FHA MTC HIIN Lead Quarterly Virtual Meeting April 30, 2018

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1 FHA MTC HIIN Lead Quarterly Virtual Meeting April 30, 2018

2 Today s Agenda Welcome and Overview for today s HIIN Lead Virtual Meeting HIINgagment and HIINaction Florida s Success, Opportunities and Line of Attack WishHIIN List

3 Our Progress Data as of 04/02/2018 Harm Measure Most Recent Month Reported To Date Relative Reduction HIIN Goal Status (1) Cost Savings Harms Prevented Lives Saved ADE Anticoag (ADE-1a) (Feb) % Achieved $5,175,602 1, ADE ADE Hypo (ADE-1b) (Feb) 8.52% Worsening ($8,968,393) (1,794) (197) ADE Opioid (ADE-1c) (Feb) % Making Progress $3,663, CAUTI CAUTI Rate - All Units excl NICU (CAUTI-2a) (Feb) % Making Progress $149, CLABSI CLABSI Rate - All Units (CLABSI-2a) (Feb) % Achieved $4,044, Falls Falls with Injury (FALLS-1) (Feb) % Making Progress $6,413, MRDO MRSA Rate (MRSA-2) (Mar) -2.22% Making Progress $82, Pressure Injuries PrU Prevalence, Stage 2+ (PrU-2) (Feb) % Making Progress $3,904, SSI Rate, Colon (SSI-2a) (Mar) 6.35% Worsening ($868,326) (41) (1) SSI SSI Rate, Abd Hyst (SSI-2b) (Feb) % Achieved $694, SSI Rate, Hip (SSI-2d) (Feb) % Achieved $1,266, SSI Rate, Knee (SSI-2c) (Feb) % Achieved $962, c. difficile rate C. diff rate (CDI-1b) (Mar) % Achieved $15,566,962 1, Post-operative sepsis Post-Op Sepsis Rate (Sepsis-1a) (Feb) -8.09% Making Progress $653, Ventilator-Associated Condition VAC (VAE-1) (Feb) % Making Progress $4,163, Post-Op. Pulmonary Embolism or Post-Op VTE (VTE-1) (Feb) Deep Vein Thrombosis % Making Progress $1,532, All Cause 30-Day Readmissions All Cause 30-Day Readmissions (READ-1) (Feb) -0.93% Making Progress $16,452,889 1,063 Total $64,727,739 6, Source: HRET Improvement Calculator, effective date April 2, 2018

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6 HIINgagement Hospital Successes, Challenges and Asks

7 Florida Hospital Fish Memorial: Strategies for Reducing CDI and Post-Op Sepsis Veronica Pichardo PT Safety/PSO liaison Florida Hospital Fish Memorial Office of Clinical Effectiveness April 30, 2018

8 Lee Health: Certified Zero Award Marilyn Kole, MD, MBA Alex Daneshmand, DO, MBA Cora Murphy, MSN, RN-BC, CNL April 30, 2018

9 What is the Certified Zero Award Purpose: The award is part of Lee Health's efforts to support the creation and sustainment of highly reliable care- care that is dependable, high quality, and safe over a long period of time Zero Harm Together 9

10 Award Eligibility Children's Hospital Units: CLABSI free for 12 consecutive months Lee Health Adult In-Patient Units: CAUTI and CLABSI free for 12 consecutive months * Once recognized, units are re-eligible once they have met an additional 12 rolling months 10

11 How it Works Initiated: March 2017 (Children s Hospital) May 2017 (Adult campuses) What Units: 1 Unit: Golisano Children s Hospital & 13 Adult Units Each unit receives : 1. Framed Certified Zero Award 2. Pizza luncheon (day/night) 3. Recognition of unit director, VP/ACMO, senior leaders Other recognition: Teaming Update, Medical Staff Matters, Nursing Matters, SafeLee Website 11

12 Certified Zero winners were asked: How did you achieve the Certified Zero? Transparency on how many lines do we have. Do we really need each line? Addressing each line every day Create a banner of how many days the team has achieved CLABSI or CAUTI free Every morning, ask the physicians, can we pull the line without any repercussion Physician-nurse rounding- It is important that the charge RN call the physician on service and review the plan of the care daily

13 Certified Zero Winners were asked: How did you make prevention important to the staff?? Make it personal and create ownership Create accountability and empowerment of the staff Make it important and make it consistent- daily follow up Having a questioning attitude with providers Share results and engage the physicians

14 Certified Zero Winners were asked: How do you make harm visible? Banner on the unit should be visible to everyone including patients and their families Real-time feedback Share safety story in huddles/meetings

15 Tracking log

16 First Recipients 16

17 CPCU Director: Beth Thacker 17

18 Thank You 18

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

20 HIINaction - UP Campaign January-March 2018 April-June 2018

21 GET UP Take Aways Eliminate sitters-train staff to mobilize patients Progressive mobility prevents harm-optimize mobility in bed or chair Interdisciplinary collaboration in mobility program Decrease medication risk to mobilization Appropriate/adequate supply of equipment is key Paradigm shift-progressive mobilization instead of falls prevention Start with small tests of change

22 GET UP Poster

23 WAKE UP Take Aways Make it easy to do the right thing, but avoid Uboxia Airway assessed Labs reviewed Past medical history reviewed Pain discussed Take advantage of PAT visits to discuss pain expectations Do not allow routine reversals using naloxone Where will the patient most likely be when the naloxone wears off? Create hard stops for orders that contain both benzodiazepines and opioids Did you know that situational delirium leads to dementia? Combine sedation level assessment with pain assessment If these two scores do not give you a clear picture, use end-tidal capnography as the umpire Ask about their comfort level, prior to asking about pain, do they match? Provide alternatives to ease anxiety and pain; What would you do at home? Ensure that leadership is aware of the actual culture

24 HIIN SafeCulture Project Why Participate? May 7 th (2-3pm ET) Measure with Ease (Survey Portal uses AHRQ s HSOPS) Improve Response Rates Quick Access to Results & Analysis Comparison to U.S. & FL hospitals (AHRQ 2018 National Benchmarks)

25 Patient and Family Engagement FHA Patient and Family Engagement (PFE) Learning Collaborative Providing hospitals with tailored resources, coaching calls, site visits, monthly newsletters, webinars and more. 21% increase in HIIN hospitals reporting Patient and Family Advisory Councils Coaching calls: providing support on PFAC sustainability, establishment, and expansion Upcoming Best Practice Webinar Series Pending national research assessing the positive correlation of performance on PFE metrics and improved quality

26 Readmissions Discussion Forums May-August Jupiter May 17 Orlando May 23 Pensacola June 15 Other areas - TBA Review the latest data Share individual hospital strategies to reduce readmissions Identification of common barriers Action planning This Photo by Unknown Author is licensed under CC BY-NC-SA

27 WOUND CARE TRAINING FHA MTC small test of change One day program 5-7 contact hours Customizable program based on needs of interested hospitals and on the participant skill level (RN, LPN, Physical Therapist) Designed for the inexperienced or novice provider Primary focus on wound assessment and bariatric wound and skin care Please complete the survey at the end of webinar.

28 OTHER ACTIVITIES IN THE WORKS Team STEPPs training Subject Matter Expert Resources SCRIPT UP Other ideas (group discussion all lines OPEN)

29 FHA New Initiative: EDIE Emergency Department Information Exchange FHA Statewide Initiative Provides real-time data on patients Used in 18 other states Results: Prevented readmissions Identified patients with opioid seeking behavior Reduced non-emergency ED visits Learn more: May 11, am ET [Webinar]

30 Future Planning: Tell us about the resources you would you like FHA to offer Lean training TCAB Sepsis training for all provider types Other ideas (group discussion)

31 In-Person Meetings: Upcoming Events WAKE UP to Protect Patients from Oversedation June 12, 2018: FHA Corporate Office, Orlando, FL June 14, 2018: Sacred Heart Hospital, Pensacola, FL SAVE THE DATES! May-August Readmissions Discussion Forums May 17, 2018: Jupiter Medical Center, Jupiter, FL May 23, 2018: FHA Corporate Office, Orlando, FL Jun. 15, 2018: Pensacola, FL Other Areas to be Announced [Regional invitations and registration details coming soon] NHSN Training (to be announced for this Summer) Wound Care Seminar (to be announced) Virtual Events: May 1 FHA HIIN - CDI in the Pediatric Population Check your HIIN INFO Upcoming Events Weekly for details and registration May 3 FHA IVAC Bi-Monthly Webinar #2 May 3 HRET HIIN NHSN CDI Surveillance Definition Review May 7 FHA HIIN SafeCulture Offering: Informational Webinar May 8 HRET HIIN Readmissions Sepsis Fishbowl Series: 2 May 8 FHA HIIN Chasing Zero Infections MRSA Coaching Call

32 Contact Us We are here to help! SAVE THE DATE! Next HIIN Lead Quarterly Virtual Meeting July 30, am ET