Staff Safety Assessment

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Staff Safety Assessment
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Learning Objectives

• To understand Step 2 of CUSPIdentify Defects
• To understand how to Implement the Staff Safety
  Assessment
• To understand ways to use results of the Staff
  Safety Assessment

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Goals

• To identify defects
• To leverage the wisdom of the front line worker
• To prepare a list of improvement opportunities
  that has face validity and provides a focus for
  CUSP activities.

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On the CUSP Stop BSI
CUSP
CLABSI

• Educate staff on science of safety
• Identify defects
• Assign executive to adopt unit
• Learn from one defect per quarter
• Implement teamwork tools

• Remove Unnecessary Lines
• Wash Hands Prior to Procedure
• Use Maximal Barrier Precautions
• Clean Skin with Chlorhexidine
• Avoid Femoral Lines

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The CUSP Team

• The smaller group that spreads the intervention
• to the rest of the unit

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Education and engagement activities on the unit

• BSI Providing Evidence, Modeling the line
  placement steps stopping insertions that violate
  protocol having one-on-one talks where
  necessary
• Facilitating CUSP Activities

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Comprehensive Unit-based Safety Program (CUSP)

• Educate staff on science of safety
  (www.safercare.net)
• Identify defects
• Assign executive to adopt unit
• Learn from one defect per quarter
• Implement teamwork tools

We are here
You are here!!!
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Identify Defects

• Review error reports, liability claims, sentinel
  eventsor M and M conference
• Ask staff how the next patient will be harmed

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Identifying Defects

• What SHOULD you know?

• What DO you know?

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Transparency

• Making project and progress visible to everyone

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How are We Going to Harm the Next Patient?

• One way to make harm visible-- get staff thinking
  about safety and how to improve it

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Step 2 Staff Identify Defects

• Frontline caregivers are the eyes and ears of
  patient safety
• Identify clinical or operational problems that
  negatively impact patient safety (have or could)
• Use the Staff Safety Assessment form (Part of
  CUSP manual)
• How will the next patient will be harmed in our
  unit
• What can be done to minimize patient harm or
  prevent this safety hazard
• ICU managers and team review suggestions, set the
  agenda for discussion with executive partner

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Step 2 Staff Identify Defects

• What Team Leaders need to do
• Hand out a Staff Safety Assessment form to all
  staff, clinical and non-clinical, in the unit
• Establish a collection box or envelope
• Identify and group common defects (such as
  communication, medications, patient falls,
  supplies, etc.)
• Summarize as frequencies (i.e., what percent of
  responses were for communication)

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Prioritize Defects

• List all defects
• Discuss with staff what are the three greatest
  risks

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Step 2 Staff Identify Defects

• Report the identified defects to staff, executive
  partner
• ICU managers and CUSP team prioritize defects
  identified by the potential level of risk to the
  patient
• Select one to work on with support of Executive
• Step 2 should be ongoing

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CUSP Team activities-keeping on track

• Team meetings (recommend monthly)
• Review of data (monthly)
• Meet w/ Exec Partner (monthly or more)
• Executive review of data (monthly)
• Presentations to hospital colleagues
• (leadership, frontline staff, board)

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Comprehensive Unit-based Safety Program (CUSP)

• Educate staff on science of safety
  (www.safercare.net)
• Identify defects
• Assign executive to adopt unit
• Learn from one defect per quarter
• Implement teamwork tools

We are here
You are here!!!
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What Should you do NOW?

• CLABSI Collect Submit Baseline Monthly BSI
  data
• CUSP Preparation Assemble team/Schedule
  meetings
• CUSP Implementation
• Science of Safety Training for all staff
• Identify Defects How will patients be harmed?
• www.safercare.net
• www.onthecuspstopbsi.org

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References

• Pronovost PJ, Berenholtz SM, Needham DM.
  Translating evidence into practice A model for
  large scale knowledge translation. BMJ. 2008
  337a1714.
• Pronovost P, Needham D, Berenholtz S, et al. An
  intervention to decrease catheter-related
  bloodstream infections in the ICU. NEJM. 2006
  355(26)2725-2732.
• Pronovost PJ, Berenholtz SM, Goeschel C, et al.
  Improving patient safety in intensive care units
  in michigan. J Crit Care. 2008 23(2)207-221.
• Pronovost P, Weast B, Rosenstein B, et al.
  Implementing and validating a comprehensive
  unit-based safety program. J Pat Safety. 2005
  1(1)33-40.
• Pronovost PJ, Weast B, Bishop K, et al. Senior
  executive adopt-a-work unit A model for safety
  improvement. Jt Comm J Qual Saf. 2004
  30(2)59-68.

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