Tennessee Center for Patient Safety Center Staff Chris Clarke, Sr. - - PowerPoint PPT Presentation
Tennessee Center for Patient Safety Center Staff Chris Clarke, Sr. VP, Clinical and Professional Practices Patrice Mayo, VP for Operations Jackie Moreland, Clinical Quality Improvement Specialist Rhonda Dickman, Clinical Quality
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3
Meetings
sharing
health systems
Consultations
Series
and coalitions – Sepsis Coordinators coalition – Care Transitions coordinators coalition – Pharmacy coalition – Patient and family advisors
Collaborative
– glycemic management,
safety
Tract Infections (CAUTI)
Stream Infections (CLABSI)
Aureus (MRSA)
– Patient Handling Injuries – Workplace Violence Incidents
Take a picture with the banner in your hospital and send it to Elizabeth Walker at ewalker@tha.com. Please include your hospital name.
Baptist Memorial Hospital – Carroll County Baptist Memorial Hospital – Collierville Baptist Memorial Hospital - Memphis Blount Memorial Hospital Bolivar General Hospital Bristol Regional Medical Center Hardin Medical Center Henry County Medical Center Holston Valley Medical Center Maury Regional Medical Center
This information is prepared and protected in accordance with the Tennessee Patient Safety and Quality Improvement Act of 2011. T.C.A. 68-11-272. Data Source: NHSN as of April 9, 2019
Topic Events SIR Hospital Outliers Events SIR Hospital Outliers 2017 2018 CAUTI ICU 268 0.701 2 260 0.697 1 CAUTI Wards 225 0.745 194 0.700 1 CLABSI ICU 220 0.828 1 188 0.728 1 CLABSI Wards 178 0.649 1 143 0.574 SSI COLO 180 0.856 2 174 0.788 1 SSI HYST 59 1.078 1 39 0.749 SSI HPRO 101 1.202 2 88 1.004 2 SSI KPRO 50 0.837 62 1.037 2 MRSA 268 1.054 4 335 1.280 4 CDI 1,983 0.838 4 1,537 0.674
This information is prepared and protected in accordance with the Tennessee Patient Safety and Quality Improvement Act of 2011. T.C.A. 68-11-272. Data Source: NHSN as of April 9, 2019
Topic Events SIR Events SIR HHS 2020 Goal 2017 2018 CAUTI ICU 268 0.701 260 0.697 0.75 CAUTI Wards 225 0.745 194 0.700 0.75 CLABSI ICU 220 0.828 188 0.728 0.50 CLABSI Wards 178 0.649 143 0.574 0.50 SSI Colon - Complex 180 0.856 174 0.788 0.70 SSI Hysterectomy - Complex 59 1.078 39 0.749 0.70 SSI HPRO - Complex 101 1.202 88 1.004 0.70 SSI KPRO - Complex 50 0.837 62 1.037 0.70 MRSA 268 1.054 335 1.280 0.50 CDIFF 1,983 0.838 1,537 0.674 0.70
▪ 77 patient deaths estimated (23% mortality estimate) ▪ $11.64 million in estimated costs ($34,657 per case)
Source of cost and mortality estimates: Infection Control and Hospital Epidemiology, April 2010
Key lessons from successful hospitals, Saint Thomas Midtown Hospital and Methodist University Hospital
– Leadership rounding, huddles, staff accountability and feedback – Invest resources for infection prevention and auditing of practice
– Focused interventions within high-risk, targeted units – Increased focus on infection prevention practices with audits
– Increased use of Chlorhexidine baths in high-risk populations – Renewed focus on central line infection prevention bundles
– Share individual data with CEO if high events. Call them and do site visits if needed. – Specific list of steps to address. Request to get prescriptive on what is expected and measure accountability. – Consider a state campaign to get everyone on board like THA early elective delivery project. Get physicians/hospitals on board together to a focused goal.
https://www.cdc.gov/hai/prevent/staph-prevention- strategies.html
– Develop multidisciplinary infection prevention workgroup – Use data to identify and target high-risk units and populations – Routinely audit and conduct competency based assessments for infection control practices.
– Intranasal antistaphyloccal antibiotic/antiseptic – Daily chlorhexidine wash or wipes
– Active surveillance screening for MRSA on admission – Decolonization protocols
– Adult ICU patients CHG bathing while in ICU with nasal decolonization – Preoperative CHG bathing with nasal decolonization for high risk surgeries (cardiothoracic, orthopedic, neurosurgery)
20 40 60 80 100
Inpatient Claims ER Claims
Age 18-64 Years Age 65+ Years
1 2 3 4 5 6 LOS in Days
Age 65+ Years Age 18-64 Years
$0 $5,000 $10,000 $15,000
Cost per Claim
Age 65+ Years Age 18-64 Years
Aged 18-64 Years
ve Disorders
Aged 65+ Years
Failure
Disorders
10 20 30 40 50 60 70 80 90 100
Aged 18-64 Years Aged 65+ Years
An initiative of the Hartford Foundation, Institute for Healthcare Improvement, AHA, and the Catholic HealthAssociation
▪ Demography ▪ 46 million Americans ages 65 and older- number is projected to double by 2060 ▪ 80% have one chronic disease ▪ 77% have at least two chronic diseases ▪ Complexity ▪ 75% will require some type of long-term care ▪ 40% will require care in a skilled nursing facility ▪ Disproportionate harm ▪ 1 in every 5 Medicare beneficiaries is hospitalized
Aim: Establish Age-Friendly Care in 20 percent of US hospitals and health systems by 2020 An Age-Friendly Health system is one where every older adult: ▪ Gets the best care possible; ▪ Experiences no healthcare-related harms; and ▪ Is satisfied with the health care they receive.
The 4Ms Description
What Matters Know and align care with each older adult’s specific health outcome goals and care preferences including, but not limited to end-of-life care, and across settings of care Medication If medication is necessary, use Age-Friendly medications that do not interfere with What Matters to the older adult, Mobility, or Mentation across settings of care Mentation Prevent, identify, treat, and manage dementia, depression, and delirium across settings of care Mobility Ensure that older adults move safely every day to maintain function and do What Matters
Age-Friendly care is the reliable implementation of a set of evidence-based, geriatric best practice interventions across four core elements, known as the 4Ms, to all older adults in your system.
▪ IHI launched 2 Action Communities
▪ Fall 2018 ▪ Spring 2019
▪ AHA to launch Action Community this fall
▪ September 2019-March 2020
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Monthly all-teamwebinars
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Scale-up leaderswebinars
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Drop in coachingsessions
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Listserv , sharing learnings
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Monthly reports on testing andlearnings
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Celebration of joining the movement!
▪ Email afhs@aha.org for more information