LEAN HEALTHCARE: Elimination of CAUTI on 8 East Providence St. Vincent Medical Center. Purdue Research Foundation

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1 LEAN HEALTHCARE: Elimination of CAUTI on 8 East Providence St. Vincent Medical Center 1

2 About Us Providence St. Vincent Medical Center PSVMC is located Portland, Oregon. We are a level 2 trauma center with 523 licensed beds 2

3 CAUTI Our Lean Project High CAUTI rate on 8E compared to other inpatient units Striving for Zero CAUTI s Decrease urinary catheter days by 10% & reducing CAUTI s by 25% by December 2013 Decrease in Device Days & CAUTI Rates 424 catheter days in the baseline period, resulting in a CAUTI rate of

4 Project Team W. Kent Williamson, MD Executive Sponsor Paula Derr, RN QM Sponsor Carla Iverson Co-Team Lead Connie Smith, RN Co-Team Lead Kathy Phipps, RN Team Member Laurie Murray-Snyder Team Member Carol Simmons, RN 8 E Manager Team Member Pat Roby, RN 8 E Charge RN Team Member DeeDee Kight, RN 8 E Charge RN Team Member Dennis Drapiza, RN Infection Prevention 4

5 Define 10 CAUTI s on 8E in 18 months CAUTI s are a Medicare Never Event Increases patient safety by reducing urinary catheter days & reducing CAUTIs to ZERO Decreases number of patient days to lower cost to hospital Increases revenue by maximizing bed capacity 5

6 Measure The areas of focus to reach the goal of eliminating CAUTIs will be to decrease device utilization days & standardize catheter care & maintenance procedures 6

7 Analyze Lack of visual system for communication Lack of developed educational materialscatheter maintenance & peri care No system to track location of bladder scanner & vital sign tower Inadequate availability of catheterization supplies & peri care due to staffing cutbacks in supply & distribution 7

8 Improve Standardized post op order to remove FC post-op day one 4/13 Facilitated access & education for 8 East charge nurses to pull daily patient catheter report from EPIC 7/25/13 8 East charge RN begins conducting daily FC rounding; monitor white board usage, UC indications & maintenance procedures 7/29/13 8

9 Created area on patient white board for documentation of Foley insertion date 7/29/13 Improve Log for staff huddles & Foley catheter rounding by charge nurse. 7/24/13 9

10 Improve House-wide computer screen savers to show proper FC maintenance 7/16/13 ses to pull daily patient catheter report from EPIC. 7/25/13 Created area on white board for documentation of insertion date of UC and epidural catheters. 7/29/13 10

11 Improve Develop FC maintenance & peri care educational materials for RN, CNA s, & patients 8/12/13 Educate Transportation team on proper placement of catheter bag during transport 8/22/13 Central Supply to develop consistent inventory and restocking area 9/16/

12 Improve Creation of a Kanban system & dedicated Foley cart with bladder scanner and necessary supplies 9/16/13 12

13 Control CAUTI rate was 0 in the 2nd quarter 2013 compared to the baseline rate of 4.72 in the first quarter. The unit has achieved the project goal of 0 The device utilization rate (DU) in the 2nd quarter 2013 was 0.15, compared to the baseline rate of The 10% DU reduction target has also been attained 13

14 Spread of project Continued personal engagement Presentation to Quality Council Engaged directors of ICU and Med Surg 8E team is currently spreading through the Medical Center 14

15 Sustainability of project 15

16 Sustainability of project 8 East charge RN will maintain daily UC rounding & log results 8 East charge RN will roll-up monthly CAUTI data, provide and share data with IC & 8E staff The IC staff will combine outcome & process data by combining CAUTI & device utilization days to present to the SCIP & QC Team will present A3 to QC & will seek endorsement & create accountability plan to spread the process housewide by year end 2013 The CAUTI team will conduct quarterly meetings for one year ending October

17 Advice to Others & Lessons Learned Look beyond catheter insertion for issues Full engagement of the team With a willing, dedicated team you can accomplish outcomes quickly Follow the Lean process and outcomes will follow 17

18 QUESTIONS? 18

19 Contact Information Constance Smith, RN, MS, Providence St. Vincent Medical Center (503) Carla Iverson, BS Providence St. Vincent Medical Center (503)

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