QUALITY IMPROVEMENT & DATA REPORTING IN PUERTO RICO

Transcription

1 QUALITY IMPROVEMENT & DATA REPORTING IN PUERTO RICO Presented by: Yanira Valle, RN, MSN, Project Manager, PRHA Gabriela Gata, MPH, PRHA San Juan, P.R. September 1, 2016

2 PRHA Quality Initiatives CUSP MVP-VAP for Mechanical Ventilated Patients: (September September 2016)- Armstrong Institute for Patient Safety and Quality AHRQ: Safety Program for ICU s: CLABSI/CAUTI (February 2016-December 2016)- Health Research and Educational Trust Hospital Engagement Network 2.0: (September 2015-September 2016)- Health Research and Educational Trust

3 CUSP MVP-VAP for Mechanical Ventilated Patients Goal: Improve care for mechanically ventilated patients and reduce the rate of patient harms associated with mechanical ventilation. 11 hospitals participating

4 AHRQ: Safety Program for ICU s: CLABSI/CAUTI Goal: Reduce Central Line-associated Blood Stream Infections (CLABSI) and Catheter associated Urinary Tract Infections (CAUTI) in Intensive Care Units (ICU) with persistently elevated infection rates. 3 hospitals participating

5 Hospital Engagement Network 2.0 (HEN) Affiliation between the American Hospital Association (AHA), the Health Research & Educational Trust (HRET), and State Hospital Associations including the Puerto Rico Hospital Association (PRHA) through the Partnership for Patients (PfP) 34 participating state hospital associations More than 1,500 participating hospitals nationwide 44 participating hospitals in Puerto Rico

6 Hospital Engagement Network 2.0 Goal: The 40/20 goal: * Reduce inpatient harm by 40% * Reduce readmissions by 20% Purpose of the HEN: *Working with hospitals to implement best practices to reduce harm and readmissions. *Provide best practice resources, education, implementation support and build improvement capacity.

7 HEN 2.0 Topics Addressed Adverse drug events (ADE) Catheter-associated urinary tract infections (CAUTI) Central line-associated blood stream infections (CLABSI) Injuries from falls and immobility Obstetrical adverse events Pressure ulcers Surgical site infections Venous thromboembolism (VTE) EED Ventilator-associated events Preventable readmissions Sepsis Clostridium Difficile Delirium Airway Safety Failure to Rescue Worker Safety Radiation Exposure Patient and Family

8 Puerto Rico HEN Educational Initiatives Puerto Rico HEN 2.0 Kick-Off Meeting 2 Collaborative Meetings 2 Regional Meetings 12 Local Webinars Physician Meeting Trustees Meeting

9 Puerto Rico HEN Initiatives Quality Coordinators hospital site visits (presentations, workshops, coaching) Data Collection coaching and follow-up Leadership site visits

10 DATA REPORTING IN PUERTO RICO Gabriela Gata, MPH, PRHA Data Analyst

11 HEN Measures HEN 2.0 measures were selected based on the CMS criteria of the most common hospital acquired conditions, change packages and were included on the encyclopedia of measures The encyclopedia of measures aligned hospitals measures in a effort to demonstrate the reduction throughout the project

12 HEN 2.0 Measures

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20 C. difficile Nombre del Indicador: Facility-wide C. difficile Rate Sepsis Nombre del Indicador: Overall Sepsis Mortality Rate Numerador: Total de eventos de C. difficile observados a través de resultados de laboratorio entre todos los pacientes hospitalizados (excluyendo nursery y NICU) Denominador: Total de días paciente (inpatient) Numerador: Total de muertes con un diagnóstico secundario de sepsis Denominador: Total de altas de adultos (18-89 años) Worker Safety Nombre del Indicador: Days Lost to Harm Events Related to Mobilization Numerador: Días perdidos por eventos de daño relacionados a la movilización de pacientes (Days lost to harm events related to patient mobilization) Denominador: Total de empleados a tiempo completo (FTEs) Failure to Rescue Nombre del Indicador: In-Hospital Mortality Numerador: Total de muertes de pacientes en el hospital Denominador: Total de pacientes hospitalizados (censo)

21 Iatrogenic Delirium * Nombre del Indicador: Patients Assessed with Delirium in ICU Numerador: Total de pacientes en ICU con delirio Denominador: Total de días paciente de ICU

22 Data Reporting HEN % of the PR participating hospitals submitted data in all applicable topics between 2012 & 2014 ADE: 100% hospitals CAUTI: 100% hospitals CLABSI: 100% hospitals Falls: 100% hospitals EED: 100% hospitals OB Harm: 100% hospitals Pressure Ulcers: 98% hospitals Readmissions: 96% hospitals SSI: 100% hospitals VAP: 100% hospitals VTE: 98% hospitals

23 PR HEN 1.0 Results We reached the 40/20 goal on the following areas: -53% CAUTI all units -61% CAUTI ICU -71% CLABSI all units -77% CLABSI ICU -40% Early Elective Deliveries (EED) -20% Readmissions 30 days all cause -49% VAP in ICU -53% Post-Op PE or VTE -78% Potentially Preventable VTE

24 PR HEN 1.0 Results We achieved improvement on the following areas: -21% Adverse Drug Events -10% C-sections -13% Falls with or without injury -30% Hospital Acquired PU Stage 2 or more -25% Surgical Site Infections

25 PR HEN 1.0 Results The PR hospitals were able to prevent an estimate of over 28,319 events of harm with an estimated cost savings of $218,026, millions.

26 Data Reporting HEN % of the PR participating hospitals submitted data in all applicable topics during HEN 2.0 in ADE: 100% hospitals CAUTI: 100% hospitals CLABSI: 100% hospitals Falls: 100% hospitals EED: 97% hospitals OB Harm: 100% hospitals Pressure Ulcers: 100% hospitals Readmissions: 95% hospitals SSI: 93% hospitals VAE: 100% hospitals VTE: 95% hospitals

27 PR HEN 2.0 Results We achieved improvement or met the 40/20 goal on the following areas: -15% Readmissions -20% Falls with Injury -24% Adverse Drug Events -29% Post-Op PE or DVT -35% Clostridium Difficile -54% Surgical Site Infections -63% Worker Safety

28 PR HEN 2.0 Results The PR hospitals were able to prevent an estimate of over 1,714 events of harm with an estimated cost savings of $26,362,517 millions.

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