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On the CUSP: Stop CAUTI National Content Webinar
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:
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Kristin Opett, RN, BS, MSHA
Today’s Presenters 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
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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
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Adaptive Components of CAUTI
CUSP for CAUTI Educate Staff on the Science of Safety Identify defects Partner with senior executive Learn from defects Improve teamwork and communication Adaptive Components of CAUTI
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Has your team completed the Staff Safety Assessment in the past 6 months?
Yes No Not Sure
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CUSP Toolkit
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How do errors happen? People are fallible
Medicine is still treated as an art, not a science Systems do not catch mistakes before they reach the patient
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What is a defect? Anything that happens, clinically or operationally, that you do not want to happen again.
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Examples of defects that affect patient safety
Intervention Unstable oxygen tanks on beds Oxygen tank holders repaired or new holders installed (institution-wide) Medication look-alike Education conducted, medications physically separated, and letter sent to the manufacturer Missing equipment on cart Checklist 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
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How can your team identify defects?
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
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The Wisdom of 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
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What is the Staff Safety Assessment?
AKA – The 2 Question Survey Please describe how you think the next patient in your unit/clinical area will be harmed Please describe what you think can be done to prevent or minimize this harm
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Administration 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
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What do teams do with results?
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
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Results from surgical teams
Percentage of Responses (%) Wick EC, et. al., J Am Coll Surg. 2012;215(2):
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Follow-up is key 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
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Venues for SSA 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
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Staff Safety Assessment
Tool Utilization for CUSP Advancement
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Rochester Presentation
Kristin Opett, RN, BS, MSHA Vice President of Patient Safety Rochester Regional Health System Rochester, New York Ann Freer, RN; BSN Patient Safety Specialist Rochester Regional Health System Rochester, New York
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Rochester Regional Health System
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+ 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
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High Value Regional System Network In Place
+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 Organizations noted in orange = hospital affiliates Organizations noted in blue = strategic partnerships
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Patient Safety Institute Development Timeline
January System Safety Summit (1st) 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 (3rd) 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 (2nd) September System Safety Summit (4th) 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
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Objectives Inspire an alternative approach to patient safety using the Staff Safety Assessment tool to capture multidisciplinary viewpoints
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Where are you? What stage of CUSP are you in? Pre-CUSP
Implementing CUSP Sustaining CUSP
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Presentation Summarize the Staff Safety Assessment tool and how it drives engagement of frontline teams Purpose Structure Explore tool enhancement of adding 3rd “culture” question Examine a CUSP unit’s successes Medical ICU (MICU)
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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”
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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
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Tool Enhancement Additional of 3rd Question
Following 2013 SAQ debriefs Captures underlying cultural barriers Envision the Ideal Unit. What does it look like? What would it take to get there?
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MICU CUSP Medical ICU team launched CUSP in March, 2013
Project Focus → Decrease HAI’s Hand Hygiene CAUTI Reduction Re-assess Oct using Staff Safety Assessment Offered online through ed 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
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MICU CUSP
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MICU CUSP Targeting pressure ulcer reduction and skin improvement
Collaborative Skin Committee Infection Prevention ICU provider Resident Goals and further defining work in progress
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Questions? Contact Ann Freer Patient Safety Specialist
Rochester Regional Health System Patient Safety Institute 1425 Portland Avenue Rochester, NY 14621 Phone:
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Next Steps 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
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Questions for our presenters? Press *1 to ask a question
Thank You! Questions for our presenters? Press *1 to ask a question
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Your feedback is important
Thank you for participating in today’s call. Please take a moment to fill out this evaluation:
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Upcoming National Content Webinars
Date Time/Duration Topic 1/13/15 12 ET/11 CT/10 MT/9 PT (60 minutes) January National Content Webinar CAUTI National Policy 2/10/15 February National Content Webinar I-ACT Successes and Lessons Learned
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January National Content Webinar
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 Review the clinical hazards that urinary catheters pose to patients Review public reporting requirements regarding hospital-acquired CAUTI Review financial penalties involving hospital-acquired CAUTI rates
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