FHA MTC HIIN Quarterly Virtual Meeting January 22, 2018

Transcription

1 FHA MTC HIIN Quarterly Virtual Meeting January 22, 2018

2 Today s Agenda Purpose of the Call UP Campaign Review of the data Needs Assessment Feedback What do you Need?

3 CMS HIIN GOALS GOALS: 20% Overall Reduction in Hospital Acquired Conditions 12% Reduction in 30-Day Readmissions By September 27, 2018 Milestones: Data through October due January 26 Data through March submitted by May 15, ADE 2. CAUTI 3. CDI 4. CLABSI 5. Falls 6. PrU 7. Sepsis 8. SSI 9. VTE 10. VAE 11. MRSA 12. Readmissions 13. Worker Safety partnershipforpatients.cms.gov

4 UP Campaign October 1 December 31, 2017 April 1 June 30, 2018 January 1 March 31, 2018

5 FHA Call to Action Ventilator Associated Conditions

6 Patient Safety Culture TCAB TeamSTEPPS Patient Safety Analytic Tool Patient Safety Strategy webinars

7 Meetings and Resources Sepsis in the ED/TeamSTEPPS Readmissions Summit Advance Care Planning Chasing Zero Regional Meetings Key locations to encourage greater participation

8 Patient and Family Engagement 13 hospitals are currently participating. Activities include coaching calls, an invitation only resource sharing and collaboration site, and monthly webinars. Topics have included: Patient and Family Advisor Rounding Programs The Power of Storytelling Communicating in a Crisis Patient and Family Advisor Onboarding Coordinating PFE Activities Across Systems Quantifying the Value of PFACs

9 Results Through December 2017 Results 6,958 Harms prevented 2,467 Readmissions avoided 761 lives saved $96.7 million in costs saved

10 Progress Toward the Goals FHA HIIN SUMMARY Hospital Performance Report All measures calculated per 1,000 unless noted. * Rate calculated per 100 Measure Rates Project Measure Baseline Rate Monitoring Data - Oct to Most Recent Data # Harms Average Rate % Improvement Progress ADE ADEs - excessive anticoagulation* , % ADEs - hypoglycemia* , % CAUTI CAUTI Rate - ICUs except NICUs % C.difficile C. diff Rate Facility-wide-all except NICUs (per , % CLABSI CLABSI Rate - All % Pressure Ulcers Pressure ulcer prevalence, stage 2+* , % Sepsis Sepsis Post-op Rate % SSI SSI rate, knee surgeries* % SSI rate, hip surgeries* % VTE Post-operative VTE or DVT % Worker Safety Worker Safety harm events - patient mobilization* , % CDS Data Pull, January 15, 2018

11 Progress Toward the Goals FHA HIIN SUMMARY Hospital Performance Report All measures calculated per 1,000 unless noted. * Rate calculated per 100 Measure Rates Project Measure Baseline Rate Monitoring Data - Oct to Most Recent Data # Harms Average Rate % Improvement Progress CAUTI Catheter Utilization -all except NICUs* , % Catheter Utilization -ICUs except NICUs* , % CLABSI CLABSI Rate - ICUs % Central line utilization - All* , % Central line utilization - ICUs* , % Pressure Ulcers Pressure ulcer rate, stage % Readmissions Readmissions - Medicare* , % Sepsis Overall sepsis mortality , % VAE Ventilator-associated condition rate , % Infection-related ventilator-associated condition rate % CDS Data Pull, January 15, 2018

12 Progress Toward the Goals FHA HIIN SUMMARY Hospital Performance Report All measures calculated per 1,000 unless noted. * Rate calculated per 100 Measure Rates Project Measure Baseline Rate Monitoring Data - Oct to Most Recent Data # Harms Average Rate % Improvement Progress Harms To Go ADE ADEs - opioids* , % 347 CAUTI CAUTI Rate - all except NICUs % 79 Falls Falls w/injury , % 306 MRSA Hospital-onset MRSA bacteremia events % 27 Readmissions Readmissions - 30 day all cause* , % 10,726 Sepsis Hospital-Onset Sepsis Mortality Rate , % ~ SSI SSI rate, colon surgeries* % ~ SSI rate, abdominal hysterectomy* % 10 Worker Safety Worker Safety harm events - workplace violence* % ~ CDS Data Pull, January 15, 2018

13 Needs Assessment Feedback What are your priority areas over the next nine months? Topic % # Readmissions 66% 27 Sepsis 63% 26 Patient Safety Culture 63% 26 Falls 59% 24 CLABSI 59% 24 CAUTI 51% 21 C. difficile 46% 19 Pressure Ulcers 41% 17 Antibiotic Stewardship 41% 17 Patient and Family Engagement 39% 16 SSI - Colon 37% 15 MRSA/MDRO 29% 12 ADE - Opioids 29% 12 Worker Safety - Workplace Violence 24% 10 VTE 24% 10 SSI - Hysterectomy 22% 9 Ventilator Associated Events 17% 7 ADE - Hypoglycemia 17% 7 Worker Safety - Safe Lifting 15% 6 SSI - Knee Surgeries 12% 5 SSI - Hip Surgeries 12% 5 ADE - Excessive Anticoagulation 12% 5

14 Needs Assessment Feedback Please select the type of support that you need for these areas. Topic % # Resources and Tools 80.5% 33 Education/Training Materials 75.6% 31 Data/Comparison Benchmarks 58.5% 24 Coaching Calls with National Subject Matter Experts 46.3% 19 Site Visit 7.3% 3 Other (please specify) 7.3% 3 Time... Re: patient and family advisory council Human resources

15 What do YOU and YOUR TEAMS need to meet the 20/12 Goal?

16 Quality Improvement Fellowship Foundation for Change 23 fellows Baptist Medical Center Jacksonville Indian River Medical Center Bay Medical Sacred Heart Lee Health Broward Health North Leesburg Regional Medical Center Florida Hospital Flagler Madison County Memorial Hospital Florida Hospital Memorial Medical Center Martin Medical Center Florida Hospital Memorial Medical Center Moffitt Cancer Center Health Central Hospital Palm Beach Gardens Medical Center Health First Inc. Sacred Heart Hospital of Pensacola Hialeah Hospital The Villages Regional Hospital Accelerating Improvement 11 fellows Central Florida Health Memorial Hospital Miramar Florida Hospital Memorial Medical Center Moffitt Cancer Center Florida Hospital North Pinellas Orlando Regional Medical Center Lakeland Regional Health South Lake Hospital The economic value of this training is college level and it is offered free to your facility. It is an excellent opportunity to take a project that is important to your facility and set new processes in motion. Kim Walker Next Fellowship Group Applications Due Feb 16

17 FHA GET UP Campaign January 1 March 31, 2018 Progressive mobility preserves muscle strength, improves lower limb circulation and lung capacity, reduces length of stay and reduces delirium Lack of mobility is most dangerous in the elderly but healthier patients are at risk as well Improves multi-disciplinary collaboration and focus on preventing patient harm Involves patients and families in the care plan Impacts seven harm topics, saves lives and avoids costs Key Message: Walk in, Walk during, Walk out!

18 Upcoming Meetings GET UP Regional In-Person Meetings: Registration is open Feb. 19 Hollywood, FL Memorial Regional Hospital-Garage Conference Center Feb. 21 Orlando, FL FHA Corporate Office-Boardroom Feb. 23 Pensacola, FL Pensacola Blue Wahoos Stadium-Better Homes and Gardens Lounge Check your HIIN INFO Upcoming Events Weekly for details and registration

19 IP Boot Camp Date: March 22-23, 2018 Location: FHA Corporate Office, Orlando Program: Led by Linda Greene, RN, MPS, CIC, FAPIC Professional development of novice infection preventionists new to their role (less than 2 years) Focus on fundamental knowledge Core competencies surveillance and epidemiology antibiotic stewardship regulatory and accreditation compliance development, implementation and evaluation of an IP Program Check the weekly MTC HIIN Upcoming Events for details and registration

20 SEPSIS Strategy Early Recognition and Treatment of Sepsis in The Emergency Department Addressing Sepsis Using TeamSTEPPS framework Assemble your team Gather your policies, protocols and order sets Review the evidence and resources Use the communication tools to improve care and outcomes Where is your hospital in the spectrum? Average Mortality Rate for the State

21 Readmissions Quarterly calls with stakeholders February 2 AHCA Partnership with HSAG and community collaboratives Starting monthly summary of strategies and hospital successes Work around end of life and palliative care

22 Upcoming Events Virtual Events: Jan. 25 TeamSTEPPS Check-in: Sepsis in the ED Jan. 25 Unit Based Action Planning for Safety Culture Improvement Jan. 26 PFE Learning Collaborative Webinar The Advisor Experience Jan. 30 SCRIPT UP: Optimizing Patient Medications, Minimizing Adverse Events Feb. 2 Readmissions Stakeholder Quarterly Virtual Meeting #1 Feb. 8 PFE Learning Collaborative & FHA WHYB Worker Safety Joint Webinar Feb. 13 Chasing Zero Infections Coaching Call: CAUTI: Catheter Utilization Feb. 14 TCAB Cohort 2 Collaborative Webinar #3 Feb. 26 Children s Hospitals: Reducing Readmissions Mar. 1 IVAC Bi-Monthly Webinar #1: IVAC and the GET UP Campaign Check your HIIN INFO Upcoming Events Weekly for details and registration

23 Contact Us We are here to help! SAVE THE DATE! Next FHA MTC HIIN Quarterly Virtual Meeting April 30, am ET