Teamwork, Communication, O.R. Safety & SSI Reduction
|
|
- Briana Cook
- 5 years ago
- Views:
Transcription
1 2011 Infection Prevention Leadership Teamwork, Communication, O.R. Safety & SSI Reduction Teamwork, Communication, O.R. Safety & SSI Reduction 2 Presented by: E. Patchen Dellinger, MD, FACS Professor of Surgery, Chief of General Surgery University of Washington Medical Center (UWMC) Seattle, Washington Disclosures This presentation was sponsored by 3M. 3 1
2 Preventing SSI in the O.R. Prophylactic Antibiotics Procedure selection Antibiotic choice Timing Dose Duration Patient warming FiO 2 Glucose control Hair removal Skin preparation Hand scrub Surgical technique Wound protectors Antibacterial sutures Teamwork 4 Prophylactic Antibiotics Procedure selection Antibiotic choice Timing Dose Duration Patient warming FiO 2 Glucose control Hair removal Skin preparation Hand scrub Surgical technique Wound protectors Antibacterial sutures Teamwork 5 6 2
3 Other Centers Experience with Briefings and Checklists Communication Failures Before and After Team Briefing ures Number of procedures with n recorded communication failu Before Briefing After Briefing Number of communication failures recorded during the procedure 7 Lingard. Arch Surg 2008;143:12-17 Surgical Safety Checklist (WHO and SCOAP) In early 2008 I was privileged to participate in the development of the WHO Surgical Safety Checklist and later to lead one of the pilot hospitals in its implementation. 8 Doing the Checklist at UWMC We had been discussing briefing and debriefing in the Division of General Surgery I saw the checklist as an opportunity to institutionalize briefing and debriefing We had added antibiotic administration to the JCAHO-mandated time out many years ago 9 3
4 UWMC Safety Attitudes Questionnaire - Results Agree or strongly agree After Checklist easy to use 56% Checklist improved O.R. safety 60% Took a long time to complete 23% I would want checklist for me 88% Communication was improved 81% Checklist helped to prevent errors 67% 10 Checklist and Complications Before After n=3773 n=3955 SSI 6.2% 3.4% Unplan Return-O.R. 2.4% 1.8% Any Complic 11.0% 7.0% Death 1.5% 0.8% Haynes. NEJM 2009; 360: Changes in Safety Attitudes and Change in Complication Rates Haynes. BMJ Qual Saf 2011;20:102e
5 Checklist and Complications Before After n=3760 n=3820 SSI 3.8% 2.7% Complic/100 pts Pts with Complic 15.4% 10.6% Death 1.5% 0.8% de Vries. NEJM 2010; 363: Checklist Completion and Complications Checklist Completion Complic Above median 7.1% Below median 11.7% de Vries. NEJM 2010; 363:
6 Communication Quality and Surgical Morbidity Davenport. JACS 2007;205: Impact of Briefings on Delays All reported delays Surgeon-reported delays Communication breakdowns 31% reduction 82% reduction 19% reduction Nundy. Arch Surg 2008; 143:
7 Behavioral Marker Risk Index (BMRI) Briefing Information sharing Inquiry Vigilance and awareness Adjusted Odds Ratio Risk Factor Complication or Death BMRI 4.82 ASA 1.51 Mazzocco. Amer J Surg 2009; 197: Challenges Ahead Institutionalizing the checklist Every O.R., every case Supporting the culture change that the checklist suggests Getting the buy-in of all surgeons Streamlining the checklist to meet the needs of individual hospitals and specialties while preserving the essentials Remembering the debriefing! 21 7
8 Prior to Skin Incision: All Team Members Briefing (Attending Surgeon Leads): Each person introduces self by name and role Surgeon, Anesthesia team and Nurse confirm patient (at least 2 identifiers), site, procedure Personnel exchanges: timing, plan for announcing changes Description of procedure and anticipated difficulties Expected duration of procedure Expected blood loss & blood availability Need for instruments/supplies/iv access beyond those normally used for the procedure Questions/issues from any team member and invitation to speak up at Nursing/Tech reviews: Equipment issues (instruments ready, trained on, requested implants available, gas tanks full) Sharps management plan Other patient concerns Anesthesia reviews: Airway or other concerns Special meds (beta blockers, etc.) Allergies Conditions affecting recovery any time in the procedure 22 Prior to Skin Incision: All Team Members Briefing (Attending Surgeon Leads): Each person introduces self by name and role Surgeon, Anesthesia team and Nurse confirm patient (at least 2 identifiers), site, procedure Personnel exchanges: timing, plan for announcing changes Description o of procedure pocedueand anticipated difficulties Expected duration of procedure Expected blood loss & blood availability Need for instruments/supplies/iv access beyond those normally used for the procedure Questions/issues from any team member and invitation to speak up at Nursing/Tech reviews: Equipment issues (instruments ready, trained on, requested implants available, gas tanks full) Sharps management plan Other patient concerns Anesthesia reviews: Airway or other concerns Special meds (beta blockers, etc.) Allergies Conditions affecting recovery any time in the procedure 23 Prior to Skin Incision: All Team Members Briefing (Attending Surgeon Leads): Each person introduces self by name and role Surgeon, Anesthesia team and Nurse confirm patient (at least 2 identifiers), site, procedure Personnel exchanges: timing, plan for announcing changes Description o of procedure pocedueand anticipated difficulties Expected duration of procedure Expected blood loss & blood availability Need for instruments/supplies/iv access beyond those normally used for the procedure Questions/issues from any team member and invitation to speak up at Nursing/Tech reviews: Equipment issues (instruments ready, trained on, requested implants available, gas tanks full) Sharps management plan Other patient concerns Anesthesia reviews: Airway or other concerns Special meds (beta blockers, etc.) Allergies Conditions affecting recovery any time in the procedure 24 8
9 After Skin Closure Complete: No Retained Objects, Debriefing, Care Transition All Team Members (Attending Surgeon Leads): Surgeon and Anesthesia: Confirm final needles/sponges/ Key concerns for patient instruments count correct recovery Nursing/Tech show Surgeon and What is the plan for pain mgmt? Anesthesia all sponges and laps in What is the plan for prevention holders ( Show Me Ten ) of PONV? Confirm name of procedure If specimen, confirm label and instructions (e.g., orientation of specimen, 12 lymph nodes for colon CA) Equipment issues to be addressed? Response planned (who/when) What could have been better? Improvement planned (who/when) Does patient need special monitoring (time in RR, ICU, tele?) If patient has elevated blood glucose, plan for insulin drip formulated If patient on beta blocker, postop continuation plan formulated 25 After Skin Closure Complete: No Retained Objects, Debriefing, Care Transition All Team Members (Attending Surgeon Leads): Surgeon and Anesthesia: Confirm final needles/sponges/ Key concerns for patient instruments count correct recovery Nursing/Tech show Surgeon and What is the plan for pain mgmt? Anesthesia all sponges and laps in What is the plan for prevention holders ( Show Me Ten ) of PONV? Confirm name of procedure If specimen, confirm label and instructions (e.g., orientation of specimen, 12 lymph nodes for colon CA) Equipment issues to be addressed? Response planned (who/when) What could have been better? Improvement planned (who/when) Does patient need special monitoring (time in RR, ICU, tele?) If patient has elevated blood glucose, plan for insulin drip formulated If patient on beta blocker, postop continuation plan formulated 26 After Skin Closure Complete: No Retained Objects, Debriefing, Care Transition All Team Members (Attending Surgeon Leads): Surgeon and Anesthesia: Confirm final needles/sponges/ Key concerns for patient instruments count correct recovery Nursing/Tech show Surgeon and What is the plan for pain mgmt? Anesthesia all sponges and laps in What is the plan for prevention holders ( Show Me Ten ) of PONV? Confirm name of procedure If specimen, confirm label and instructions (e.g., orientation of specimen, 12 lymph nodes for colon CA) Equipment issues to be addressed? Response planned (who/when) What could have been better? Improvement planned (who/when) Does patient need special monitoring (time in RR, ICU, tele?) If patient has elevated blood glucose, plan for insulin drip formulated If patient on beta blocker, postop continuation plan formulated 27 9
10 After Skin Closure Complete: No Retained Objects, Debriefing, Care Transition All Team Members (Attending Surgeon Leads): Surgeon and Anesthesia: Confirm final needles/sponges/ Key concerns for patient instruments count correct recovery Nursing/Tech show Surgeon and What is the plan for pain mgmt? Anesthesia all sponges and laps in What is the plan for prevention holders ( Show Me Ten ) of PONV? Confirm name of procedure If specimen, confirm label and instructions (e.g., orientation of specimen, 12 lymph nodes for colon CA) Equipment issues to be addressed? Response planned (who/when) What could have been better? Improvement planned (who/when) Does patient need special monitoring (time in RR, ICU, tele?) If patient has elevated blood glucose, plan for insulin drip formulated If patient on beta blocker, postop continuation plan formulated 28 More Information Intraoperative Behavior and Surgical Site Infections Factor Odds Ratio P value BMI > Duration > 3 hr 3.3 < Discipline score > Intest. Anastomosis 6.7 < Not Significant: Extended antiseptic measures - including frequent glove changes, more compulsive cover up and scrub clothing, iodineimpregnated adherent drapes, changing instruments, and extensive irrigation. Beldi. Am J Surg 2009; 198:
11 Intraoperative Behavior and Surgical Site Infections Significant behavior elements: Exchange of surgical team members Movement in the O.R. Noise Visitors Not significant elements: Preparation of patient - extended v. standard Hand scrub - extended v. standard Type of cap/mask Distance to surgical tables maintained Change of patient s position Beldi. Am J Surg 2009; 198: Effect of Noise in the O.R. on SSI Risk Kurmann. Br J Surg 2011; 98: JAMA 2010; 304:
12 Team Training in the O.R. Day-long onsite learning session involving Surgeons Anesthesiologists Nurse anesthetists Nurses Technicians Neily. JAMA 2010; 304: Team Training in the O.R. (Content) Work as a team Challenge each other about safety risks Conduct checklist guided briefings and postoperative debriefings Communication strategies recognize red flags rules of conduct for communication stepping back to reassess a situation effective communication during care transitions Neily. JAMA 2010; 304: Team Training and Mortality Neily. JAMA 2010; 304:
13 Team Training and Mortality In each facility, for every reported increase in degree of briefings and debriefings, mortality was reduced by 0.6 per 1000 procedures (95% CI, , 0.8, p-0.001) Neily. JAMA 2010; 304: Improvements Reported by Medical Team Training Facilities From Structured Interviews Neily. JAMA 2010; 304: Clearly, culture, communication and teamwork in the O.R. have an enormous amount to do with patient outcome, including SSI risk and many other potential complications
14 Thank You 40 14
Teamwork, Communication, Briefing, Checklists, & O.R. Safety
Teamwork, Communication, Briefing, Checklists, & O.R. Safety E. Patchen Dellinger, MD, FACS Professor of Surgery, Chief of General Surgery, Chief of Staff, University of Washington Medical Center (UWMC),
More informationWashington Patient Safety Coalition & Surgical Public Health:
Washington Patient Safety Coalition & Surgical Public Health: Surgical Quality in Washington State (SCOAP- Surgical Care and Outcomes Assessment Program), Surgical Safety, and the Introduction of the WHO/SCOAP
More informationRobert J. Welsh, MD Vice Chief of Surgical Services for Patient Safety, Quality, and Outcomes Chief of Thoracic Surgery William Beaumont Hospital
Robert J. Welsh, MD Vice Chief of Surgical Services for Patient Safety, Quality, and Outcomes Chief of Thoracic Surgery William Beaumont Hospital Royal Oak, Michigan, USA 1 ARE OUR OPERATING ROOMS SAFE?
More informationSURGICAL SAFETY CHECKLIST
SURGICAL SAFETY CHECKLIST WHY: INFORMATION, RATIONALE, AND FAQ May 2009 Building a safer health system INFORMATION, RATIONALE, AND FAQ May 2009 - Version 1.0 The aim of this document is to provide information
More informationQUALITY NET REPORTING
5/18/15% A webinar series that keeps you in the know Brought to you by Progressive QUALITY NET REPORTING Sarah Martin, MBA, RN, CASC Progressive Huddle May 18, 2015 ASCQR ASC Quality Reporting started
More informationHow do we know the surgical checklist is making a meaningful. impact in surgical care? Virginia Flintoft, MSc, BN Vancouver, BC March 9, 2010
How do we know the surgical checklist is making a meaningful impact in surgical care? Virginia Flintoft, MSc, BN Vancouver, BC March 9, 2010 1 Show Me the Evidence You simply have to MEASURE! 2 Why Measure?
More informationJOB DESCRIPTION: SURGICAL TECHNOLOGIST
1507.00. JOB DESCRIPTION: SURGICAL TECHNOLOGIST 1507.01. The Standards & Guidelines for the Accreditation of Educational Programs in Surgical Technology have been approved by the Association of Surgical
More informationOscar Guillamondegui, MD, MPH, FACS Associate Professor of Surgery Tennessee Surgical Quality Collaborative
Oscar Guillamondegui, MD, MPH, FACS Associate Professor of Surgery Tennessee Surgical Quality Collaborative NSQIP 2014 A Collaborative that has Reduced Surgical Site Infections Tennessee Surgical Quality
More informationImproving Compliance
Improving Compliance * The following planners, speakers, moderators, and/or panelists of this CME activity have no relevant financial relationships with commercial interests to disclose: Mary B. Johnson
More informationPOLICY. The purpose of this policy is to establish Saskatoon Health Region s (SHR s) communication requirements for all surgical patients.
POLICY Number: 7311-60-026 Title: Surgical Safety Checklist Authorization [ ] President and CEO [ X] Vice President, Finance and Corporate Services Source: Chair(s), Surgical Operations Committee Cross
More informationSafe Surgery The Checklist Experience
Safe Surgery The Checklist Experience Modificirana prezentacija uz suglasnost Gerald Dziekan, WHO Patient Safety The Surgical burden Estimated 234 million major operations performed worldwide each year
More informationImplementation of Surgical Safety Checklist
Implementation of Surgical Safety Checklist The World Health Organisation has identified through consultation with surgeons, anaesthetists and nurses a checklist of critical steps that are common to all
More informationROLE OF THE ANESTHETIST IN ORGANIZING AMBULATORY SURGERY. Dr. Paul Vercruysse M.D. Belgium
ROLE OF THE ANESTHETIST IN ORGANIZING AMBULATORY SURGERY Dr. Paul Vercruysse M.D. Belgium DISCLOSURES - Conflicts of interest? I am an anesthesiologist... TRADITIONAL ROLE OF THE ANESTHESIOLOGIST EVOLVING
More informationZ: Perioperative Nursing Specialty
Z: Perioperative Nursing Specialty Alberta Licensed Practical Nurses Competency Profile 263 Major Competency Area: Z Perioperative Nursing Specialty Priority: One Competency: Z-1 HPA Authorizations and
More informationEnhancing Patient Safety through Team Work and Communication Strategies
Enhancing Patient Safety through Team Work and Communication Strategies St. Joseph Medical Center- Towson Maryland Program/Project Description. In July 2009, Catholic Health Initiatives, of which St Joseph
More informationINTRODUCTION TO THE OPERATING ROOM FOR OBSERVERS
INTRODUCTION TO THE OPERATING ROOM FOR OBSERVERS DIRECTION FOR DAY OF OBSERVATION Assure that you eat breakfast Bring your ID Obtain scrubs The scrub room opens at 7:45am Take brown elevators to the ground
More informationA System-Based Approach to Colorectal Surgery SSI Reduction: Interventions Across the Episode of Care
A System-Based Approach to Colorectal Surgery SSI Reduction: Interventions Across the Episode of Care Robert R. Cima, MD, MA Minnesota SSI Reduction Effort December 2013 2011 MFMER slide-1 Attestation
More information2012 WEBINAR SERIES. ASC Knowledge Share SAFE SURGERY CHECKLIST: TOOLS TO SUPPORT COMPLIANCE WITH THE NEW CMS REPORTING REQUIREMENT.
2012 WEBINAR SERIES ASC Knowledge Share SAFE SURGERY CHECKLIST: TOOLS TO SUPPORT COMPLIANCE WITH THE NEW CMS REPORTING REQUIREMENT February 23, 2012 Welcome ASC Knowledge Share is a new webinar series
More informationTranslating Evidence to Safer Care
Translating Evidence to Safer Care Patient Safety Research Introductory Course Session 7 Albert W Wu, MD, MPH Former Senior Adviser, WHO Professor of Health Policy & Management, Johns Hopkins Bloomberg
More informationUniversity of Washington Medical Center Approach: Using the NSQIP ROI Calculator to Demonstrate Medical Center Cost Savings
University of Washington Medical Center Approach: Using the NSQIP ROI Calculator to Demonstrate Medical Center Cost Savings E. Patchen Dellinger, MD Rosemary Mitchell Grant, RN, BSN, CPHQ Disclosures E.
More informationOrganizational Culture Change Results in Improvement in Outcomes, Value and Experience. Elizabeth C. Wick, M.D.
Organizational Culture Change Results in Improvement in Outcomes, Value and Experience Elizabeth C. Wick, M.D. Objectives To describe the burden and complexity of surgical site infections To outline the
More informationWelcome to Baylor Scott & White Hillcrest. A Perioperative Services Orientation
Welcome to Baylor Scott & White Hillcrest A Perioperative Services Orientation What does "Perioperative" mean? When a patient is cared for in the Perioperative setting, they receive care preoperatively,
More informationNational Priorities for Improvement:
National Priorities for Improvement: Standardization of Performance Measures, Data Collection, and Analysis Dale W. Bratzler, DO, MPH Principal Clinical Coordinator Oklahoma Foundation Contracting for
More informationEducate, Empower, Engage: A Collaborative Interdisciplinary Call to Action for Reducing Surgical Site Infections
Educate, Empower, Engage: A Collaborative Interdisciplinary Call to Action for Reducing Surgical Site Infections Proceedings and Recommendations from the 2011 Infection Prevention Leadership Summit E.
More informationSURGICAL SAFETY CHECKLISTS
1 SURGICAL SAFETY CHECKLISTS Power Play: Managing the Forces that Impact Implementation The Experience of a small isolated community hospital Presentation by: Mark Balcaen. March 8-9, 2010 2 Background
More informationSSI/OR Safety Introductory Webinar. A partnership of the Healthcare Association of New York State and the Greater New York Hospital Association
SSI/OR Safety Introductory Webinar A partnership of the Healthcare Association of New York State and the Greater New York Hospital Association Agenda 2 Introduction to SSI/OR Safety Approach Zeynep Sumer
More informationWaiting for a family member who is having surgery
Waiting for a family member who is having surgery UHN Information for families, friends and caregivers in the Surgical Family Waiting Room Your family member, friend or loved one is having surgery. We
More informationENVIRONMENT Preoperative evaluation clinic. Preoperative evaluation clinic. Preoperative evaluation clinic. clinic. clinic. Preoperative evaluation
Goals and Objectives, Preoperative Evaluation Clinic Rotation, CA-1 and CA-2 year UCSD DEPARTMENT OF ANESTHESIOLOGY PREOPERATIVE EVALUATION CLINIC ROTATION GOALS AND OBJECTIVES, CA-1 and CA-2 YEAR PATIENT
More informationGoals and Objectives University of Minnesota Department of Anesthesiology Senior Resident Supervising Rotation
UM Anesthesiology Page 1 June, 2007 Introduction Goals and Objectives University of Minnesota Department of Anesthesiology Senior Resident Supervising Rotation The ABA defines the attributes of consultant
More informationSAMPLE Perioperative Self-Assessment Questionnaire
SAMPLE Perioperative Self-Assessment Questionnaire Hospital Name: Person Completing the Assessment: Date: I. Executive Leadership Yes No 1. Do executive leaders have a defined mode of regular communication
More informationMeasuring Harm. Objectives and Overview
Patient Safety Research Introductory Course Session 3 Measuring Harm Albert W Wu, MD, MPH Former Senior Adviser, WHO Professor of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health
More informationPatient Safety Research Introductory Course Session 3. Measuring Harm
Patient Safety Research Introductory Course Session 3 Measuring Harm Albert W Wu, MD, MPH Former Senior Adviser, WHO Professor of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health
More informationUsing the American College of Surgeons Strong for Surgery Toolkit to Optimize Patients for Surgery
Using the American College of Surgeons Strong for Surgery Toolkit to Optimize Patients for Surgery April 2018 1 A partnership of the Healthcare Association of New York State and the Greater New York Hospital
More informationCombined SSI Bundles and ERAS in Colorectal Surgeries
Combined SSI Bundles and ERAS in Colorectal Surgeries Joy Lanfranchi BSN, RN, CNOR, CMLSO Richard Bollin Jr. M.D. Kevin Kinzinger M.D. MBA, FACS, FASCRS Joanne Bonnot MSN, RN, BBA, NE-BC Claudia Skinner
More informationThe Joint Commission and Cleveland Clinic Reducing Colorectal Surgical Site Infections
The Joint Commission and Cleveland Clinic Reducing Colorectal Surgical Site Infections Cleveland Clinic Experience for NSQIP Conference Guido Bergomi 26 July, 2014 Mission Dr. Frank E. Bunts Dr. George
More informationIntroduction to Perioperative Nursing
C H A P T E R 1 Introduction to Perioperative Nursing LEARNER OBJECTIVES 1. Define the three phases of the surgical experience. 2. Describe the scope of perioperative nursing practice. 3. Discuss application
More informationClinical Standardization
Clinical Standardization Joe Sharma, MD, FACS, FACE Associate Professor of Surgery Director, of Endocrine Surgery Chief Quality Officer Emory University School of Medicine Disclosures Engineer US Navy
More informationWelcome to Scott & White Memorial Hospital. Perioperative Services
Welcome to Scott & White Memorial Hospital Perioperative Services What is a Perioperative Nurse? A perioperative nurse is a nurse who provides patient care, manages, teaches, and studies the care of patients
More informationORs in facilities that adopted team training had a lower rate of deaths for
Patient safety VA study shows fewer patient deaths after OR team training ORs in facilities that adopted team training had a lower rate of deaths for surgical patients than facilities that had not yet
More informationPerioperative Surgical Home
None Disclosures Debnath Chatterjee, M.D. Associate Professor of Anesthesiology CRASH 2015 - Vail, Colorado 2 Learning Objectives What is the PSH model? Describe the concept of the Perioperative Surgical
More informationPatient Safety in Resource Poor Settings
Patient Safety in Resource Poor Settings Global Opportunities (MIT April 8, 2011) Pedro Delgado, Executive Director Institute for Healthcare Improvement www.ihi.org 1 Safe, Timely, Effective, Efficient,
More informationOnline Education Modules & Courses Facility Order Form
Online Education Modules & Courses Facility Order Form FACILITY INFORMATION Facility Name: Business Address 1: Business Address 2: City: State/Province: Postal Code: Country: Phone: Health Care System:
More informationNoCVA SSI/VTE Safe Surgery Collaborative
NoCVA SSI/VTE Safe Surgery Collaborative Orientation Webinar #3 Measures and Data Collection July 19, 2012 Presented by: Jan Mangun, MT(ASCP), MSA, CPHRM Executive Director, Quality and Patient Safety
More informationImplementation Manual for the World Health Organization Surgical Safety Checklist (First Edition)
SAGES Society of American Gastrointestinal and Endoscopic Surgeons http://www.sages.org Implementation Manual for the World Health Organization Surgical Safety Checklist (First Edition) Author : SAGES
More informationABG QCDR MEASURES LIST 2017
2017-2018 Anesthesia Business Group, LLC All Rights Reserved. ABG QCDR MEASURES LIST 2017 ** Labor Epidurals are excluded from the definition of cases in operating rooms/procedure rooms. Measure # Measure
More informationOnline Education Modules & Courses Facility Order Form
FACILITY INFORMATION Facility Name: Business Address 1: Business Address 2: City: State/Province: Postal Code: Country: Phone: Health Care System: ADMINISTRATOR/CONTACT INFORMATION First Name: Last Name:
More informationThe deteriorating patient recognition and management Dave Story
The deteriorating patient recognition and management Dave Story MBBS, MD, BMedSci, FANZCA Professor and Foundation Chair of Anaesthesia Head of Anaesthesia, Perioperative and Pain Medicine Unit (APPMU)
More informationAppendix A.1 SURGICAL TECHNOLOGIST WORK PROCESS SCHEDULE AND RELATED INSTRUCTION OUTLINE
WORK PROCESS SCHEDULE AND RELATED INSTRUCTION OUTLINE A.1-1 WORK PROCESS SCHEDULE O*NET-SOC CODE: 29-2055.00 RAPIDS CODE: 1051CB This schedule is attached to and a part of these Standards for the above
More informationThe dawn of hospital pay for quality has arrived. Hospitals have been reporting
Value-based purchasing SCIP measures to weigh in Medicare pay starting in 2013 The dawn of hospital pay for quality has arrived. Hospitals have been reporting Surgical Care Improvement Project (SCIP) measures
More informationPrevention of Orthopaedic Surgical Site Infections in the Perioperative Setting. Disclosures. Objectives
Prevention of Orthopaedic Surgical Site Infections in the Perioperative Setting Mary Atkinson Smith, DNP, FNP-BC, ONP-C, RNFA, CNOR & W. Todd Smith, MD, FAAOS Disclosures We hereby certify that, to the
More informationAdmission Record IVF/Gynae
Admission Record IVF/Gynae Surgeon: Operation : of Admission: Please state your full name and date of birth - correct Nurse Checklist Yes No Please tell me your full address - correct Consent form signed,
More informationVERNON COLLEGE SYLLABUS. DIVISION: Allied Health and Human Services DATE:
VERNON COLLEGE SYLLABUS DIVISION: Allied Health and Human Services DATE: 2011-2012 CREDITS HRS: 4 HRS/WK LEC: 2 HRS/WK LAB: 6 LEC/LAB COMB: 8 I. VERNON COLLEGE GENERAL EDUCATION PHILOSOPHY STATEMENT General
More informationENVIRONMENT Preoperative evaluation clinic, Preoperative holding area. Preoperative evaluation clinic, Postoperative care unit, Operating room
Goals and Objectives, Main Operating Room Anesthesia, VAMC, CA-3 year UCSD DEPARTMENT OF ANESTHESIOLOGY OPERATING ROOM CLINICAL ANESTHESIA AT VAMC GOALS AND OBJECTIVES, CA-3 YEAR PATIENT CARE: To provide
More informationCREATING THE SURGICAL ENVIRONMENT AST. Association of Surgical Technologists
CREATING THE SURGICAL ENVIRONMENT AST Association of Surgical Technologists ASSURING HIGHER OR QUALITY AND LOWER CARE COSTS? For CSTs and CSFAs, it s a matter of principles. Skilled in the principles of
More informationExpedition: Improving Safety and Reliability for Surgical Procedures
These presenters have nothing to disclose Expedition: Improving Safety and Reliability for Surgical Procedures Session 5 William Berry, MD, MPA, MPH, FACS Kathy Duncan, RN January 23, 2014 Expedition Coordinator
More informationSCIP. Surgical Care Improvement Project. Making Surgeries Safer. By: Roshini Mathew, RN
SCIP Surgical Care Improvement Project Making Surgeries Safer By: Roshini Mathew, RN Importance Hospitals could prevent 13,000 patient deaths and 271,000 surgical complications each year 4 measures are
More information4/10/2013. Learning Objective. Quality-Based Payment Models
Creating Best in Class Perioperative Services under Accountable Care and Value- Based Purchasing Becker s Healthcare Jeffry Peters Learning Objective How ACA/VBP changes how we measure surgical services
More informationEnhanced Recovery in NSQIP (ERIN): an update on the collaborative. Julie Thacker, LianeFeldman, and Julia Berian ACS NSQIP National Conference 2015
Enhanced Recovery in NSQIP (ERIN): an update on the collaborative Julie Thacker, LianeFeldman, and Julia Berian ACS NSQIP National Conference 2015 No disclosures ERIN, ERAS, and ERP ERIN-Enhanced Recovery
More informationStrategy/Driver Prevention Strategies Action Strategies
I. Hospital executive leadership commitment to prevention of surgical site infections 1. Establish Surgical Site Infection prevention as a strategic priority 2. Develop and implement business/strategic
More informationMastectomy. Patient Education. What to expect, how to prepare, and planning for recovery after breast surgery. What is a mastectomy? How do I prepare?
Patient Education What to expect, how to prepare, and planning for recovery after breast surgery This handout explains what to expect when you are planning to have a mastectomy. It includes how to prepare,
More informationWhich Elements in a Wound Infection Prevention Process are Important? Aaron Chen, BS, Sebastian Perez, MSPH, John Sweeney, MD, Joe Sharma, MD
Which Elements in a Wound Infection Prevention Process are Important? Aaron Chen, BS, Sebastian Perez, MSPH, John Sweeney, MD, Joe Sharma, MD Disclosure Slide No COI and no disclosures. SSI Surgical Site
More informationPressure Ulcers ecourse
Pressure Ulcers ecourse Module 5.8: Pressure Ulcer Surgery Handout College of Licensed Practical Nurses of Alberta (Canada) CLPNA.com and StudywithCLPNA.com CLPNA Pressure Ulcers ecourse Module 5.8: Pressure
More information9/29/2017. Enhanced Recovery After Surgery at the University of Virginia Medical Center. Disclosures. Objectives. None
Enhanced Recovery After Surgery at the University of Virginia Medical Center Bethany Sarosiek, RN, MSN, MPH, CNL University of Virginia Health System Charlottesville, VA ErasRN@virginia.edu Disclosures
More informationPhysician Executive Council. Using the Perioperative Surgical Home to Improve Joint Replacement
Physician Executive Council Using the Perioperative Surgical Home to Improve Joint Replacement 9 Today s Presenters Julie Riley Physician Executive Council Senior Consultant 202-266-5628 RileyJu@advisory.com
More informationQuality Improvement Initiative (QII): 2018 Options
Quality Improvement Implementation, Option A: Increase Surgeon Engagement Outcome Measure: SSI Summary: Surgeon Engagement is essential for the success of quality improvement programs within hospitals.
More informationInstitutional Handbook of Operating Procedures Policy
Section: Admission, Discharge, and Transfer Institutional Handbook of Operating Procedures Policy 9.1.29 Responsible Vice President: EVP & CEO Health System Subject: Admission, Discharge, and Transfer
More information1/10/2012. Objectives. Normothermia as a SSI Reduction Tool. Disclosure. Darin Prescott, MSN, MBA, RN,BC, CNOR, CASC
Normothermia as a SSI Reduction Tool Darin Prescott, MSN, MBA, RN,BC, CNOR, CASC Disclosure Arizant Healthcare Inc., a 3M company Objectives Describe the impact of hypothermia on perioperative patient
More informationPrinciples In developing these recommendations the Consensus Panel first established the following principles for anesthesia outcomes capture:
Outcomes of Anesthesia: Core Measures The following Core Measures are the consensus recommendations of the Anesthesia Quality Institute (AQI) and the Multicenter Perioperative Outcomes Group (MPOG). They
More informationDepartment of Veterans Affairs VHA Directive Washington, DC March 5, 2016 PREVENTION OF RETAINED SURGICAL ITEMS
Department of Veterans Affairs VHA Directive 1103 Veterans Health Administration Transmittal Sheet Washington, DC 20420 March 5, 2016 PREVENTION OF RETAINED SURGICAL ITEMS 1. REASON FOR ISSUE: This Veterans
More informationEnsuring Your Surgical Service Line is Successful in an ACO Value-Based Purchasing and Bundled Payment Environment
Ensuring Your Surgical Service Line is Successful in an ACO Value-Based Purchasing and Bundled Payment Environment Jeffry Peters, President Surgical Directions, LLC Joseph Bosco, MD Associate Professor;
More informationTranslating recommendations into practice for surgical site infection prevention. Claire Kilpatrick IPC Global Unit SDS, HIS, WHO HQ
Translating recommendations into practice for surgical site infection prevention Claire Kilpatrick IPC Global Unit SDS, HIS, WHO HQ XXVIII e Congrès National de la Société Française d Hygiène Hospitalière
More informationAssociate Professor Jennifer Weller University of Auckland Specialist Anaesthetist, Auckland City Hospital
Associate Professor Jennifer Weller University of Auckland Specialist Anaesthetist, Auckland City Hospital A doctor tends to a mortally ill child in Sir Luke Fildes s 1891 painting The Doctor. The Rise
More informationCRITICAL ACCESS HOSPITALS
Are anesthesia services and post-anesthesia services medical director(s) qualified in terms of education, experience and competency as determined by the hospital medical staff and appointed by the governing
More informationOlutoyin Abitoye, MD Attending, Department of Internal Medicine Virtua Medical Group New Jersey,USA
Olutoyin Abitoye, MD Attending, Department of Internal Medicine Virtua Medical Group New Jersey,USA Introduce the methods of using core measures to compare quality of health care US hospitals provide Have
More informationSCIP-Inf-2, SCIP-Inf-3, SCIP-Inf-4, SCIP-Inf- 9, SCIP-Inf-10, SCIP-VTE-1, SCIP-VTE-2 Anesthesia End Time 5
Release Notes: Alphabetical Data Dictionary Version 3.3 Surgical Care Improvement Project (SCIP) - Data Dictionary The General Abstraction Guidelines explain the different sections of the data element
More informationQuality in the US healthcare system is not what it should be. Even
CHAPTER Healthcare Quality and the Patient 1 Maulik S. Joshi and Donald Berwick Quality in the US healthcare system is not what it should be. Even before evidence was available, people had long been aware
More informationWebinar SURGICAL OBJECT SURVEILLANCE. Kyung Jun, RN, MSN, CNOR January 22, 2014
Webinar SURGICAL OBJECT SURVEILLANCE Kyung Jun, RN, MSN, CNOR January 22, 2014 TITLE Please vote for best title regarding preventing retained surgical item SOS : Surgical Object Surveillances? What Goes
More informationRisk Factor Analysis for Postoperative Unplanned Intubation and Ventilator Dependence
Risk Factor Analysis for Postoperative Unplanned Intubation and Ventilator Dependence Adam P. Johnson MD, MPH, Anisha Kshetrapal MD, Harold Hsu MD, Randi Altmark RN, BSN, Herbert E Cohn MD, FACS, Scott
More informationBeth Israel Deaconess Medical Center Perioperative Services Manual. Guidelines for Perioperative Handoffs from OR to receiving units.
Beth Israel Deaconess Medical Center Perioperative Services Manual Title: Guidelines for Perioperative Handoffs from OR to receiving units. Policy #: PSM 100-102A Purpose: This guideline provides a standard
More informationInstitutional Handbook of Operating Procedures Policy
Section: Clinical Policies Institutional Handbook of Operating Procedures Policy 09.13.28 Responsible Vice President: EVP & CEO Health System Subject: Patient Risk, Treatment, and Safety Responsible Entity:
More informationCost Effectiveness of Physician Anesthesia J.P. Abenstein, M.S.E.E., M.D. Mayo Clinic Rochester, MN
Mayo Clinic Rochester, MN Introduction The question of whether anesthesiologists are cost-effective providers of anesthesia services remains an open question in the minds of some of our medical colleagues,
More informationUsing Evidence to Improve Outcomes for the Surgical Patient: Post-Operative Interventions
Using Evidence to Improve Outcomes for the Surgical Patient: Post-Operative Interventions January 16, 2014 1 A partnership of the Healthcare Association of New York State and the Greater New York Hospital
More informationEffect of Colon Bundle Implementation in a Community Hospital. Michael Barringer, MD, FACS CHS Cleveland
Effect of Colon Bundle Implementation in a Community Hospital Michael Barringer, MD, FACS CHS Cleveland Doug Hobson, MD, Surgeon Champion Mike Barringer, MD, Surgeon Champion No Disclosures Except for
More informationStandard Location YES. Activities of Daily Living section completed. VMG Clinic Intake Form
Tracer Record Review - Outpatient Only updated: 3/21/2016 Data Definition Tool The Tracer Packet is to be completed in each outpatient area by the manager or designee on a monthly basis. It is suggested
More informationAccreditation Program: Hospital Chapter: National Patient Safety Goals
Universal Protocol Accreditation Program: Hospital Chapter: National Patient Safety Goals The organization meets the expectations of the Universal Protocol. UP.01.01.01 Conduct a pre-procedure verification
More informationNEUROSURGERY COMMUNICATION INITIATIVE STUDY
MQP-BIO-DSA-4183 NEUROSURGERY COMMUNICATION INITIATIVE STUDY A Major Qualifying Project Report Submitted to the Faculty of the WORCESTER POLYTECHNIC INSTITUTE in partial fulfillment of the requirements
More informationValue-based incentive payment percentage 3
Report Run Date: 07/12/2013 Hospital Value-Based Purchasing Value-Based Percentage Payment Summary Report Page 1 of 5 Percentage Summary Report Data as of 1 : 07/08/2013 Total Score Facility State National
More informationValue Based Purchasing
Value Based Purchasing Baylor Health Care System Leadership Summit October 26, 2011 Sheri Winsper, RN, MSN, MSHA Vice President for Performance Measurement & Reporting Institute for Health Care Research
More informationChecklists after Gawande
Checklists after Gawande John A Windsor University of Auckland Member, WHO Safer Surgery Study Group CAUSE OF DEATH Lack of clean water and basic healthcare for children DEATHS PER DAY 30,000 Smoking 14,000
More informationYour surgery is scheduled for: Date: Time: 202 S. Park Street, Madison. Location: Please plan to arrive 2 hours before your scheduled time.
Patient Guide to Surgical Care at Meriter Hospital Thank you for choosing Meriter Hospital for your surgical procedure. We re glad that you and your surgeon have chosen us to provide the care you need.
More informationModel VBP FY2014 Worksheet Instructions and Reference Guide
Model VBP FY2014 Worksheet Instructions and Reference Guide This material was prepared by Qualis Health, the Medicare Quality Improvement Organization for Idaho and Washington, under a contract with the
More informationSPONGE ACCOUNTing SYSTEM AUDIT TOOL
Verna C. Gibbs M.D. NoThing Left Behind SPONGE ACCOUNTing SYSTEM Nurses use a standardized process to put sponges in hanging plastic holders and document the counts on a wall-mounted dry-erase board in
More informationNEOSHO COUNTY COMMUNITY COLLEGE MASTER COURSE SYLLABUS. Principles and Practices of Surgical Technology Lab
NEOSHO COUNTY COMMUNITY COLLEGE MASTER COURSE SYLLABUS COURSE IDENTIFICATION Course Code/Number: SURG 103 Course Title: Principles and Practices of Surgical Technology Lab Division: Applied Science (AS)
More informationCommunication failure in the operating room
Communication failure in the operating room Amy L. Halverson, MD, a Jessica T. Casey, MD, b Jennifer Andersson, RN, c Karen Anderson, RN, d Christine Park, MD, e Alfred W. Rademaker, PhD, f and Don Moorman,
More informationAn Overview of the. Measures. Reporting Initiative. bwinkle 11/12
An Overview of the National Hospital Quality Measures A National Voluntary Hospital Reporting Initiative bwinkle 11/12 What Are Hospital Quality Measures? The Joint Commission (TJC) and the Centers for
More informationAPPENDIX I QUESTIONNAIRE FOR INTERVIEWING THE ANAESTHESIA PROVIDER
APPENDIX I QUESTIONNAIRE FOR INTERVIEWING THE ANAESTHESIA PROVIDER We are carrying out a survey to establish the quality of anaesthesia care provided to Obstetric patients in East Africa. We therefore
More information3 SCIP-Inf-2, SCIP-Inf-3, SCIP-Inf-4, SCIP-Inf-9, SCIP-Inf-10, SCIP-VTE-1, SCIP-VTE-2 Anesthesia End Time
Release Notes: Alphabetical Data Dictionary Version 3.0b Surgical Care Improvement Project (SCIP) - Data Dictionary The General Abstraction Guidelines explain the different sections of the data element
More informationThe Use of Patient Audits and Nurse Feedback to Decrease Postoperative Pulmonary Complications
The Use of Patient Audits and Nurse Feedback to Decrease Postoperative Pulmonary Complications Christine M. Schleider, RN, BSN Adam P. Johnson, MD, MPH Kathleen M. Shindle, RN, BSN Scott W. Cowan, MD,
More informationJournal of Biology, Agriculture and Healthcare ISSN (Paper) ISSN X (Online) Vol.4, No.2, 2014
Impact of a World Health Organization (WHO) Surgical Safety Checklist Implementation During Urgent Operations on Compliance with Basic Standards of Care and Occurrence of Complications Shaimaa El-Hadary
More informationSystem Quality Control and. Peter Shamamian, MD FACS Vice President and Chief Quality Officer Vice Chairman for Quality and Performance Improvement
System Quality Control and Malpractice Costs Peter Shamamian, MD FACS Vice President and Chief Quality Officer Vice Chairman for Quality and Performance Improvement Disclosures 1 The world of healthcare
More information