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On the CUSP: Stop CAUTI National Content Webinar 1 Welcome to the National Content Webinar! Today’s Topic: Finding Value in the Staff Safety Assessment.

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Presentation on theme: "On the CUSP: Stop CAUTI National Content Webinar 1 Welcome to the National Content Webinar! Today’s Topic: Finding Value in the Staff Safety Assessment."— Presentation transcript:

1 On the CUSP: Stop CAUTI National Content Webinar 1 Welcome to the National Content Webinar! Today’s Topic: Finding Value in the Staff Safety Assessment Access slides, audio recording and transcript of today’s webinar on the national project website: http://www.onthecuspstophai.org/on-the-cuspstop- cauti/educational-sessions/content-calls/

2 Today’s Presenters 2 Lisa H. Lubomski, PhD Assistant Professor Johns Hopkins University School of Medicine Armstrong Institute for Patient Safety and Quality Kristin Opett, RN, BS, MSHA Vice President of Patient Safety Rochester Regional Health System Ann Freer, RN, BSN Patient Safety Specialist Rochester Regional Health System

3 Learning Objectives After attending the webinar, participants will be able to: Administer the Staff Safety Assessment to all of those who work in their clinical area Analyze the results of the Staff Safety Assessment Identify opportunities for improvement 3

4 CUSP for CAUTI 4 1.Educate Staff on the Science of Safety 2.Identify defects 3.Partner with senior executive 4.Learn from defects 5.Improve teamwork and communication Adaptive Components of CAUTI

5 Has your team completed the Staff Safety Assessment in the past 6 months? 5 Yes No Not Sure

6 http://www.ahrq.gov/professionals/education/curriculum-tools/cusptoolkit/modules/identify/index.html CUSP Toolkit 6

7 How do errors happen? 7 People are fallible Medicine is still treated as an art, not a science Systems do not catch mistakes before they reach the patient

8 What is a defect? 8 Anything that happens, clinically or operationally, that you do not want to happen again.

9 Examples of defects that affect patient safety 9 DefectIntervention Unstable oxygen tanks on bedsOxygen tank holders repaired or new holders installed (institution-wide) Medication look-alikeEducation conducted, medications physically separated, and letter sent to the manufacturer Missing equipment on cartChecklist developed for stocking cart Inconsistent use of Daily Goals Rounding Tool Consensus reached on required elements of Daily Goals Rounding Tool Inaccurate information by residents during rounds Electronic progress note developed

10 How can your team identify defects? 10 Event reporting systems, liability claims, sentinel events, M&M conference Staff Safety Assessment – completed by all staff members (not just medical) in the clinical area

11 The Wisdom of Frontline Providers Frontline providers: – Understand the patient safety risks in their clinical areas – Have insight into potential solutions to these problems Tap into this knowledge to guide safety improvement efforts

12 What is the Staff Safety Assessment? 12 AKA – The 2 Question Survey 1.Please describe how you think the next patient in your unit/clinical area will be harmed 2.Please describe what you think can be done to prevent or minimize this harm

13 Administration 13 SUSP project lead or designee Recommendation: Administer SSA following training on the Science of Safety – providers will have lenses to see system problems To encourage staff to report safety concerns, establish a collection box or envelope in an accessible location where completed forms can be dropped off Complete the SSA at least every 6 months

14 What do teams do with results? 14 Prioritize identified defects using the following criteria: Likelihood of the defect harming the patient Severity of harm the defect causes How commonly the defect occurs Likelihood that the defect can be prevented in daily work

15 Results from surgical teams 15 Percentage of Responses (%) Wick EC, et. al., J Am Coll Surg. 2012;215(2):193-200.

16 Follow-up is key 16 It is crucial that physician and nurse leaders respond to staff patient concerns The SUSP team and other leaders must be ready to follow-up on the defects identified on the SSA You can use SSA data to develop your local CAUTI care improvement processes

17 Venues for SSA 17 Present the SOS video and administer SSA during these ideal times: Medical staff Grand Rounds New staff orientation Regularly scheduled staff meetings (for nurses, surgeons, anesthesiologists, etc.) Lunch and learn sessions Special educator sessions Make video available in break room Hang up SOS factsheet in break room, restroom, etc. Annual recertification requirements Hospital Intranet

18 Staff Safety Assessment Tool Utilization for CUSP Advancement

19 CUSP Staff Safety Assessment Kristin Opett, RN, BS, MSHA Vice President of Patient Safety Rochester Regional Health System » Rochester, New York 19 Ann Freer, RN; BSN Patient Safety Specialist Rochester Regional Health System » Rochester, New York

20 CUSP Staff Safety Assessment  Annual Revenues: $1.9 billion  Total Licensed Beds: 2,000+ – Medical/Surgical – Obstetrics – Rehab – Behavioral Health – Nursing Homes  Team Members: 14,000+  Physicians: 2,000+ 600+ employed physicians  Volunteers: 3,000+  Potential Regional Customers: 1,000,000+ Rochester Regional Health System Locations –15 counties in greater Rochester region –Global Lab Services: U.S., England, India, Singapore and China Full Continuum of Care –5 acute care hospitals* –7 long term care/post-acute facilities –5 ambulatory centers –80+ physician practices –7 housing facilities –Multiple ancillary and specialty services *Includes Clifton Springs & United Memorial Medical Center 20

21 CUSP Staff Safety Assessment  +20% of patients come from outside of Monroe County  5 hospital affiliates throughout region Rochester General Hospital Unity Hospital Newark-Wayne Community Hospital Clifton Springs Hospital & Clinic United Memorial Medical Center  Strategic partnerships with providers & payers Cayuga Medical Center, Ithaca Rochester Institute of Technology (RIT) Roswell Park Cancer Center, Buffalo Finger Lakes Medical Associates, Geneva  More than 2,400 cardiac procedures from outside of Monroe County in 2011 High Value Regional System Network In Place 21 Organizations noted in orange = hospital affiliates Organizations noted in blue = strategic partnerships

22 CUSP Staff Safety Assessment Patient Safety Institute Development Timeline January System Safety Summit (1 st ) June First SAQ February Workplace Violence Committee initiation June Launch of Patient Safety Champions December BH/ Hill Haven/ ILS Affiliate Safety Summits December Internal CUSP Network launched January Start of RGMG Affiliate Safety Summit (through March 2013) April ElderONE and Hill Haven Safety Champions created August Organizational Framework trip to John’s Hopkins University November Patient Safety Institute initiated 2 CUSP teams Launched in 2011 June System Safety Summit (3 rd ) November Newark Affiliate Safety Summit 6 CUSP teams launched in 2012 February RGH Affiliate Safety Summit 2 CUSP teams launched in 2013 2011 2012 2013 2010 09 September System Safety Summit (2 nd ) September System Safety Summit (4 th ) June Second SAQ) December Hill Haven DSC launch 2014 January CUSP Readiness Tool completed June Safety Champions work presented at National Premier Conference August ElderONE Champions Retreat October NWCH DSC launch 2 CUSP teams launched in 2014

23 CUSP Staff Safety Assessment Objectives  Inspire an alternative approach to patient safety using the Staff Safety Assessment tool to capture multidisciplinary viewpoints 23

24 CUSP Staff Safety Assessment Where are you?  What stage of CUSP are you in? Pre-CUSP Implementing CUSP Sustaining CUSP 24

25 CUSP Staff Safety Assessment Presentation  Summarize the Staff Safety Assessment tool and how it drives engagement of frontline teams Purpose Structure  Explore tool enhancement of adding 3 rd “culture” question  Examine a CUSP unit’s successes Medical ICU (MICU) 25

26 CUSP Staff Safety Assessment Staff Safety Assessment  Purpose Begin conversation about harm Guide the CUSP team » Recognize potential gaps or defects » Identify suggestions for change Build Team Member Engagement » Allow opportunity for all members to have a voice » Creates sense of “buy-in” 26

27 CUSP Staff Safety Assessment Staff Safety Assessment  Structure Pre-CUSP work » Assess Culture, Identify Core Team, Attend Workshop, Senior Exec. Orientation, Create meeting schedule Implementation » Science of Safety / CUSP training » Staff Safety Assessment Ongoing / Sustainment » Routinely use to re-assess » Identify new gaps → project focuses » Keep conversation of harm at the forefront 27

28 CUSP Staff Safety Assessment Tool Enhancement  Additional of 3 rd Question Following 2013 SAQ debriefs Captures underlying cultural barriers 28 Envision the Ideal Unit. What does it look like? What would it take to get there?

29 CUSP Staff Safety Assessment MICU CUSP  Medical ICU team launched CUSP in March, 2013  Project Focus → Decrease HAI’s Hand Hygiene CAUTI Reduction  Re-assess Oct. 2014 using Staff Safety Assessment Offered online through emailed link 50% of clinical and support team participated Top three project focuses discussed at monthly CUSP meeting. » Opened up for team member discussion on which to move forward with 29

30 CUSP Staff Safety Assessment MICU CUSP 30

31 CUSP Staff Safety Assessment MICU CUSP  Targeting pressure ulcer reduction and skin improvement Collaborative » Skin Committee » Infection Prevention » ICU provider » Resident  Goals and further defining work in progress 31

32 CUSP Staff Safety Assessment Questions? Contact Ann Freer Patient Safety Specialist Rochester Regional Health System Patient Safety Institute 1425 Portland Avenue Rochester, NY 14621 Phone: 585-922-5145 Email: ann.freer@rochestergeneral.organn.freer@rochestergeneral.org 32

33 Next Steps 33 Decide on a process and timeline for completing the Staff Safety Assessment Complete the Staff Safety Assessment with all staff in your clinical area Summarize the results of the Staff Safety Assessment, discuss at a CUSP team meeting, share broadly with unit staff Choose a defect to address

34 Thank You! 34 Questions for our presenters? Press *1 to ask a question

35 Your feedback is important Thank you for participating in today’s call. Please take a moment to fill out this evaluation: https://www.surveymonkey.com/s/CAUTI_Content 35

36 Upcoming National Content Webinars 36 DateTime/DurationTopic 1/13/15 12 ET/11 CT/10 MT/9 PT (60 minutes) January National Content Webinar CAUTI National Policy 2/10/15 12 ET/11 CT/10 MT/9 PT (60 minutes) February National Content Webinar I-ACT Successes and Lessons Learned

37 January National Content Webinar 37 Motivations for prevention of CAUTI: clinical hazards, public reporting and financial penalties Jennifer Meddings, MD, MSc Assistant Professor of Internal Medicine University of Michigan Linda Greene, RN, MPS, CIC Manager of Infection Prevention Highland Hospital in Rochester, NY 1.Review the clinical hazards that urinary catheters pose to patients 2.Review public reporting requirements regarding hospital-acquired CAUTI 3.Review financial penalties involving hospital-acquired CAUTI rates


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