted medical patients 3)Ensure completion of BPMH for admitted surgical patients Monthly review of total BPMH by the total volume of admitted medical patients Monthly review of total BPMH by the total volume of admitted surgical patients % completion of BPMH for all admitted medical patients 91 % completion of BPMH for all admitted surgical patients 91 1)Provide education to staff on nursing units regarding the expectations of testing and isolation specific patients with diarrhea. Audit charts of patients with diarrhea to determine compliance with expected practices % compliance with testing and isolation for C difficile in accordance with our guidelines 75 2)Ensure patients are given an opportunity to clean hands before every meal Survey of 100 patients asking if hands are cleaned before meals % patients who report having been given an opportunity to clean hands before meals 100

18 3)Explore the use of an electronic alert to stimulate isolation and testing for patients who have greater than 2 episodes of diarrhea within 24 hours Development and functioning of an electronic alert in Meditech % compliance with testing and isolation of patients with suspected C difficile 75 1)1) Develop a surge policy "Physician initial assessment" (PIA) time is followed to address fluctuations in ED through the Daily DART; Data captured in NACRS for visits to properly align monthly review resources which will help to expedite the time to final disposition of the patient. Number of hours from triage to physician assessment 3.4 2)Develop a standardized process for discharge of patients whose LACE score is 11 or over. Audit components of the standardized discharge process % patients with a LACE score of 11 or higher who receive the standardized discharge process. To be measured in Q )Deploy Mental Health Wait time is measured from the triage time to time that Crisis Intervention Service to the patient leaves the Emergency Department for improve the disposition admission. Diagnosis codes are used to identify the time for admitted patients. target patient group. Number of hours in Emergency Department for admitted patients with Mental Health and Substance Abuse issues 18 4)Develop admission criteria Randomized chart audit of 20 patients referred to ACE for the Acute Care of the to determine if each met the admission criteria. Elderly (ACE) Unit to identify appropriate patients as quickly as possible. % appropriate referrals from Emergency Department to ACE 100

19 Comments Each consult will take approximately 1 hour, and this resource will also be completing the initiation of the year 1 plan for the diabetes tool kit The measure will take place in quarter 4 to allow for this new process to be developed and implemented. In addition, it will require education to all staff for implementation. We are targeting 75% of patients as we recognize that there are patients for whom the pre-printed or "standardized" orders will not apply

20 In order to provide an effective discharge process in order avoid patients who are at high risk for readmission having to return to the ED, and to increase capacity in the hospital by efficiently moving people out of hospital, we are developing a standardized discharge process with measurement (audit?) that the specific steps are completed as intended. Many CHF patients are already connected to the CHF clinic, the University of Ottawa Health Institute,their family physician or a community cardiologist prior to the current admission, and a repeat referral would not be required. This initiative will go forward if requested resources are able to be allocated to support it. Although we will aim to have 100% of COPD patients assessed to determine their needs postdischarge, we appreciate that some patients will not be reached such as those with very short admissions.

21 Verification of this process is a new initiative that will help us understand the reasons that appointments are not booked prior to discharge. We anticipate some barriers including inability to contact family physician. Rapid Response Nurses work collaboratively with CCAC Care Coordinators and other existing health-care professionals, hospital staff, physicians, nurse practitioners and community agencies to help vulnerable patients - both adults and children - avoid unnecessary emergency department visits and hospital re-admissions following discharge. This initiative will go forward if requested resources are able to be allocated to support it. Use of best practices in caring for stroke patients enhances their management and recovery. There are times when illness or other conflicts will not allow the hospitalist to attend rounds. These events should be less than 10% of the time.

22 Rapid Response Nurses work collaboratively with CCAC Care Coordinators and other existing health-care professionals, hospital staff, physicians, nurse practitioners and community agencies to help vulnerable patients avoid unnecessary emergency department visits and hospital re-admissions following discharge. Verification of this process is a new initiative that will help us understand the reasons that appointments are not booked prior to discharge. We anticipate some barriers including inability to contact family physician. Use of sitters and guards is currently costing over $600,000 annually. With increased attention and standardized processes, we expect to decrease this to $500,000.

23 Non-urgent patient transport is currently costing the hospital almost $500,000. We anticipate that these costs can be reduced through improvement of the processes used to identify patients who are using nonurgent transport. This area is intended to provide a higher intensity of resources due to the higher acuity of patients. The annual HSMR report gives information on potentially avoidable deaths in various patient populations. We are able to house 50% of the median number of hip fracture patients that are typically in the hospital in this specialty unit. We expect therefore to see a statistical 50% reduction in avoidable deaths. This 4-bed unit will have capacity to hold only half of the average in-patient volume of patients with fractured hips. Therefore, we must develop criteria that allows us to select those who would most benefit from the additional services.

24 To provide an effective discharge process in order avoid patients who are at high risk for readmission having to return to the ED, and to increase capacity in the hospital by efficiently moving people out of hospital, develop a standardized discharge process with measurement (audit?) that the specific steps are completed as intended. Although we will aim to have 100% of patients assessed to determine their needs postdischarge, we appreciate that some patients will not be reached such as those with very short admissions. November 2015 to March 2016 (4 months) of data represented 72% acceptance rate The first step of improving functional status is the process of measuring functional status with a validated tool that is incorporated into our processes on the ACE unit to provide a baseline measure. Further work to improve functional status will result from this process. A number of calls from patients have noted dissatisfaction with time to triage

25 Regular rounding by the Nurse Manager improves the satisfaction of patients by assessing care and addressing immediate concerns, relaying the message that the leader cares about their issues, and relaying the message that patients can expect excellent care. The new model of nursing care will lead to enhanced opportunities for nursing assignment and use of the full scope of nursing professional standards, allowing enhanced patient care. Currently at 5.3 hours Issues such as the new visiting hours policy, the whiteboards redevelopment, physician assisted suicide policy and all patient education material will be tabled at the patient and family advisory council for input, development and/or feedback.

26 Currently over 6% of complaints are related to finance and billing Our goal is to execute the plan in fiscal year We intend to maintain or exceed the level of completion of Med Rec for medicine patients compared to previous year We intend to exceed the level of completion of Med Rec for surgical patients compared to the previous year. Current compliance is low, based on data collected last year. Some patients, who have alternative explanations for diarrhea, may not be isolated or tested as quickly as the guidelines require. C. difficile is an ingested organism. Cleaning hands before eating is very important. Ensuring patients who are unable to get up to an alcohol gel dispenser or a sink have an opportunity to clean their hands, at least with alcohol gel will help to remove organisms form patient's hands.

27 Current compliance is low, based on data collected last year. Some patients, who have alternative explanations for diarrhea, may not be isolated or tested as quickly as the guidelines require. Long wait times in the Emergency Department (ED) negatively impact patient access to clinical services. PIA has significant impact on the total ED wait time. To provide an effective discharge process in order avoid patients who are at high risk for readmission having to return to the ED, and to increase capacity in the hospital by efficiently moving people out of hospital, develop a standardized discharge process with measurement (audit?) that the specific steps are completed as intended. Long wait times in the Emergency Department (ED) negatively impact patient access to clinical services. ED will follow the admission criteria for ACE 100% of the time.

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