i plan on making the door by the time i hit thirty november 16, 2012 fraser health – burnaby...
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I plan on making the door by the time I hit
thirty
I plan on making the door by the time I hit
thirty
November 16, 2012November 16, 2012Fraser Health – Burnaby Hospital Detectives Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team NSQIP Pneumonia Prevention Action Team
November 16November 16, , 20122012
Reducing respiratory infections and Reducing respiratory infections and strengthening staff engagement at strengthening staff engagement at Fraser Health’s Burnaby Hospital Fraser Health’s Burnaby Hospital through the use of best practices through the use of best practices and data from the National Surgical and data from the National Surgical Quality Improvement Program Quality Improvement Program (NSQIP)(NSQIP)Kamaljit Sahota, Darlene
Jager, Ashley Camp, Susann Camus
Our Team
Team MembersTeam MembersAshley Camp, Surgical Staff NurseSusann Camus, NSQIP Quality Improvement ConsultantGrit Chiu, Surgical Staff NurseGabriela Gheorghe, Patient Care Coordinator, Surgical UnitJan Huggan, Surgical Manager & Team SponsorDarlene Jager, Surgical Clinical ReviewerDr. Jean-Noel Mahy, Surgeon ChampionMelody Pan, Surgical Clinical ReviewerChrista Parkin, Clinical Care Coordinator, Preadmission Kamaljit Sahota, Clinical Nurse Educator, Surgery, & Team Leader
November 16, 2012November 16, 2012Fraser Health – Burnaby Hospital Detectives Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team NSQIP Pneumonia Prevention Action Team 44
Why preventing Why preventing pneumonia matterspneumonia matters
Pneumonia can be life-Pneumonia can be life-threatening for surgical threatening for surgical patientspatients
Results in increased Results in increased morbidity and mortalitymorbidity and mortality
Costly to treat (~$50,000 per Costly to treat (~$50,000 per patient with major patient with major complications) complications) (Dimick et al., 2004)(Dimick et al., 2004)
November 16, 2012November 16, 2012Fraser Health – Burnaby Hospital Detectives Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team NSQIP Pneumonia Prevention Action Team 55
Rationale for TeamRationale for TeamNSQIP data NSQIP data for BH for BH postsurgical postsurgical pneumonia pneumonia shows shows higher than higher than average average ratesrates
November 16, 2012November 16, 2012Fraser Health – Burnaby Hospital Detectives Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team NSQIP Pneumonia Prevention Action Team 66
Burnaby Hospital Non Risk Adjusted Pneumonia Rate
0.00%
1.00%
2.00%
3.00%
4.00%
5.00%
6.00%
7.00%
Apr 2
011
May
201
1
Jun
2011
Jul 2
011
Aug 2
011
Sep 2
011
Oct
2011
Nov 2
011
Dec 2
011
Jan
2012
Feb 2
012
Mar
201
2
Apr 2
012
May
201
2
Jun
2012
% of Patients
Team GoalsTeam GoalsPrevent/Reduce pneumonia in postsurgical patients
Promote best nursing practices through staff engagement and their active involvement in translating those into action
Provide nurses, patients and their families with educational tools
November 16, 2012November 16, 2012Fraser Health – Burnaby Hospital Detectives Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team NSQIP Pneumonia Prevention Action Team 77
MeasuresMeasuresPDSA cycles to PDSA cycles to assess how assess how well we are well we are implementing implementing best practicesbest practices
NSQIP risk & NSQIP risk & non-risk non-risk adjusted dataadjusted data
Staff Staff engagementengagement
November 16, 2012November 16, 2012Fraser Health – Burnaby Hospital Detectives Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team NSQIP Pneumonia Prevention Action Team 88
Initiatives to dateInitiatives to dateDevelopment of a team charterDevelopment of a team charter
Biweekly focused team meetingsBiweekly focused team meetings
Implementation of NSQIP Best Implementation of NSQIP Best Practices Practices
PDSA cyclesPDSA cycles
Patient and nurse educationPatient and nurse education
November 16, 2012November 16, 2012Fraser Health – Burnaby Hospital Detectives Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team NSQIP Pneumonia Prevention Action Team 99
Other initiativesOther initiativesPatient & staff educational Patient & staff educational materialsmaterials
Lit Research - Lit Research - chlorohexidine for oral carechlorohexidine for oral care
Investigate benefits of Investigate benefits of disposable blood pressure disposable blood pressure cuffs to time for patient cuffs to time for patient care & mobilization .care & mobilization .
Review patient charts for Review patient charts for symptoms, actions symptoms, actions taken/not takentaken/not taken
November 16, 2012November 16, 2012Fraser Health – Burnaby Hospital Detectives Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team NSQIP Pneumonia Prevention Action Team 1010
Whenever something goes wrong, I just push this little button and restart. I wish my whole
life was like this!
Whenever something goes wrong, I just push this little button and restart. I wish my whole
life was like this!
ChallengesChallengesGetting all the players involvedGetting all the players involved
Coordinating meeting Coordinating meeting schedules/Release time for schedules/Release time for members to attend meetings/staff members to attend meetings/staff coming in for meetings on days offcoming in for meetings on days off
Great expectationsGreat expectations
November 16, 2012November 16, 2012Fraser Health – Burnaby Hospital Detectives Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team NSQIP Pneumonia Prevention Action Team 1212
Lessons LearnedLessons LearnedInvaluable to have a supportive manager and Invaluable to have a supportive manager and a knowledgeable, engaged surgeon champion a knowledgeable, engaged surgeon champion participatingparticipating
Very helpful to have facilitated, documented Very helpful to have facilitated, documented meetingsmeetings
Share resources (e.g. learn from others, share Share resources (e.g. learn from others, share with others)with others)
Recognize change takes time.Recognize change takes time.
Be patient. Persevere.Be patient. Persevere.
November 16, 2012November 16, 2012Fraser Health – Burnaby Hospital Detectives Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team NSQIP Pneumonia Prevention Action Team 1313
The trouble with success is that the
formula is the same for a nervous breakdown.
The trouble with success is that the
formula is the same for a nervous breakdown.
November 16, 2012November 16, 2012Fraser Health – Burnaby Hospital Detectives Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team NSQIP Pneumonia Prevention Action Team 1414