1. February 25, 2016 Natalie Erb MPH Program Manager, HRET AHA/HRET HEN 2.0 THE HEN 2.0 SPRINT 1

2. Review the HEN 2.0 partners Celebrate progress to date – HEN 1.0 successes and opportunities HEN 2.0 progress, goals and deliverables Resources and opportunities 2 OBJECTIVES

3. Name, organization and primary HEN focus 3 WELCOME!

4. 4 AHA/HRET HEN Patients & Families Hospital Team State Hospital Association (SHA) Team AHA/HRET HEN Team

5. HRET HEN SHA PARTNERS 34 SHAs, > 1,500 hospitals

6. 6 PROJECT TIMELINE January 2012 HEN Kick Off December 2014 HEN Ends September 2015 HEN 2.0 Kick Off September 2016 HEN 2.0 End February 2016 Baseline Data Due Improvement, improvement, improvement! ???

7. 7 Results are a cumulative effort but have been spurred in part by Medicare payment incentives and catalyzed by the Partnership for Patients (PfP) initiative.

8. Aim 1: 40% Reduction from Baseline 1. Adverse Drug Events (ADE) 2. Catheter-associated Urinary Tract Infections (CAUTI) 3. Central Line-associated Blood Stream Infections (CLABSI) 4. Early Elective Deliveries (EED) and Obstetrical (OB) Harm 5. Injuries from Falls and Immobility 6. Pressure Ulcers (HAPU) 7. Surgical Site Infections (SSI) 8. Venous Thromboembolisms (VTE) 9. Ventilator-associated Events (VAE) 8 THE DETAILS

9. Aim 2: 20% Reduction from Baseline 1. Readmissions 9 THE DETAILS

10. Aim 3: 40% Reduction from Baseline 1. Airway Safety 2. Clostridium difficile (C. diff) 3. Culture of Safety 4. Failure to Rescue 5. Iatrogenic Delirium 6. Radiation Exposure 7. Sepsis 10 THE DETAILS

11. Patient and Family Engagement (PFE) –Looking at best practices to assist hospitals in improving quality and safety (e.g., bedside huddles with patient participation vs. having a conversation near the patient bed) Health Care Disparities –Looking at quality and safety by demographic groupings (i.e., race, age, ethnicity, language, rural v. urban) 11 CROSS CUTTING FOCUS AREAS

12. Focus on: –Data submission – standardization of measures to enable benchmarking and comparison and to show collective impact –Rapid cycle improvement – monthly data submission to monitor results in real time –Prioritize topics most relevant to your organization – look at your data and prioritize based on biggest need and ability to make an impact –Sustainability – how can you build systems, processes and a culture that promotes continuous improvement beyond the HEN 2.0 project 12 7 MONTHS TO GO…

13. 13 NORTH DAKOTA – HEN 1.0 Topic% Reporting% Improvement ADE (Anticoagulation)91%10% CAUTI100%34% (B) CLABSI100%19% Falls94%-118% EED100%-- Pressure Ulcers97%B SSI82%-284% VTE59%-- VAP33%-- Readmissions100%-2%

14. 14 NORTH DAKOTA – HEN 2.0 Topic% Reporting Baseline ADE93% CAUTI90% CLABSI100% Falls97% EED100% Pressure Ulcers100% SSI100% VTE67% VAE33% Readmissions97%

15. 15 WE’RE HERE TO HELP!

16. 16 HRET SUPPORT Data Comprehensive Data System Monthly data webinars Monthly data office hours Improvement Calculator Rural/CAH Data Collection Tool Fact Sheets Excessive anticoagulation with WarfarinExcessive anticoagulation with Warfarin Hypoglycemia in inpatients receiving insulinHypoglycemia in inpatients receiving insulin ADEs due to opioids Sepsis Education Topic-specific webinarswebinars Website – www.hret-hen.orgwww.hret-hen.org Content by topic Content by audience Comprehensive resource library Revised change packages and checklists Improvement Leader Fellowship Monthly sessions, Foundational and Experienced tracks Monthly QI office hours Topic LISTSERVsLISTSERVs

17. 17 Search by audience Search by topic

18. 18 Access the revised change package and checklist Watch the latest webinar on HAPU Access resources based on audience

19. Adverse Drug Event (ADE) Data Analytics Infections (CAUTI, CLABSI, C. diff, SSI, VAE) Early Elective Delivery & Obstetrical Adverse Event Other Harm (VTE, Airway Safety, Failure to Rescue, Iatrogenic Delirium and Radiation Exposure) Patient and Family Engagement/Health Care Disparities Pressure Ulcers and Falls Readmissions Rural/Critical Access Hospitals Sepsis 19 JOIN OUR LISTSERVS HTTP://WWW.HRET-HEN.ORG/INC/DHTML/LISTSERV.DHTML HTTP://WWW.HRET-HEN.ORG/INC/DHTML/LISTSERV.DHTML

20. How many current fellows in the room? Attended an in-person fellowship event? Previous (HEN 1.0) fellows? Lead improvement teams at your hospital? 20 ACTION LEADER FELLOWSHIP (ALF)

21. Curriculum developed in collaboration with the Institute for Healthcare Improvement (IHI) Two tracks: Foundational and Experienced –Foundational: new to the fellowship, new to QI, new to your organization –Experienced: Previous fellowship participant, lots of experience in QI, experience managing improvement teams and implementing improvement science 21 ACTION LEADER FELLOWSHIP (ALF)

22. Mark your calendar! March 9 –11:00 – 12:00 CT Foundational Foundational –12:30 – 1:30 CT Experienced Experienced April 13 –11:00 – 12:00 CT Foundational Foundational –12:30 – 1:30 CT Experienced Experienced 22 ACTION LEADER FELLOWSHIP (ALF)

23. Ask questions! –To your SHA team –To HEN data support –On data and QI office hours Provide feedback –Let us know what works and what doesn’t. Email hen@aha.org if you don’t see what you need. hen@aha.org Partner with patients and families on your improvement efforts. Submit your data to CDS and utilize the reports and tools in the platform to enable your success. Network and share best practices. –In the room –On the LISTSERVs –During the webinars and fellowship 23 SUCCESS FACTORS

24. 24 WHAT WORKS FOR YOU?

25. General Questions: hen@aha.orghen@aha.org Data Questions: HRETdatasupport@aha.orgHRETdatasupport@aha.org Clinical Questions: Topic LISTSERVsTopic LISTSERVs Me: nerb@aha.orgnerb@aha.org 25 QUESTIONS OR SUGGESTIONS?

26. For your dedication to patient safety and high quality care For your willingness to collaborate and share ideas, suggestions and questions For all the work you do to care for patients 26 THANK YOU!