NYSPFP-ACOG District II Joint Webinar on Maternal Emergencies

Transcription

1 NYSPFP-ACOG District II Joint Webinar on Maternal Emergencies February 9, 2015 A partnership of the Healthcare Association of New York State and the Greater New York Hospital Association

2 Agenda

3 NYSPFP and ACOG DII to Reduce Maternal Harm NYSPFP is supporting implementation of ACOG District II Safe Motherhood Initiative bundles of hemorrhage and severe hypertension through: Bimonthly(every other month) educational webinars/ coaching calls that will reinforce the clinical components of the ACOG SMI bundles and highlight process improvement that can lead to reduction in harm arising from maternal hemorrhage and hypertension. Hands-on technical support from Project Managers and ACOG District II Measure alignment measures to be submitted in NYSPFP data portal Begins with December 2015 performance period Data submission due 45 days after close of month (Feb. 15)

4 Safe Motherhood Initiative Update 4 February 9, 2016

5 NYSPFP Data Entry Wing Lee, NYSPFP 5 February 9, 2016

6 Summary of Measures

7 Data Submission: FAQs 7

8 Data Entry Page 8

9 Data Entry Page: Maternal Hemorrhage 9

10 Data Entry Page: Hypertension in Pregnancy 10

11 Data Entry Page: PC

12 Case Review: Maternal Hemorrhage Marina Gore, NP, CNM Perinatal Network Manager Northwell Health

13 HEMORRHAGE CASE

14 01/29/2016, 08:40

15 01/29/2016 AT 11:56

16 01/29/2016, 13:25 PACU

17 CONT PACU

18 CONT. PACU

19 TRANSFERRED TO SICU

20 SICU

21 LESSONS TO BE LEARNED:

22 LESSONS TO BE LEARNED:.

23 Process Improvement Case Study Deborah Tuttle, NYSPFP

24 PDSA Example Test #1 SMI OB Hemorrhage Risk Assessment Tables

25 PDSA Example Test #1(continued) Do Describe what actually happened when you ran the test. The test was conducted by two nurses for one week. Both nurses worked at least three 7am 7pm shifts and achieved a cumulative 96% hemorrhage risk assessment completion rate. Study Describe the measured results and how they compared to the predictions Test successful, but limited. Plan Retest with 3 nurses to ensure capturing effectiveness of the process 24/7, and weekends.

26 PDSA Example Test #2 26

27 PDSA Example Test #2 (continued) Do Describe what actually happened when you ran the test. The test was conducted by the three nurses on different shifts as described in the plan. The nurses who worked Monday through Friday on any shift were able to complete the risk assessment 97% of the time, but were concerned with the time it took to access another tool/screen. Saturday and Sunday results were less than 60%. Study Describe the measured results and how they compared to the predictions Weekend hours presented some challenges due to high labor and delivery volume. It was felt that if the questions were incorporated into the EHR assessment, it would flow naturally, and eliminate the need to go to another screen. Plan: All agreed process was successful and would flow well if added to EHR. Jane Smith to meet with IT to discuss incorporating risk assessment into EHR nursing assessment with input from nurses on placement and flow. IHI PDSA Worksheet: 27

28 Next Steps Deborah Tuttle, NYSPFP

29 Polling Question o What can NYSPFP/ACOG do to better support your implementation work? o More webinars o More process improvement teaching o More information on clinical bundles o Site visits from clinical faculty o Site visit from process improvement experts o Site visits from both faculty and process improvement experts together o Other (please describe in Chat Box ) 29

30 Summary & Next Steps 30

31 Upcoming & Recorded Webinars 31 February 9, 2016

32 Contacts NYSPFP Contacts Lorraine Ryan, GNYHA Loretta Willis, HANYS Wing Lee, GNYHA ACOG District II Contacts Kristin A. Zielinski, MA, MPP Director, Medical Education Norain A. Siddiqui, MPH Manager, Medical Education Deborah Tuttle, HANYS 32

33 Appendix: Measure Definitions for Reference 33 February 9, 2016

34 NYSPFP: Maternal Hemorrhage - Outcome Measure 34

35 NYSPFP: Maternal Hemorrhage - Process Measure* *Sampling Permitted

36 NYSPFP: Persistent Hypertension In Pregnancy - Outcome Measure 36

37 NYSPFP: Persistent Hypertension in Pregnancy - Process Measure Definitions: Persistent hypertension: two (2) severe blood pressure values taken within minutes apart. Severe blood pressure values do not need to be consecutive Treatment: includes labetalol, hydralazine, oral nifedipine 37

38 NYSPFP: Early Elective Delivery (PC-01) 38