georgia hospital engagement network cohort 9 coaching call august 27, 2014 cohort 2 + cohort 3 +...

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GEOR GIA HOS PITA L ENGAG EMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COH ORT 2 + COHO RT 3 + COH ORT 4 = COHO RT “9”

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Page 1: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

GEORGIA H

OSPITA

L ENGAGEMENT

NETWORK

COHORT 9

COACHIN

G

CALL

AUGUST 27, 2

014

CO

HO

RT

2 +

CO

HO

RT

3 +

CO

HO

RT

4 =

CO

HO

RT

“ 9”

Page 2: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

FRAMING

• PATIENT STORY

• HEN UPDATES (Data Submission Document)

• Videos for Employee Education “Patient’s perspective”

• Re-Admissions

• PFE

• QIO Update

• LEAPT Spread• Worker Safety – Getting Started

Getting ready for September spread – Procedural Harm and Failure to Rescue

• Calendar Review – Upcoming Events

• HEN Regional Meetings

September 16, 2014 GHA

September 30, 2014 Macon

Page 3: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

HEALTH DISPARITIES

A hospital story….

Page 4: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

COHORT 2, 3, 4: READMISSIONS

2010 41456 41487 41518 41548 41579 41609 41640 41671 4169916.00%

16.50%

17.00%

17.50%

18.00%

18.50%

19.00% 18.69%

17.67%17.53%

17.13%17.38%

17.88% 17.78%

17.38% 17.49%

17.13%

Cohort 2, 3, & 4 Medicare 30 day All Cause Rate

Base line 2010 toJuly 2013 - March 2014

RateLinear (Rate)

20% Reduction = 14.96%

Page 5: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

COHORT 2, 3, 4: READMISSIONS

Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-141850

1900

1950

2000

2050

2100

2150

2200

2250

2300

2143

2231

1985

20942070

2181

2223

1996

2120

Cohort 2, 3, 4The number of Individuals Readmitted

July 2013 - March 2014

NumLinear (Num)

Page 6: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

SENSE OF URGENCY

What actions will you take to adjust your improvement process based on what you have heard?

What can the HEN do to support your efforts?

• Do Your PART campaign

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Page 7: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”
Page 8: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

 http://www.gmcf.org/AlliantWeb/Files/QIOFiles/Members/Important%20Message%20from%20Medicare-English.pdf

Updated patient letter from new QIO

Page 9: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

FAILURE TO RESCUE: SPREAD

Bold Aims:

PSI-4 – decrease deaths per 1000 patients having developed specified complications of care during hospitalization to 10% by December 2014.

Reduce the number of unplanned transfers to a higher level of care by 20% by December 2014.

Reduce the number of patients who had a code blue where there was not a Rapid Response Team called first by 20% by December 2014

Page 10: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

FAILURE TO RESCUE: SPREAD

The Institute for Healthcare Improvement's 5 Million Lives campaign, which is a continuation of its initial 100,000 Lives campaign, calls for the establishment of Rapid Response Systems.i In particular, the goal of RRS implementation is to reduce the number of medical errors by decreasing the number of unmet patient needs prior to cardiac arrest.ii RRSs are established to "respond to a 'spark' before it becomes a 'forest fire,'" thereby preventing failure to rescue.iii

Page 11: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

FAILURE TO RESCUE: SPREAD

• Observable signs of deterioration develop within 6-8 hrs. of a cardiac arrest

• As many as 17% of cardiac arrests occur in patients being cared for in an inappropriate clinical settingiv

• Cardiac arrest was potentially avoidable in as many as 95% of these patientsiv

• FTR is potentially avoidable in as many as 60% of patients who were cared for in an appropriate setting.iv

 

Page 12: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

FAILURE TO RESCUE: SPREAD

Key Learnings:

• Position to Spread best practices within our HENs and across the nation starting September 2014

Provide mentor support and monthly coaching calls/webinars

• Leadership buy-in and Champion to assist with spread throughout organization  

• Formation of Rapid Response Team (RRT) – multidisciplinary team with skill sets to handle emergency care

• Standardize RRT protocols—(policy/procedure/protocol)

Page 13: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

FAILURE TO RESCUE: SPREAD

Key Learnings:

• Education of entire hospital staff AND Patients and Families---when and who can call a RRT call (anyone and everyone); role of each department in RRT is KEY

• Analyze data and give feedback to entire hospital on regular basis; report card format is preferred

• Continuous education of staff , patients and families is necessary to increase utilization

 

Page 14: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

FAILURE TO RESCUE: SPREAD

Rapid Test of Change:

• Drills and simulations

• RRT Call Simulations

• Code Blue Grand Rounds• Rapid Response Teams (RRTs)

• Implement RRT Policy

Page 15: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

FAILURE TO RESCUE: SPREAD

Rapid Test of Change:

• Chart Review: Reconcile Patients with RRT calls with complications / mortality / unplanned transfers

• Educate staff to reinforce RRT activation criteria

• Post RRT- call huddles

• Hospitals are reviewing Rapid Response Team (RRT) activations and comparing to the Modified Early Warning System* (MEWS) scoring to determine feasibility of using the MEWS to identify patients who need an early intervention from a RRT or early response nurse.

Page 16: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

“CAREGIVER SAFETY”WHERE TO START?

1. Establish - a Team of “stakeholders”

Suggest representatives from Occupational / Employee Health,

Human Resources, Risk Management, Nursing, Quality, ….

2. Complete - OSHA’s Self –Assessment Tool:

“How Safe is my Hospital?”

3. Evaluate - Employee Turnover, and Culture of Safety Survey

Results

4. First Step Suggestions -

Hospital Governing Board review of Worker Injury data

Safe Patient Handling / Use of Low Tech Devices16

Page 17: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

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Page 18: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

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Page 19: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

“HOW SAFE IS MY HOSPITAL FOR WORKERS?”

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Page 20: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

“HOW SAFE IS MY HOSPITAL FOR WORKERS?”

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Page 21: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

“HOW SAFE IS MY HOSPITAL FOR WORKERS?”

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Page 22: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

“HOW SAFE IS MY HOSPITAL FOR WORKERS?”

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Page 23: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

CALENDAR OF UPCOMING EVENTS

Next Cohort Coaching Call: October 22, 2014

HEN Fall Regional Meetings: September 16 (GHA)

September 30 (MACON)

Data Submissions:

July Data Due September 15:

ADE’s including INR, BG, and Opioids

Falls with injury

VTE-6 (due once a quarter)

HAI (if not submitting via NHSN)

EED if applicable

Workers Safety if applicable

Page 24: GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

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