Reducing Patient Harm

1
Reducing Patient Harm

• Surgical and Heart Failure Improvement Initiative
• Fall 2008

2
HealthInsight

• Private non-profit organization
• Federally-designated Quality Improvement
  Organization (QIO)
• Neutral Convener
• Improve the quality and safety of health care in
  Nevada and Utah

3
Workshop Objectives

• Review the SCIP/HF project requirements and plans
• Address questions and concerns
• Develop project aim and action plan
• Understand your needs for technical assistance

4
Project Overview

• Reduce patient harm by improving health care
  processes and systems
• Baseline 1st quarter 2007
• Remeasurement 1st quarter 2010

5
Measures

• Surgery Patients on a Beta Blocker Prior to
  Arrival Who Received a Beta Blocker During the
  Perioperative Period
• Prophylactic antibiotic received on time-- within
  one hour prior to surgical incision (2 hours for
  vancomycin)
• Prophylactic antibiotic selection for surgical
  patients
• Prophylactic antibiotics discontinued within 24
  Hours after surgery end time
• Cardiac Surgery Patients With Controlled 6 a.m.
  Postoperative Serum Glucose

• Surgery Patients with Appropriate Hair Removal
• Surgery Patients with Recommended VTE Prophylaxis
  Ordered
• Surgery Patients Who Received Appropriate VTE
  Prophylaxis Within 24 Hours Prior to Surgery to
  24 Hours After Surgery
• Heart failure patients with left ventricular
  systolic dysfunction without ACEI and ARB
  contraindications who are prescribed ACEI/ARB at
  discharge

6
Evaluation

• Data from Clinical Warehouse
• Achievable Benchmarks of Care (ABC)
• Objective, data-driven benchmarks
• Targets already achieved by best practice
  providers
• Focuses on excellent care

7
Other Project Components

• Surveys
• Agency for Healthcare Research and Quality (AHRQ)
  Patient Safety Culture Survey (ahrq.gov/qual/hospc
  ulture/)
• Baseline 1st quarter 2009 Remeasurement TBD
• Assess culture, track changes, evaluate impact of
  patient safety interventions

8
Other Project Components

• Surveys
• Hospital Leadership and Quality Assessment Tool
  (HLQAT) (www.ofmq.com/hlqat)
• Baseline and Remeasurement TBD
• Assess perceptions of hospital board members,
  senior leaders and middle managers about clinical
  quality improvement
• Strong correlation between organizations scoring
  high on HLQAT and being high performing
  organizations on clinical measures

9
Other Project Components

• Workshops, webinars
• Quarterly data submission and project updates
• Community of Practice
• Protocols/policies
• Pre- or Post-op VTE
• Prophylactic antibiotic
• FUN!!!

10
Thank You!

• Linda Johnson, RN, MA, CPHQ
• HealthInsight
• Patient Safety Facilitator
• ljohnson_at_healthinsight.org
• 801-892-6677
• www.healthinsight.org
• 9SOW-UT-2008-00-024 This material was prepared
  by HealthInsight under a contract with the
  Centers for Medicare Medicaid Services (CMS),
  an agency of the U.S. Department of Health and
  Human Services (DHHS). The contents presented do
  not necessarily reflect CMS policy.

• Deborah Huber, RN, MHSA
• HealthInsight
• Transparency Strategy Director
• Dhuber_at_healthinsight.org
• 702-933-7305
• www.healthinsight.org