Culture f Safety Next Steps Tls-Supprt A partnership f the Healthcare Assciatin f New Yrk State and the Greater New Yrk Hspital Assciatin
Webinar Objectives Overview f NYS Results Jerry Salkwe Brief Data Orientatin Alyssa Kick Next Steps Jerry Salkwe Tls and Resurces Alissa D Ameli Sample Actin Plan Nancy Landr 2
3 Overview f NYS Results
NYSPFP Results 87% f NYSPFP hspitals participated in the COS survey Mre than 87,000 COS surveys were cmpleted Direct survey respnse rate = 41% Target = 40% 60% f hspitals cmpleted the AHRQ RFC Self- Assessment Mre than 80% f hspitals had at least ne representative at the reginal TeamSTEPPS trainings 4
NYSPFP Hspital Perfrmance n COS Cmpsite Measures (% psitive) 100% Percent f Respndents with a Psitive Respnse 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% NYSPFP Average NYSPFP 90th Percentile Natinal Average Natinal 10th Percentile Natinal 90th Percentile 5 AHRQ COS Cmpsite Measures
Primary Safety Grade All Respndents and by Primary Wrk Unit/Area All Respndents Rehabilitatin Supprt Services Primary Wrk Area/Unit Outpatient Services Prfessinal Services Emergency Medicine Operating Rm Pediatrics Critical Care Med Surg Psychiatry Obstetrics -L&D 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% AHRQ COS Patient Safety Grade Excellent Very gd Acceptable Pr Failing 6
A Brief Data Orientatin AHRQ Culture f Safety Survey
AHRQ Leadership Dashbard 8
Culture f Safety Dimensin Charts 9
AHRQ COS Survey Data Table 10
AHRQ COS Survey Raw Data 11
Next Steps Yu have yur results....nw what? 12
Culture f Safety Survey Results Identify dimensins with greatest pprtunity fr imprvement 13
Culture f Patient Safety Survey and Readiness fr Change Assessment Alignment and Integratin Tl This dcument is prvided as a tl fr hspital use in assessing pprtunities fr imprvement, related t the AHRQ Hspital Culture f Patient Safety Survey and the AHRQ Readiness fr Change Assessment Tl. It is intended t guide internal analyses. It s use is vluntary and NYSPFP will nt be cllecting resulting data r dcuments. 14
COS-RFC Alignment & Integratin Tl 15
COS-RFC Alignment & Integratin Tl Cntinued 16
Planning fr Imprvement Inventry yur tls and prcesses Key cmpnents utlined n fllwing slides Sample tl available n website But if yu have an apprach that has wrked fr yur rganizatin Tune it up and turn it n 17
Planning fr Imprvement Cntinued Study yur COS results Respnse rate If < 40% cnsider hw respnders and nn-respnders might differ Tp three dimensins Bttm three dimensins Fcus n actinable pprtunities Review prir COS like surveys What was impact? Are actin plans and change teams still functinal? 18
Create the Change Team Define Yur Aims/Gals What will be achieved? What departments will be invlved? When and where will the change ccur? Example: We will strengthen ur cmmunicatin skills and make it psychlgically safe fr all t advcate fr patients. We will d this by using SBAR fr cmmunicatin between all wh exchange patient infrmatin, and teaching all staff t use CUS. We will start with acute care; Nurses and supprt staff will effectively use SBAR and CUS by Octber 1, 2012. 19
Design the Interventin Hspital as a whle? Units/departments f fcus? Which tls/strategies? Measures? Observatins Cunts Outcmes Patient/Staff surveys 20
Implementatin Plan Management, Medical Staff, and Bard Share current results Feedback t Department Heads Aggregate and department specific results Cmmunicate Aims & Gals Hspital and department levels Ensure P&Ps supprt actin plans 21
Sustain and Spread Changes Cmmunicatin Plan Stakehlder analysis Talking Pints Rle Mdeling Mnitring Feedback at hspital and department level Integratin int new emplyee rientatin, cmpetency testing 22
23 Tls and Resurces
AHRQ Culture f Safety Resurces http://www.ahrq.gv/qual/patientsafetyculture/hspimpptsaf.htm Practical resurces hspitals can use t imprve patient safety culture Glbal, crss-cutting interventins Targeted resurces specific fr each f the survey s dimensins f patient safety culture Resurces selected will depend n: Interventin Facility fit Glbal need fr imprvement vs. single dimensin(s) with significant rm fr imprvement Imprving Patient Safety in Hspitals: A Resurce List fr Users f the AHRQ Hspital Survey n Patient Safety Culture. AHRQ Publicatin N. 11-0012-2-EF, August 2010. Agency fr Healthcare Research and Quality, Rckville, MD. 24
Sample Resurces Multi-Dimensin Single-Dimensin Team STEPPS 25 Dimensin 1: Teamwrk within units Dimensin 7: Cmmunicatin penness Dimensin 9: Teamwrk acrss units Dimensin 11: Handffs and transitins Just Culture Dimensin 4: Organizatinal learning Dimensin 7: Cmmunicatin penness Dimensin 8: Frequency f events reprted Dimensin 12: Nn-punitive respnse t errr Teamwrk Acrss Units Dimensin 1: Patient Safety Thrugh Teamwrk and Cmmunicatin Tlkit Management Supprt fr Patient Safety Dimensin 3: Appint a Safety Champin fr Every Unit Handff and Transitins Dimensin 11: Dr-t-Dc Patient Safety Tlkit; Medicatin Safety Recnciliatin Tlkit
NYSPFP Supprt One-n-ne Prject Management supprt t assist hspitals with: Interpreting the survey results Develping a disseminatin/cmmunicatin plan Targeting pprtunities fr imprvement Develping, implementing, and evaluating a strategic, fcused actin plan 26
Sample Actin Plan
Analysis This example analysis is fcused n determining the tp NYS pprtunities fr imprvement in patient safety culture. 28
Analysis: Brief Prcess Overview Develped criteria that wuld enable NYSPFP t capture the tp issues based n scres Readiness fr Change: Questins were 40% f the hspitals answered n r t a limited extend Culture f Patient Safety: Questins were there was 5% difference between the NYS and Natinal results Analyzed the results at the questin level and the categry r dmain level Themed tp pprtunities 29
Findings: Emerging Themes Management Perspective (RFC) Staff Perspectives (COS) Opprtunities t prvide strnger infrastructure t supprt staff: training, data, reliable prcesses Opprtunities t develp cllabratin at all levels f the staff, including the medical staff. Opprtunities t address alignment f strategic t peratinal gals and accuntability systems in day t day practice Staffing Issues (Nte: perceptins with staffing are nt exclusively r necessarily related t numbers ) Lack f a nn-punitive envirnment Teamwrk and Cmmunicatin 30
Relatinship t NYSPFP Part 1 Opprtunities t prvide strnger infrastructure t supprt staff: training, data, reliable prcesses Training: 31 NYSPFP Educatinal Prgramming Resurces fr Hspital Leads t spread the educatin Data: Prvide cmparative data Prvide educatin and tls fr getting the data t the staff Reliable prcess: Further imprve the cnsistent use f evidence-based practices Onging training r re-dsing Recgnize success
Relatinship t NYSPFP Gals Part 2 Opprtunities t prvide strnger infrastructure t supprt staff: training, data, reliable prcesses Training: 32 NYSPFP Educatinal Prgramming Resurces fr Hspital Leads t spread the educatin Data: Prvide cmparative data Prvide educatin and tls fr getting the data t the staff Reliable prcess: Increase the cnsistent use f evidence based practices Onging training r re-dsing Recgnize success
Relatinship t NYSPFP Gals Part 3 Opprtunities t develp cllabratin at all levels f the staff, including the medical staff. TeamSTEPPS educatin, supprt, and tls Ensure educatin and best practices cnsistently addresses the multi-disciplinary prcesses and cllabratin Utilize team-specific (OR team, OB team, CC team, Medical- Surgical Nurse Manager-Hspitalist/Resident Team......) tactics and appraches t HAC reductin Incrprate team building skills and cmmunicatin techniques int the prgramming 33
Relatinship t NYSPFP Gals Part 4 Staffing Issues NYSPFP can prvide supprt thrugh: TeamSTEPPS: literature shws that increased teamwrk, cmmunicatin, and mutual supprt imprves staff sense f cntrl and assistance Prmte cnsistent use f evidence-based practices in the mst efficient and effective ways. 34
Next Steps... Develp r update yur hspital s strategic, peratinal, and quality plans t address pprtunities t imprve the culture f safety. (Perfect Timing!) Highlight similar r same actins that will have a synergistic r psitive impact in ther target areas such as patient satisfactin scres, emplyee retentin, r efficiency. (Cmbine teams?) Utilize yur NYSPFP Prject Manager as yur cnnectin t supprt and assistance. 35