CWC: TRANSFUSION MEDICINE
|
|
|
- Maryann Hill
- 5 years ago
- Views:
Transcription
1 CWC: TRANSFUSION MEDICINE FROM RECOMMENDATION TO PRACTICE IN PERIOPERATIVE MEDICINE SYLVAIN GAGNÉ, MD, (ANESTHESIA) FRCPC APRIL 13TH,
2 CFPC CoI Templates: Slide 1 FACULTY/ PRESENTER DISCLOSURE Faculty: Dr. Sylvain Gagné Relationships with commercial interests: None
3 CFPC CoI Templates: Slide 2 DISCLOSURE OF COMMERCIAL SUPPORT This program has received financial support from [organization name] in the form of [describe support here e.g. an educational grant]. This program has received in-kind support from [organization name] in the form of [describe support here e.g. logistical support]. Potential for conflict(s) of interest: none
4 Examine the barriers to implementing CWC- Transfusion Medicine in the perioperative setting OBJECTIVES Describe approaches used at The Ottawa Hospital to implement recommendations from CWC- Transfusion Medicine List remaining challenges Encourage discussion exploring other solutions
5
6 FAILURE TO IMPLEMENT EBM Failure to implement evidence based medicine 30-40% of patients do not receive care according to present scientific evidence and 20-25% of care provided is not needed or is potentially harmful.
7 CHANGE TAKES TIME 1996 ACC/AHA Guidelines for the Management of Patients With Acute Myocardial Infarction: Executive Summary. - Recommendation for ASA, b-blocker and ACEi at discharge, Statin if LDL elevated : b-blocker 56-71%, ACEi/ARB 37-70%, Statin 22-66% (Canada) 2007: ASA 97.8%, beta-blockers 87%, ACEi/ARB 72%, Statins 87%
8
9 WHEN CHANGE COMES FROM OUTSIDE A SPECIAL CHALLENGE FOR CWC TM
10 WHEN CHANGE COMES FROM OUTSIDE A SPECIAL CHALLENGE FOR CWC TM Cross specialty working group/collaboration Champions within Transfusion Medicine, Hematology and Perioperative Medicine Donna Touchie, RN ONTraC program Elianna Saidenberg, MD, Hematopathology, TOH Marc Carrier, MD, Thrombosis
11
12 CHANGE!!!!!!
13 It s not easy HOW TO AFFECT CHANGE? Reminders: Median improvement across interventions % Dissemination of educational materials -8.1% Audit and Feedback - 7.0% Educational outreach - 6.0% Grimshaw J, 2006
14 PROTOCOLS AND CHECKLISTS? The Checklist Manifesto Atul Gawande Potentially very effective WHO Surgical Safety Checklist 1 Central line insertion checklist 2 Simple, cheap Not effective as stand alone technique Slow adoption of checklists in medicine 1. Weiser TG, Haynes AB, Dziekan G, Berry WR, Lipsitz SR, Gawande AA. Effect of a 19-item surgical safety checklist during urgent operations in a global patient population. Ann Surg 2010; 251: An Intervention to Decrease Catheter-Related Bloodstream Infections in the ICU Peter Pronovost, M.D., et al. N Engl J Med 2006; 355:
15 FORCED FUNCTION Definition: This is how we operate from now on so suck it up buttercup!!
16 FORCED FUNCTION Any management device or tool used to limit user errors by prohibiting specific actions without p rior use of necessary safety procedures A forcing function is an aspect of a design that prevents the user from taking an action without consciously considering information relevant to that action. It forces conscious attention upon something ("bringing to conciousness") and thus deliberately disrupts the efficient or automatised performance of a task.
17 BEYOND FORCED FUNCTION Quasi automation
18 RECOMMENDATION #8 AUTOLOGOUS TRANSFUSIONS Barrier: Perceived safety benefit Solution: You are the Gatekeepers TOH abandoned this routine practice in ~2011 due to mounting evidence of cost-ineffectiveness Preoperative autologous donation decreases allogeneic transfusion but increases exposure to all red blood cell transfusion: results of a meta-analysis. International Study of Perioperative Transfusion (ISPOT) Investigators. Forgie MA, Wells PS, Laupacis A, Fergusson D. Arch Intern Med. 1998;158(6):610.
19 RECOMMENDATION #5 NO PLASMA OR PCCS FOR NON-URGENT COUMADIN REVERSAL Barriers: Need system that ensures proof of normalization of INR preop Cancelling is not an option Who s responsibility? Where? Timing Vitamin K administration?
20 Solutions: Partnerships: (TOH) Thrombosis unit, GP, medical day care clinic, ER Make it easy Standard process (consult/instructions/testing) POCT for INR 24hrs preop Communication
21 COMMUNICATION
22 COMMUNICATION
23 RECOMMENDATION #5 URGENT COUMADIN REVERSAL PCCS Barriers: Knowledge, timing, process (recent INR) Solution: Education Cross specialty buy-in and relationships Pre-printed order set/protocol
24
25 RECOMMENDATION #7 UNNECESSARY TYPE & SCREEN Barrier: Habit/individual decision CBC, lytes, BUN/Cr, PTT/INR, CXR, ECG, T&S. No perceived downside of continuing Perceived risk of not testing
26 RECOMMENDATION #7 UNNECESSARY TYPE & SCREEN Solutions: Medical directives or MBOS (preop clinic) Statistics Education Partnerships Administration (cost-savings) Surgeons Anesthesia CBC, lytes, BUN, Cr, PTT/INR,, CXR, ECG, Type and Screen
27 LOOK AT YOUR NUMBERS Red Cell Utilization January 1-June 30, 2015 Procedures Primary total knee replacement Revision total knee replacement Primary total hip replacement Revision total hip replacement Biannual TOH Red Cell Rates Provincial Benchmark 1.5% 3% 8% 6% 3% 3% 33% 27% Those patients who were transfused received their PRBCs on POD#3 not urgent
28 WHAT IS THE COST? Type & Screen ~ 50$ Crossmatch add 25$ Depending on your surgical volumes Tens of THOUSANDS OF $$$ /year
29 MEDICAL DIRECTIVES/MBOS Numbers allowed us to convince the surgeons, anesthesiologists and administration But what about those high risk patients?
30 For selected procedures (i.e. knees) WHAT ABOUT HIGH RISK PATIENTS? T&S if: - Hgb < Angina - < 50Kg - Coagulopathy/bleeding disorder - High risk of antibodies POCT for Hgb
31 ONGOING CHALLENGES But I still want a T&S! The non-compliant physician Urgent/non-elective surgery Any suggestions welcome
32 RECOMMENDATION #2 SINGLE UNIT TRANSFUSION If you need to give a unit of PRBC, give 2 if you drink one beer, you should drink 2 Solutions: Education Transfusion Guideline form (feedback/reminder)
33 RECOMMENDATION #2 TRANSFUSION TRIGGERS No formal triggers from CWC But decision should be influenced by symptoms and Hgb concentration Solution: If CPOE hard limits based on Hgb when not bleeding 1,2 Transfusion Guideline form 1. Murphy, M.F., et. al, Transfusing blood safely and appropriately. BMJ, Hibs, S.P., The impact of electronic decision support on transfusion practice: a systematic review. Transfusion Medicine Reviews, 2015
34
35 RECOMMENDATION #9-10 LIMIT USE OF O -- PRBC AND AB PLASMA EXCEPT FOR EMERGENCIES WITH UNKNOWN TYPE Prospective monitoring of blood orders Risk of delay during emergencies Individual feedback post-emergency Opportunity to intervene is lost CPOE + decision support Murphy, M.F., et. al, Transfusing blood safely and appropriately. BMJ, 2013 Hibs, S.P., The impact of electronic decision support on transfusion practice: a systematic review. Transfusion Medicine Reviews, 2015
36 RECOMMENDATION #1 ANEMIA CORRECTION Barriers: Complicated Timing Lack of perceived risk Lack of perceived solution
37 RECOMMENDATION #1 ANEMIA CORRECTION Solutions: Early identification screen at risk populations Rapid access Cancellation of surgery with iron deficiency anemia? Partnerships / support from administration
38 TOH BLOOD MANAGEMENT PROGRAM Identified high risk cases Established criteria Flagging system Early identification
39
40 RECOMMENDATION #3 ACCEPT AN INR OF <1.8 FOR INVASIVE PROCEDURES Barriers Knowledge Conflicting guidelines Perceived risk (hemorrhage, neuraxial hematoma) Lack of perceived benefit for change Abdel-Wahab OI, Healy B, Dzik WH. Effect of fresh-frozen plasma transfusion on prothrombin time and bleeding in patients with mild coagulation abnormalities. Transfusion (Paris). Aug 2006;46(8): Estcourt L, Stanworth S, Doree C, et al. Prophylactic platelet transfusion for prevention of bleeding in patients with haematological disorders after chemotherapy and stem cell transplantation. Cochrane Database Syst Rev. 2012;5:Cd Szczepiorkowski ZM, Dunbar NM. Transfusion guidelines: when to transfuse. Hematology Am. Soc. Hematol. Educ. Program. 2013;2013:
41 OTHER GUIDELINES When INR < 1.5
42 The current ASRA guidelines recommends an INR value of 1.4 as acceptable for the performance of neuraxial blocks.(4) The value was based on studies that showed excellent perioperative hemostasis when the INR value was 1.5. The concurrent use of other medications, such as aspirin, NSAIDs, and heparins that affect the clotting mechanism, increases the risk of bleeding complications without affecting the INR.
43 RECOMMENDATION #3 ACCEPT AN INR OF <1.8 Solutions?
44 CONCLUSION Champions Cross-specialty collaboration Education + intervention based on identified barriers Local solutions to local barriers Patience and perseverance Thank you.
45 QUESTIONS?
Aldijana Avdić, BSN, RN, PBMS, CPHQ Assistant Director, Patient Safety and Privacy 1
Aldijana Avdić, BSN, RN, PBMS, CPHQ Assistant Director, Patient Safety and Privacy 1 Program Definition The timely application of evidence-based medical and surgical concepts designed to maintain hemoglobin
Translating 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
Patient Blood Management Certification Revisions
Issued October 3, 07 Patient Blood Management Certification Revisions Patient Blood Management (PBM) Certification Program Assessments: Internal and External (PBMAM) Chapter Standard PBMAM. The program
Cognitive Aids to Improve Crisis Management
Cognitive Aids to Improve Crisis Management Alexander A. Hannenberg, M.D. Council on Surgical & Perioperative Safety Emergency Manual Implementation Collaborative Past President American Society of Anesthesiologists
How and Why We Implemented a Preop Anemia Service as Part of our Patient Blood Management Program
How and Why We Implemented a Preop Anemia Service as Part of our Patient Blood Management Program Katie Dettenwanger, MLS (ASCP) CM Transfusion Safety Officer University of Missouri Health Care Emily Coberly,
Disclosure. I have no conflict of interest with this event because I have no affiliations, sponsorships, honoraria, monetary support or conflict of
The RBC Audit: What s in your closet? Yulia Lin, MD, FRCPC Transfusion Medicine & Hematology, Sunnybrook HSC Assistant Professor, Dept of LMP, University of Toronto On behalf of the RBC Audit Working Group
Robert 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?
ENVIRONMENT 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
Manitoba Transfusion Best Practice Resource Manual Appendix 17 Guidelines for Perioperative Autologous Blood Collection and Administration
Guidelines for Perioperative Autologous Blood Collection and Administration Purpose These guidelines intend to inform health care providers about the principles of Perioperative Autologous Blood Collection
Investigation Outline for a Reportable Incident Non-Hospital Surgical Facility
Investigation Outline for a Reportable Incident Non-Hospital Surgical Facility MANDATORY NOTIFICATION The Medical Director shall notify the College of Physicians & Surgeons of Alberta (Accreditation Department)
An 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
Adverse Drug Events: A Focus on Anticoagulation Steve Meisel, Pharm.D., CPPS Director of Patient Safety Fairview Health Services, Minneapolis, MN
Adverse Drug Events: A Focus on Anticoagulation Steve Meisel, Pharm.D., CPPS Director of Patient Safety Fairview Health Services, Minneapolis, MN Fairview Health Services 6 hospitals, ranging from rural
PATIENT SAFETY KNOWLEDGEBASE. How to prepare for a Survey
PATIENT SAFETY KNOWLEDGEBASE How to prepare for a Survey 1 DEFINITIONS Patient Safety v is a process that guards against any adverse condition occurring in a patient as a result of wrong diagnosis or treatment
Teamwork, Communication, O.R. Safety & SSI Reduction
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
Title: Massive Transfusion Event Protocol Policy: Clinical Manual/General Clinical
Title: Massive Transfusion Event Protocol Policy: Manual/General I. POLICY: Massive Transfusion Event (MTE) Protocol: The MTE Protocol is initiated at the request of the anesthesiologist, surgeon or physician
Hospital Inpatient Quality Reporting (IQR) Program Measures (Calendar Year 2012 Discharges - Revised)
The purpose of this document is to provide a reference guide on submission and Hospital details for Quality Improvement Organizations (QIOs) and hospitals for the Hospital Inpatient Quality Reporting (IQR)
PATIENT SAFETY OVERVIEW
PATIENT SAFETY OVERVIEW MUHAMMAD ISLAM, MBBS, MS, MCH, LSSBB DIRECTOR OF PATIENT SAFETY SUNY DOWNSTATE MEDICAL CENTER 1 DEFINITIONS Patient Safety v is a process that guards against any adverse condition
The Joint Commission Blood Management Performance Measure Development Process
The Joint Commission Blood Management Performance Measure Development Process Jonathan H. Waters, MD Chief and Professor Magee-Womens Hospital of University of Pittsburgh Medical Center Medical Director,
Patient Blood Management Certification Program. Review Process Guide. For Organizations
Patient Blood Management Certification Program Review Process Guide For Organizations 2018 What's New in 2018 Updates effective in 2018 are identified by underlined text in the activities noted below.
Low hgb care plan care plan Low Care Plan Care
Low hgb care plan Sep 16, 2016. A patient with anemia has hemoglobin levels between 9 to 11 g/dl. Fatigue... Plan of care and persons involved. Teaching plan. Client's. Nursing Care Plan - Download as
HGH Rotation Objectives Updated June 11, 2014
HGH Rotation Objectives Updated June 11, 2014 Key Portfolio Outcomes: Markers: Description: 1.1 Manage the transfusion needs of a complex patient Develop a repository of cases that can be used by you and
Health Service Circular
Health Service Circular Series number: HSC 1998/224 Issue date: 11 December 1998 Review date: 11 December 2001 Category: Clinical Effectiveness Status: Action sets out a specific action on the part of
Blood Management: Improving Patient Outcomes. Derek Langner MBA, MT(ASCP) Blood Bank Specialist Jackson Hospital and Clinic
Blood Management: Improving Patient Outcomes Derek Langner MBA, MT(ASCP) Blood Bank Specialist Jackson Hospital and Clinic What is Blood Management? Ensuring that every decision to transfuse blood is made
PATIENT SAFETY OVERVIEW
PATIENT SAFETY OVERVIEW MUHAMMAD ISLAM, MBBS, MS, MCH DIRECTOR OF PATIENT SAFETY SUNY DOWNSTATE MEDICAL CENTER 1 DEFINITIONS Patient Safety is a process that guards against any adverse condition occurring
The Importance of Transfusion Error Surveillance This is step #1 in error management. Jeannie Callum, BA, MD, FRCPC, CTBS
The Importance of Transfusion Error Surveillance This is step #1 in error management Jeannie Callum, BA, MD, FRCPC, CTBS 6051 Clinical Errors 9083 Laboratory Errors 15134 Errors over 6 years I don t want
Preparing your Patient for Surgery at The Valley Hospital
Preparing your Patient for Surgery at The Valley Hospital Ensuring a smooth preoperative course to provide safe and efficient care Cristina Smith, RN, BSN, CPAN HOUSEKEEPING Bathroom location Cell Phone
An Overview of Blood Transfusion Link Nurse Meeting MARY METCALFE/CARMEL PARKER TRANSFUSION PRACTITIONERS 7 TH SEPTEMBER 2007
An Overview of Blood Transfusion Link Nurse Meeting MARY METCALFE/CARMEL PARKER TRANSFUSION PRACTITIONERS 7 TH SEPTEMBER 2007 Reasons for Transfusion Massive blood loss Anaemia Surgery Critical care setting
PATIENT BLOOD MANAGEMENT: WHY? WHAT? WHEN? HOW?
PATIENT BLOOD MANAGEMENT: WHY? WHAT? WHEN? HOW? Presented by Kathleen Sazama, MD, JD Chief Medical Officer LifeSouth Community Blood Centers, Inc. Rationale for Patient Blood Management Increased public
Guidelines for the Preoperative Process
Guidelines for the Preoperative Process Preparation of Patients for Procedural Sedation and Anesthesia. Department of Anesthesiology Thomas May, MD Witold Waberski, MD Department of Internal Medicine Aized
Just Culture Toolkit Scenarios
Just Culture Toolkit Scenarios In order to promote a just culture where staff is comfortable in reporting errors or near misses, healthcare organizations must adopt a disciplinary system theory approach.
The Health Care Improvement Foundation 2017 Delaware Valley Patient Safety and Quality Award Entry Form 1. Hospital Name Jefferson Health
The Health Care Improvement Foundation 2017 Delaware Valley Patient Safety and Quality Award Entry Form 1. Hospital Name Jefferson Health 2. Title Of Initiative Implementation of a Patient Blood Management
QI and DUE in Pharmacy Practice
Pharmacy 483: QI and DUE in Pharmacy Practice Steve Riddle, BS Pharm, BCPS QI and Medication Utilization Lead HMC Pharmacy February 24, 2004 Acute Myocardial Infarction HA, 52yo male admitted via ER with
Iowa Healthcare Collaborative - HEN 2.0 Measures
Iowa Healthcare Collaborative - HEN 2.0 Measures Yellow Pink Purple Green Blue Legend Readmissions and Care Transitions Healthcare-associated Infections Hospital Acquired Conditions Safety Across the Board
NEW JERSEY HOSPITAL PERFORMANCE REPORT 2012 DATA PUBLISHED 2015 TECHNICAL REPORT: METHODOLOGY RECOMMENDED CARE (PROCESS OF CARE) MEASURES
NEW JERSEY HOSPITAL PERFORMANCE REPORT 2012 DATA PUBLISHED 2015 TECHNICAL REPORT: METHODOLOGY RECOMMENDED CARE (PROCESS OF CARE) MEASURES New Jersey Department of Health Health Care Quality Assessment
ENVIRONMENT 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
Infection Control in Hospital Accreditation. Paul Ananth Tambyah
Infection Control in Hospital Accreditation Paul Ananth Tambyah Are Hospitals Dangerous??? Hospitals were originally set up for the sick and dying among the poor The wealthy had physicians go to their
Olutoyin 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
Surgeon Champion: Getting Started, What You Need to Know
Surgeon Champion: Getting Started, What You Need to Know Ninh T. Nguyen, MD, FACS Professor of Surgery Surgeon Champion Vice-Chair, Dept Surgery University of California, Irvine, Medical Center, Orange,
Perioperative 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
for Patient Blood Management Programs
SABM Administrative and Clinical Standards for Patient Blood Management Programs 3rd EDITION Unpublished Work 2014. Society for the Advancement of Blood Management, Inc. All rights reserved. table of contents
COMBAT Research Study
COMBAT Research Study Questions & Answers What is the title of this research study? The Control Of Massive Bleeding After Trauma (COMBAT): A prospective, randomized comparison of early fresh frozen plasma
The 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
Achieving Positive Clinical Outcomes, Cost Savings, and Regulatory Compliance using Clinical Decision Support Alerts in the Electronic Health Record
Achieving Positive Clinical Outcomes, Cost Savings, and Regulatory Compliance using Clinical Decision Support Alerts in the Electronic Health Record Jason Lam, PharmD Assistant Clinical Professor / Lean
National Patient Safety Goals & Quality Measures CY 2017
National Patient Safety Goals & Quality Measures CY 2017 General Clinical Orientation 2017 January National Patient Safety Goals 1. Identify Patients Correctly 2. Improve Staff Communication 3. Use Medications
N ATIONAL Q UALITY F ORUM. Safe Practices for Better Healthcare 2006 Update A CONSENSUS REPORT
N ATIONAL Q UALITY F ORUM Safe Practices for Better Healthcare 2006 Update A CONSENSUS REPORT NATIONAL QUALITY FORUM Foreword Every person who seeks care in a healthcare facility should expect to receive
2016 HCPro, a division of BLR. All rights reserved. These materials may not be duplicated without express written permission.
To Err Is Human: CDI Impact on Patient Safety Indicators Kathleen Shindle, RN, BSN, CCDS, CDIP Allison Clerval, RN, BSN, CCDS, CDIP Clinical Supervisors Thomas Jefferson University Hospital Philadelphia,
A. Hospital demographics
A. Hospital demographics 1. Contact details Name of the Hospital Last name of person in charge First name of person in charge City Country 2. Demographics # of inpatient beds # of operating rooms # of
Optum Anesthesia. Completely integrated anesthesia information management system
Optum Anesthesia Completely integrated anesthesia information management system 2 Completely integrated anesthesia information management system Optum Anesthesia Information Management System (AIMS) helps
New research: Change peripheral intravenous catheters only as clinically
Content page New research: Change peripheral intravenous catheters only as clinically indicated, not routinely. The results of a nurse led and nationally funded multicentre, randomised equivalence trial
NEW JERSEY HOSPITAL PERFORMANCE REPORT 2014 DATA PUBLISHED 2016 TECHNICAL REPORT: METHODOLOGY RECOMMENDED CARE (PROCESS OF CARE) MEASURES
NEW JERSEY HOSPITAL PERFORMANCE REPORT 2014 DATA PUBLISHED 2016 TECHNICAL REPORT: METHODOLOGY RECOMMENDED CARE (PROCESS OF CARE) MEASURES New Jersey Department of Health Health Care Quality Assessment
Zukunftsperspektiven der Qualitatssicherung in Deutschland
Zukunftsperspektiven der Qualitatssicherung in Deutschland Future of Quality Improvement in Germany Prof. Richard Grol Fragmentation in quality assessment and improvement Integration of initiatives and
4/10/2013. 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
The Day of Your TAVR
UW MEDICINE PATIENT EDUCATION The Day of Your TAVR What to expect This handout describes what to expect on the day of your transcatheter aortic valve replacement (TAVR). It includes where to check in at
Working together to improve health care quality, outcomes, and affordability in Washington State. Coronary Artery Bypass Graft Surgical Bundle
Working together to improve health care quality, outcomes, and affordability in Washington State. Coronary Artery Bypass Graft Surgical Bundle TBD 2015 The intent of the Coronary Artery Bypass Graft Surgical
Champlain BASE Service: Building Access to Specialists through econsultation
Champlain BASE Service: Building Access to Specialists through econsultation Dr. Erin Keely Chief, Division of Endocrinology and Metabolism The Ottawa Hospital Dr. Clare Liddy The Ottawa Hospital Academic
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),
APPLIES TO: x SummaCare, Inc. x Apex Health Solutions PRODUCT LINE(S): (Check all that apply)
POLICY NAME: ANESTHESIA PAYMENT POLICY POLICY NUMBER: ISSUING DEPT.: Claims EFFECTIVE DATE: 9/25/2017 APPROVED BY: APPLIES TO: x SummaCare, Inc. x Apex Health Solutions PRODUCT LINE(S): (Check all that
Safer Healthcare Now! Instructions for Data Entry and Submission Using Measurement Worksheets
Instructions for Data Entry and Submission Using Measurement Worksheets SHN Central Measurement Team January 30, 2009 Table of Contents Section 1. General and Background Information... 2 CAMPAIGN BACKGROUND...
Presentation Handouts
Presentation Handouts (9233-LMT-PBM) A Case Study in Patient Blood Management at a Private Community Hospital October 7, 2012 4:00 PM - 5:30 PM Event Faculty List 9233-LMT-PBM: A Case Study in Patient
ACCOUNT NO. MED. REC. NO. NAME BIRTHDATE. Patient Identification ALL ORDERS MUST BE MARKED IN INK WITH A CHECKMARK ( ) TO BE ACTIVE.
PO7071 *PO7071* Page 1 of 4 ALL MUST BE MARKED IN INK WITH A CHECKMARK ( ) TO BE ACTIVE. Weight: kg Height: cm Allergies: Treatment Start Date: Date(s) of Transfusion(s): Current Labs: WBC: Hgb/Hct: Platelets:
2014 ANCC National Magnet Conference. Safeguarding Valuable Resources through Partnership, Technology, and Education
2014 ANCC National Magnet Conference Safeguarding Valuable Resources through Partnership, Technology, and Education Session # C707, 8:00AM 9:00AM Friday, October 10, 2014 Michelle L. Kopp, RN, MSN, AOCNS,
The Transfusion Medicine diplomate will respect the rights of the individual and family and must
Competency Portfolio for the Diploma in Transfusion Medicine Guide for AFC-Diploma Committees/Working Groups, Educators 2012 VERSION 1.0 This portfolio applies to those who begin training on or after July
9/29/2017. 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
Alsius Intravascular Temperature Management. Temperature is Vital
Alsius Intravascular Temperature Management Temperature is Vital Intravascular Temperature Management (IVTM) Temperature Management Is Vital to Life Temperature is one of the four main vital signs. Management
OHA HEN 2.0 Partnership for Patients Letter of Commitment
OHA HEN 2.0 Partnership for Patients Letter of Commitment To: Re: Request to Participate in the Ohio Hospital Association Hospital Engagement Contract Date: September 24, 2015 We have reviewed the information
Minnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654
This document is made available electronically by the Minnesota Legislative Reference Library as part of an ongoing digital archiving project. http://www.leg.state.mn.us/lrl/lrl.asp Minnesota Statewide
National Provider Call: Hospital Value-Based Purchasing
National Provider Call: Hospital Value-Based Purchasing Fiscal Year 2015 Overview for Beneficiaries, Providers, and Stakeholders Centers for Medicare & Medicaid Services 1 March 14, 2013 Medicare Learning
Stasis and VTE Is lack of order putting patients at risk?
Stasis and VTE Is lack of order putting patients at risk? Professor Cliff Hughes AO 29March 2012 Safe Driving - NSW (435) 376 CF Hughes 29 th March 2012 NSW Heavy Vehicle Statistics 2011 General fatalities
Competency Assessment for Non Medical Prescribing of Blood and Blood Components
Competency Assessment for Non Medical Prescribing of Blood and Blood Components Name of Candidate (please print). Ward/Department:... Band/Job Title:.. Professional Registration Number Date initial in-house
SABM Administrativeand ClinicalStandardsfor PatientBlood ManagementPrograms
SABM Administrativeand ClinicalStandardsfor PatientBlood ManagementPrograms 4thEdition Table of Contents Foreword Standard 1 Leadership and Program Structure Standard 2 Consent Process and Patient Directives
SANTA ROSA MEMORIAL HOSPITAL AND AFFILIATED ENTITIES ONGOING PROFESSIONAL PRACTICE EVALUATION POLICY (OPPE)
SANTA ROSA MEMORIAL HOSPITAL AND AFFILIATED ENTITIES ONGOING PROFESSIONAL PRACTICE EVALUATION POLICY (OPPE) Discussion Draft August 6, 2017 Horty, Springer & Mattern, P.C. 250979.8 ONGOING PROFESSIONAL
IBBM PBMS Review Course The Job, Quality, and Data
JECT 2017 PBMS Review Course IBBM PBMS Review Course The Job, Quality, and Data Jeff Riley MHPE, CCP Portland OR October 21, 2017 1 1996 ABCA-Sponsored Job Analysis 1996 demographics for PMBT Rating scales
Malpractice Litigation & Human Errors. National Practitioners Data Bank. Judging Clinical Competence. Judging Physician Competence.
Judging Clinical Competence Robert S. Lagasse, MD Professor & Vice Chair Quality Management & Regulatory Affairs Department of Anesthesiology Yale School of Medicine New Haven, CT 64 th Annual Postgraduate
SUNY Downstate Medical Center -University Hospital of Brooklyn Network Department of Pathology Policy and Procedure
SUNY Downstate Medical Center -University Hospital of Brooklyn Network Department of Pathology Policy and Procedure Subject: BLB 1 Procedures for Ordering Picking-up and Delivery of Blood Prepared By:
By Marcus E. Semel, Stephen Resch, Alex B. Haynes, Luke M. Funk, Angela Bader, William R. Berry, Thomas G. Weiser, and Atul A.
By Marcus E. Semel, Stephen Resch, Alex B. Haynes, Luke M. Funk, Angela Bader, William R. Berry, Thomas G. Weiser, and Atul A. Gawande Adopting A Surgical Safety Checklist Could Save Money And Improve
IHI Open School Advanced Case Study October 14, 2010 Clemson University
IHI Open School Advanced Case Study October 14, 2010 Clemson University Catherine Simmons 1, Drew Sargent 1, and Kate Wright 1 Public Health Science Hallie Bagnal 2 and Megan Hohenberger 2 Biological Science
Hospital Compare Quality Measure Results for Oregon CAHs: 2015
KEY FINDINGS: Flex Monitoring Team STATE DATA REPORT February 2017 Hospital Compare Quality Measure Results for Oregon : 2015 Michelle Casey, MS; Tami Swenson, PhD; Alex Evenson, MA University of Minnesota
Medical Errors. Christopher L. Nuland, Esq. September 10, 2016
Medical Errors Christopher L. Nuland, Esq. September 10, 2016 WHY ARE WE HERE Medical errors statute 456.013 (7) 456.013 (7) (7) The boards, or the department when there is no board, shall require the
Beth Israel Deaconess Medical Center Department of Anesthesia, Critical Care, and Pain Medicine Rotation: Post Anesthesia Care Unit (CA-1, CA-2, CA-3)
Beth Israel Deaconess Medical Center Department of Anesthesia, Critical Care, and Pain Medicine Rotation: Post Anesthesia Care Unit (CA-1, CA-2, CA-3) Goals GOALS AND OBJECTIVES To analyze and interpret
How to Establish a Multi Hospital STEMI Transfer System
How to Establish a Multi Hospital STEMI Transfer System Dr. Greg Mishkel for the Doctors of Prairie Cardiovascular and in collaboration with our Community & Springfield Hospitals MI: Evolution of care
Expedition: 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
General information. Hospital type : Acute Care Hospitals. Provides emergency services : Yes. electronically between visits : Yes
General information 80 JESSE HILL, JR DRIVE SE ATLANTA, GA 30303 (404) 616 45 Overall rating : 1 out of 5 stars Learn more about the overall ratings General information Hospital type : Acute Care Hospitals
Physician 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
Journal 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
Root Cause Analysis of Transfusion Incidents The Leeds Experience
Root Cause Analysis of Transfusion Incidents The Leeds Experience Richard Haggas Quality Manager, Blood Transfusion Lab Claire Thompson Transfusion Nurse Practitioner, Hospital Transfusion Team LTH Transfusion
HAEMOVIGILANCE. Ms. Emma O Riordan Haemovigilance, CNM2 (Acting) Ms. Bríd Doyle, MSc. FAMLS. Haemovigilance Co-ordinator, (Acting)
HAEMOVIGILANCE a set of surveillance procedures covering the whole transfusion chain from the collection of blood and its components to the follow-up of its recipients, intended to collect and assess information
Improving 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
Implementation Guide Single Unit Transfusion Policy
Implementation Guide Single Unit Transfusion Policy National Institute for Health and Care Excellence (NICE) Blood Transfusion Recommendations: Consider single-unit red blood cell transfusions for adults
IMPORTANT NOTICE REGARDING NEW ANESTHESIA BILLING GUIDELINES AND REIMBURSEMENT PROCEDURES November 2008
IMPORTANT NOTICE REGARDING NEW ANESTHESIA BILLING GUIDELINES AND REIMBURSEMENT PROCEDURES November 2008 This notice will serve as an update to the August 2007Anesthesia Billing Guidelines and Reimbursement
An audit of the engagement in the Time Out section of the WHO Checklist in Urology Theatres in a district general hospital.
An audit of the engagement in the Time Out section of the WHO Checklist in Urology Theatres in a district general hospital. Dr L Spooner (CT1 Urology), Mr P Polson (ST4 Urology), Mr I Apakama (Consultant
After reading this learning module, the nurse should be able to:
After reading this learning module, the nurse should be able to: Identify the VTE dashboard and understand how to initiate it Identify the requirements of the VTE Core Measure and the nurse s responsibilities
Protocol Applies To: UW Health Clinics: all adult outpatients with an active order for warfarin
Protocol Number: 7 Protocol Title: Ambulatory Initiation and Management of Warfarin for Adults Protocol Applies To: UW Health Clinics: all adult outpatients with an active order for warfarin Target Patient
Aligning Hospital and Physician P4P The Q-HIP SM /QP-3 SM Model. Rome H. Walker MD February 28, 2008
Aligning Hospital and Physician P4P The Q-HIP SM /QP-3 SM Model Rome H. Walker MD February 28, 2008 A Concerted Effort Because the rewards are based on shared performance, the program is intended to create
Research on nurse practitioner diagnostic reasoning
Clinical Stream Research on nurse practitioner diagnostic reasoning Alison Pirret Research on nurse practitioner diagnostic reasoning Alison Pirret (NP, BA, MA, PGCert, PhD) Introduction Nurse practitioners
Why Focus on Perioperative Services?
1 Why Focus on Perioperative Services? 80% 60% 40% 20% 0% Perioperative Services are key to a hospital/system's success 68% % better performers revenue from perioperative services Perioperative Services
The Development of the Oncology Symptom Management Clinic
The Development of the Oncology Symptom Management Clinic Submitted by: Catherine Brady-Copertino BSN, MS, OCN Executive Director Anne Arundel Medical Center s Geaton and JoAnn DeCesaris Cancer Institute
Lessons for Transfusion Laboratory Staff. from the 2007 SHOT Report SHOT SERIOUS HAZARDS OF TRANSFUSION
Lessons for Transfusion Laboratory Staff from the 2007 SHOT Report SERIOUS HAZARDS OF TRANSFUSION SHOT The Serious Hazards of Transfusion Scheme (SHOT) is a UK-wide confidential enquiry that collects data
Risk 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
ABG 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
AmSECT Quality and Outcomes Conference
AmSECT Quality and Outcomes Conference Patient Blood Management: A Wise Investment for the Patient and the Health System Miriam A. Markowitz, CEO October 2, 2014, 1:45pm 2:10pm AABB Introduction 2 Emerging