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© 2009 On the CUSP: STOP BSI Christine A Goeschel RN MPA MPS ScD (candidate) Tennessee Center for Patient Safety December 2, 2009
© 2009 Learning Objectives To consider to make your investment of time and improvements in BSI rates last forever To make sure all patients in your institution have access to the same level of central line safety To share what you know about how to create strong teamwork and safe culture
© 2009 Sustaining Change: On the CUSP: Stop BSI Are necessary structures and human resources in place – policies, people, roles, authority and responsibility? Are project support processes codified and clear: decision making, problem solving, coordination and conflict management? Are material resources in place – space, equipment, supplies, Are performance tracking mechanisms in place?
© 2009 Action Items for Senior Leaders 1.Make certain an executive is assigned to each team and meets routinely with them – let the staff know senior leaders are invested and will work as hard as they do to reduce infections and improve culture 2.Set clear project goals and expectations for the leaders and staff Provide opportunities for project teams to meet with senior leaders and the board to discuss the project 3.Provide the necessary resources – time to work on the Project, funds for travel, training, equipment, supplies, etc.
© 2009 Action Items for Senior Leaders 3. Support transparent communication – BSI rates – Process barriers and successes – Tell your own Josie Story; publically discuss a patient who suffered preventable harm at your organization 4. Expect resistance and be prepared to address it effectively 5. Celebrate wins and provide encouragement, support, attention, and resources if there are set backs.
© 2009 Implementation Framework
© 2009 Implementation Framework
© 2009 Why worry about the distant future? What you can anticipate: Turnover of staff New projects/ distractions Complacency Emergencies and complex cases (someone will call for exceptions to be made) EndurePlan for Sustainability
© 2009 Things you can do now to support long term viability of the BSI reduction Write it into policy Include in training for all new members Check to be sure it is routine practice Set up reliable supply chain (borrowing protocol; alert system) Quarterly review by executive partner Set up a Learning Network of peers Have regular meetings with your HEIC dept EndurePlan for Sustainability
© 2009 ExpandSpread the Interventions Why think about expanding to other units? – Requires self study – Solidifies own understanding – Equal protection for all patients – Unique challenges of other units may offer new ideas and methods
© 2009 ExpandSpread the Intervention What quality and safety issues are a priority in your organization? Might CUSP provide a foundation for progress? – Understand the science of safety – Staff Safety Assessment – Partner with Executives – Learn from Defects – Implement teamwork tools
© 2009 Action Items Plan now to sustain the interventions until empirical evidence or law dictates the need for change Policies Procedures Process measures Performance measures Create an incremental plan to roll out the intervention across the hospital Units that insert central lines (short and long term use) Units that maintain central lines
© 2009 For More Information Never doubt that a small group of thoughtful committed citizens can change the world. Indeed, its the only thing that ever has. Margaret Meade
© 2009 Reference List Buchanan D, Fitzgerald L, Ketley D, Gollop R, Jones JL, Saint Lamont S, Neath A and Whitby E. No going back: A review of the literature on sustaining organizational change. International Journal of Management Reviews 2005; 7(3): Evashwick C, Ory M. Organizational characteristics of successful innovative health care programs sustained over time. Fam Community Health Jul- Sep;26(3): Greenhalgh T, Robert G, Macfarlane F, Bate P and Kyriakidou O. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q 2004;82(4):
© 2009 On the CUSP: STOP BSI Two More E’s. © 2009 Learning Objectives To think ahead about ways to make your investment of time and improvements in BSI.
Two More E’s and How to Spread On the CUSP: Stop BSI.
Two More E’s and How to Spread. Learning Objectives To think ahead about ways to make your investment of time and improvements in BSI rates last forever.
© 2009 On the CUSP: STOP BSI Senior Leadership of Quality and Safety Initiatives in Health Care.
Lessons from CUSP/CLABSI – Getting to Zero and Sustaining your Improvements On the CUSP: Stop BSI Jill Marsteller, PhD, MPP Armstrong Institute for Patient.
CSTS: The Cardiovascular Surgical Translational Study Senior Leadership of Quality and Safety Initiatives in Health Care Peter J. Pronovost, MD, PhD The.
© 2009 On the CUSP: STOP BSI Nurse Empowerment Christine A. Goeschel RN MPA MPS ScD (candidate) Tennessee Center for Patient Safety December 2, 2009.
CSTS Staff Empowerment Christine A. Goeschel ScD MPA MPS RN.
The Team Check-up Tool. Slide 2 Learning Objectives To understand the tool we use to: – Describe the anticipated activities of your ICU quality improvement.
Nurse Empowerment On the CUSP: Stop BSI. Learning Objectives To understand the importance of nurse empowerment To consider the regulatory and accreditation.
Improving Care Through Technical & Adaptive Work Chris Goeschel RN MPA Director, Patient Safety &Quality Initiatives JHU Quality & Safety Research Group.
© 2009 On the CUSP: STOP BSI Nurse Empowerment.
© 2009 On the CUSP: STOP BSI Physician Engagement.
Learning Objectives 2 2 Explain the role of the senior executive in addressing technical and adaptive work Identify characteristics to search for when.
Seeing a Way Forward Peter Pronovost, MD, PhD Johns Hopkins University.
Improving ICU Care Through Teamwork Chris Goeschel RN MPA MPS
Staff Safety Assessment 1. Learning Objectives To understand Step 2 of CUSP:Identify Defects To understand how to Implement the Staff Safety Assessment.
© The Johns Hopkins University and The Johns Hopkins Health System Corporation, 2011 Sustaining and Spreading surgical safety improvements with SUSP Mike.
On the CUSP: STOP BSI Physician Engagement. Immersion Call Overview 1.Project overview 2.Science of Improving Patient Safety 3.Eliminating CLABSI 4.The.
Who We Are ~Where We are Going. Slide 2 Workshop Objectives Describe the purpose and vision of the ICU Safe Care Initiative/Comprehensive Unit-Based Safety.
© The Johns Hopkins University and The Johns Hopkins Health System Corporation, 2011 CUSP for VAP Adaptive CUSP Sustainability Sustainment and Spread David.
Engaging Senior Executives in SUSP Work Mike Rosen, PhD and Liza Wick, MD December 9 and December 11, 2013.
AHRQ Safety Program for Long-term Care: HAIs/CAUTI A Team Members Guide to a Culture of Safety Onboarding #1 for LTC Facility Team Leads and Core Team.
Identifying Defects Chris Goeschel June Identifying Defects What DO you know? What SHOULD you know?
© 2011 Melinda Sawyer, RN, MSN, CNS-BC Armstrong Institute for Patient Safety and Quality The Comprehensive Unit-based Safety Program (CUSP)
Physician Engagement. Learning Objectives To relate what is meant by physician engagement To discuss strategies at management and staff levels to enhance.
Understanding Implementation and Leadership in School Mental Health.
Upon completion the participant will identify and list steps to implement The Comprehensive Unit-based Safety Program (CUSP) and patient care bundles.
Using CUSP as a Framework for Improving Patient Safety Steve Levy Director of Operations MHA PSO.
NICU CLABSI Affinity Group Meeting May 9, 2012 Denise Flook, RN, MPH, CIC HAI Collaborative Lead Vice President, Infection Prevention/Staff Engagement.
Building Your CUSP Team Part I Michael Rosen, PhD August 28, 2012 Armstrong Institute for Patient Safety and Quality Conference Number(s):
Small Rural/CAH Learning Community Meeting May 23, 2012 Denise Flook, RN, MPH, CIC HAI Collaborative Lead Vice President, Infection Prevention/Staff Engagement.
CLABSI Supplemental Call Series Best Practices: How Successful Units Engaged Their Senior Executive Leaders October 18, 2011 Presenters: Jonathan Kling,
Picture Seniors Health Services Presentation to Health Advisory Councils October 13, 2012 Cheryl Knight, Seniors Health Primary & Community Care
Moving Beyond the Horizon: Where are we going? How will we get there? Chris Goeschel RN MP MPS ScD (candidate) October 30, 2008
Learning Objectives 2 Identify characteristics of successful teams and barriers to team performance Understand the importance of your CUSP team Develop.
بسم الله الرحمن الرحیم. Teamwork Challenges Dr Fatemeh Oskouie Center for Nursing Care Research Iran University of Medical Sciences.
Evidence-Based Practices Implementation for Capacity Chad Dilworth EBP Implementation Specialist Ty Crocker EBP Implementation Specialist.
Patient/Family Centered Safe Care: Putting Patients First Quality Improvement and Patient Safety Everyone Has A Role and Responsibility.
© 2009 On the CUSP: STOP BSI The Comprehensive Unit-based Safety Program (CUSP): An Intervention to Learn form Mistakes and Improve Safety Culture.
11/10/20111 On The Cusp Journey: Sentara CarePlex Hospital Gail J. Rudder RN, CRNI Infection Preventionist November 10 th, 2011.
Wednesday 10 June 2015 Carrie Marr Executive Director Organisational Effectiveness WSLHD Mobilising People and Leading Sustainable Change.
Leadership for Healthcare Excellence The Power of Boards Healthcare Trustees of Montana Mountain – Pacific Quality Health Barbara Balik, RN, EdD May 25,
A Framework That Fits Enhancing Interdisciplinary Collaboration in Primary Health Care (EICP) Initiative Principles & Framework.
SUSP: Improving Surgical Care through TRIP and CUSP Denise Flook, RN, MPH, CIC HAI Lead Vice President, Infection Prevention/Staff Engagement.
Service-Learning and Grant Writing Workshop Tennessee Technological University February 23, 2010 Presented by: Shelley Brown Department of Sociology and.
CUSP 4 MVP – VAP Improving Care for Mechanically Ventilated Patients Revisiting Science of Safety & Identifying Defects ARMSTRONG INSTITUTE FOR PATIENT.
Building Your SUSP Team Part I Armstrong Institute for Patient Safety and Quality.
Transforming Patient Experience: The essential guide
© 2009 On the CUSP: STOP BSI Overview of STOP-BSI Program.
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