Nursing Home Quality Care Collaborative Team 20 April 2017
Interacting with the Webinar 2
Slides & Recording Registrants were sent a PDF of the slides in advance of the webinar The slides and a recording of today s presentation will also be available in a few days at www.medicare.qualishealth.org/ls1 3
Qualis Health A leading national population health management organization The Medicare Quality Innovation Network - Quality Improvement Organization (QIN-QIO) for Idaho and Washington The QIO Program One of the largest federal programs dedicated to improving health quality at the local level 4
Welcome to the Collaborative! 5
Learning Session 1: Team April 4 Kick-off Webinar April 12 Team Assessment Webinar April 20 Team Webinar Self-Study & PDSA cycles May/June In-person Peer-to-Peer Sharing Events June/July Action Period Office Hours Call 6
Homework Multi-team System Exercise Team observation tool TeamSTEPPS session review http://qioprogram.org/teamstepps%c2%ae-ltc-communicationstrategies-promote-quality-and-safety 8 tools, 4 videos 7
TeamSTEPPS Tools 8
Learning Session 1: Team April 4 Kick-off Webinar April 12 Team Assessment Webinar April 20 Team Webinar Self-Study & PDSA cycles May/June In-person Peer-to-Peer Sharing Events June/July Action Period Office Hours Call 9
Assumptions Fatigue Distractions HIPAA
Objectives Describe the importance of communication Recognize the connection between communication and medical error Define communication and discuss the standards of effective communication Describe strategies for information exchange Identify barriers, tools, strategies, and outcomes to communication Mod 6 06.1 Page 11 11
Mod 6 06.1 Page 12 12
Importance of Ineffective communication is a root cause of nearly 66 percent of all sentinel events reported* Mod 6 06.1 Page 13 * (The Joint Commission Root Causes and Percentages for Sentinel Events (All Categories) January 1995 December 2005) DHHS Office of Inspector General, Adverse Events in Skilled Nursing Facilities: National Incidence Among Medicare Beneficiaries 13
The process by which information is exchanged between individuals, departments, or organizations The lifeline of the Core Team Effective when it permeates every aspect of an organization is Assumptions Fatigue Distractions HIPAA Mod 6 06.1 Page 14 14
Standards of Effective Complete Communicate all relevant information Clear Convey information that is plainly understood Brief Communicate the information in a concise manner Timely Offer and request information in an appropriate timeframe Verify authenticity Validate or acknowledge information Mod 6 06.1 Page 15 15
Mod 6 06.1 Page 16 16
Information Exchange Strategies SBAR (Situation Background Assessment Recommendation) Call-Out Check-Back Handoffs/I PASS the BATON Briefs Huddles Debriefs CUS/Two-Challenge Rule Mod 6 06.1 Page 17 17
SBAR provides A framework for team members to effectively communicate information to one another Communicate the following information: Situation What is going on with the resident? Background What is the clinical background or context? Assessment What do I think the problem is? Recommendation What would I recommend? Remember to introduce yourself. Mod 6 06.1 Page 18 18
Call-Out is A strategy used to communicate important or critical information It informs all team members simultaneously during emergency situations It helps team members anticipate next steps On your unit, what information would you want called out? Mod 6 06.1 Page 19 19
Check-Back is Mod 6 06.1 Page 20 20
Handoff The transfer of information (along with authority and responsibility) during transitions in care; to include an opportunity to ask questions, clarify, and confirm Mod 6 06.1 Page 21
Handoff Optimized Information Responsibility Accountability Uncertainty Verbal Structure Checklists IT Support Acknowledgment Great opportunity for quality and safety Mod 6 06.1 Page 22
Mod 6 06.1 Page 23
Leadership Team Events Briefs planning Huddles problem solving Debriefs process improvement Leaders are responsible to assemble the team and facilitate team events But remember Anyone can request a brief, huddle, or debrief Mod 3 06.1 Page 24 24
Mutual Support Please Use CUS Words but only when appropriate! Mod 5 06.1 Page 25 25
Mutual Support Two-Challenge Rule Invoked when an initial assertion is ignored It is your responsibility to assertively voice your concern at least two times to ensure that it has been heard The member being challenged must acknowledge If the outcome is still not acceptable Take a stronger course of action Use supervisor or chain of command Mod 5 06.1 Page 26 26
Challenges Language barrier Distractions Physical proximity Personalities Workload Varying communication styles Conflict Lack of information verification Shift change Great Opportunity for Quality and Safety Mod 6 06.1 Page 27 27
Barriers to Team Effectiveness Mod 6 06.1 Page 28
Teamwork Actions Communicate with team members in a brief, clear, and timely format Seek information from all available sources Verify and share information Practice communication tools and strategies daily (SBAR, call-out, check-back, handoff, briefs, huddles, debriefs, CUS/Two-Challenge Rule) Mod 6 06.1 Page 29 29
Q & A 30
Action / Next Steps View/review video examples http://qioprogram.org/teamstepps%c2%ae-ltc-communicationstrategies-promote-quality-and-safety Prepare for learning assessment Test a TeamSTEPPS tool with your team Register for in-person Peer-to-Peer Sharing Event in your area Prepare a storyboard to share your test, results & learning! 31
References & Links Additional TeamSTEPPS LTC Training Videos https://www.ahrq.gov/teamstepps/lon gtermcare/video/index.html Guidelines for Storyboards www.medicare.qualishealth.org/stor yboard Collaborative website www.medicare.qualishealth.org/ls1 32
Contact Traci Treasure QI Consultant tracit@qualishealth.org 208-383-5947 Paula Parsons QI Associate paulap@qualishealth.org 206-288-2470 For survey: https://www.surveymonkey.com/r/52jdykv For more information: www.medicare.qualishealth.org/nhqcc This material was prepared by Qualis Health, the Medicare Quality Innovation Network - Quality Improvement Organization (QIN-QIO) for Idaho and Washington, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. ID/WA-C2-QH-2842-03-17 33