Partners for PatientsHEN 2.0 Kick-Off

Orientation

Courtesy Reminders: •During the webinar, you may select *7 on your phone to speak, and use *6 to mute. •Please refrain from placing the phone on HOLD during the presentation.

In this presentation• Overview of the WHA HEN (Partners for Patients)• Initiatives planned for HEN 2.0• New Approaches• Measures and Reporting requirements• Enrollment Process

The HEN in Wisconsin

94 Hospitals

What We’ve Achieved• Agency for Healthcare Research and Quality (AHRQ)

– Wisconsin 2nd highest in healthcare quality in the nation

• WI Health System Cost Saving through PfP– $87,094,000

• Harm Reduced by:– 9,304 Wisconsin Patients

• Our relatives, friends and neighbors

WHA Partners for Patients All Hospital Aggregate Results

17%

Venous Thromboembolism

15%

Pressure Ulcers

0%Falls*

43%

Adverse Drug

Events

30%

Catheter-Associated

Urinary Tract Infections 48%

Central Line Infections

6%

Surgical Site

Infections

7%

Readmissions

* While the rate of falls has remained steady, Wisconsin’s rate is 24% better than the national average.

WHA’s Approach to Quality

• Expand the hospital’s capacity to improve (be agile)• Promote the involvement of front-line clinical staff, as essential

partners, in safety work and process design.• Improve the QI knowledge base of front-line staff.• Teach effective “rapid cycle change” methodologies.• Incorporate ‘learning by doing’ approaches.• Provide a flexible learning environment (on-demand).• Influence the role of hospital QI to be less the “doers” and

more the “leaders”.

The Key: Foundational QI methods executed very well

Evolution of Methods – our PDSA’s

9 mos. webinars

Teach PDSATo Teams;

Followed by best

practices

6 mos. Webinars

Teach best practices 1st,

and tie to PDSA tools

Hospitals attend

according to their needs

6 mos. Webinars,

Improvement Workbook;

Hospitals Recruit team leads from

clinical areas

New HAC initiative for hospital? WHA Webinar Series

Need for ‘hardcoding’ practices?

Implementing a Protocol series

Our

Pla

n

2015-2016

201420132012

Patient-Family Engagement Practices

Improving cross-cutting Essential Safety Practices

Emphasis is on “How” to improve Updated with new sections!

The work is not done yet

• Readmissions• Falls• Pressure Ulcers• VTE• Adverse drug events• Surgical site infections• OB harm and Early Elective

Delivery

• CLABSI• CAUTI• Ventilator Associated Events• Sepsis• C. difficile• Patient and Family

Engagement• Antimicrobial Stewardship

About the Initiatives for Partners for Patients

What’s the Same• Access to latest best practices (HRET and IHI)• WHA Quality Center resources• Hospital wide engagement – beyond the quality

department• Access to HRET learning opportunities

– Topic webinars– IHI Improvement Fellowship

• Your friendly Improvement Advisors

Improvement Advisors

StephanieSobczak

Tom Kaster

Jill Hanson

Regular phone consultations

Site visits at your request

Regions are approximated

What’s Different

• More frequent networking calls (we heard you)

• More Rapid Cycle approaches• Targeted CAUTI Approach, using NHSN TAP

reports to identify hospitals needing improvement

• Collaborative development on Patient-Family Engagement, Anti-microbial Stewardship, ADE

Approach

• Targeted Approach– Focus on opportunities relative to CMS benchmarks

– Based on hospital performance – we will work with you to customize your approach

• Efficiently Implementing Protocols and Bundles - Closing the gaps in practice to get to zero harms

• Incorporate 7 Essential Safety Practices to address multiple impacts on patient safety

• QI Improvement Lead Fellowship - Expanding QI capacity and agility for your staff

Resources for Partners for PatientsImprovement Strategy

– Webinars• Webinar series (Sepsis, C. diff, Readmissions, Falls,

Patient/Family Engagement)• Implementing a Protocol – New approach for CAUTI,

CLABSI, Falls, PUP, VTE, etc. – a 4 month series• HRET QI Fellowship with Institute for Healthcare

Improvement • Essential Safety Practices – cross cutting strategies

– In-person Regional Events – CAUTI, Patient/Family Engagement

Your Options

There are three approaches you could apply to an initiative:1. Doing well, no assistance needed 2. Brand new topic & people new to QI3. Need to close a few gaps

Doing Well

Enroll, and sign Statement of Work #12 We will use WHA Information Center data You may optionally track Falls with Injury,

manual entry or track process measures Utilize WHA resources as needed You will continue to receive Wednesday

Weekly for educational opportunities

New Topic or New Team Leads

Enroll, and sign Statement of Work #12 Use WHA-IC data, or Enter more current data Track process measures as needed Assign a Team Lead for our topic content Enroll for the appropriate webinar series Enroll in the IHI Quality Fellowship through HRET Consider selecting a few Essential Safety Topics

Need to Close a Few Gaps

Enroll, and sign Statement of Work #12 Use WHA-IC data, or Enter more current data Enroll a Team Facilitator and Team Lead in the

Efficiently Implementing a Protocol SeriesConsider selecting a few Essential Safety

Topics to apply

WHA Monthly Webinar Engagement

20

Webinar

• Part I: Evidence & Best Practice Sharing (30 min)

• Part II: Improvement Methods (30 min)

30 day Action Items

• Select from list of options

• Engage the team & any staff impacted by changes

• Anytime consultation or Interim Coaching Calls

Data Submission

• Outcome and Process data submitted monthly

• Progress Reports to leaders

• View data in real time

When webinars make a difference (several of these are true)

Clinical areas attend the webinars (not just QI)More than one person attends the webinarsMore than one shift views the webinarsThere is accountability in the hospital to move

forward with selected action itemsThere is active participation on requests for

sharing and best practice write-ups

Efficiently Adopting Protocols and Bundles

• New approach• Using a structured change management

method – “Fix it in 6”• 4 month webinar series• Mid-month coaching calls (optional)• Applicable to any HAC initiative or other topic

Learn more during the October Improvement Forum – Oct 22nd at Noon

Efficiently Implementing BundlesInternal Meetings Purpose

Webinar 1Engaging StakeholdersDec 9, 2 pm

Optional Coaching callJan 27, 2pm

Pre-work Huddle Identify participantsGather information needed for stakeholders

1 – Stakeholders Meeting Identify gaps in best practicesDetermine other key stakeholders

Webinar 2Action PlanningJanuary 13, 2pm

2 – Action Planning Meeting Discuss prioritiesIdentify low hanging fruitIdentify processes to test

Webinar 3Change PlanningFeb 10, 2 pm

3 – Change Planning Meeting Involve staff doing the workPlan for just in time trials/tests

4 – Progress Check Meeting Reports on pilots and testsDecision to continue, or adopt the change

Webinar 4Making ProgressMar 9, 2 pm

5 – Implementation Planning Meeting

Discuss the implementation checklistDetermine next steps

Coaching Call onImplementationMarch 30 2pm

6 – Implementation Follow-up Meeting

Monitor progress with implementationDetermine accountable staff

Essential Safety PracticesTopics for Collaborative Learning and CoachingDaily Whole House Safety Huddle January & February Use of Patient White Boards December Bedside Shift Report / Structured Hand-offs Purposeful (Hourly) Rounding Multi-disciplinary Care Huddles Hand Hygiene Compliance Leadership Rounds

Patient and Family EngagementOur Aim

Pool the existing resources within the state of Wisconsin to develop a strategy and structure for facilitating the spread of Patient and Family Centered Care and Engagement through education, consultation, collaboration, training and dedication.

Patient and Family Centered Care

• Resources• Event in 2016 – Patient and Family Advisory

Councils• Quarterly webinars

OB – Early Elective Deliveries

• Great progress in past 3 years• Showing some decline in performance• If your hospital has an EED rate over 2%, we

will contact you and discuss additional resources that may help.

OB Clinical Simulation Training

• Training for high risk OB situations• Scholarships through WHA Foundation• One full day or two half days at a SIM lab• OB interdisciplinary team of 8-10• Application for limited spots• Contact Stephanie Sobczak for an application

– ssobczak@wha.org

Targeted Approach

We will consult with you on your hospital’s drivers of improvement

We will come to your hospital for customized training of your team leads and staff

We can help connect you with topic experts

HRET Learning Opportunities

We will post links in the Wednesday Weekly

Tentatively:October 27 CAUTIOctober 29 ReadmissionsNovember 4 – QI Fellowship with IHI launches

Measures and Reporting

Measures and Reporting

Easy Data• Measures – The majority are the same• 15 measures from WHA Information Center (via

Statement of Work #12)• EED transferred from Checkpoint• Five optional manual entry measures (Falls (2), ADE

(3), Pressure Ulcer (1))• 18 measures from NHSN (if applicable to your

hospital)

Process Measures

• You select which process measures will be helpful to drive improvement for a given topic.

• See the Encyclopedia of Measures document on the Quality Center for details

Getting Started

Enrollment Packet Next Steps

Participation and WHAQ Agreement Senior Leader Attestation Form Contact Information Form

Orientation Webinars

New Team Lead On-Boarding• We are presenting orientation webinars for any new

team leaders• WHA resources, Quality Center, and data submission• Senior Leader Orientation webinar

Team Lead Orientation – option 1 Webinar Thursday, November 12, NoonTeam Lead Orientation – option 2 Webinar Friday, November 13, 2 pmSenior Leader Orientation Webinar Tuesday, November 17, Noon

Register on the Quality Center Calendar

Questions?

Please select *7 on your phone keypad to speak