1. I plan on making the door by the time I hit thirty November 16, 2012 Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team

2. November 16, 2012 Reducing respiratory infections and strengthening staff engagement at Fraser Health’s Burnaby Hospital through the use of best practices and data from the National Surgical Quality Improvement Program (NSQIP) Kamaljit Sahota, Darlene Jager, Ashley Camp, Susann Camus

3. Our Team

4. Team Members Ashley Camp, Surgical Staff Nurse Susann Camus, NSQIP Quality Improvement Consultant Grit Chiu, Surgical Staff Nurse Gabriela Gheorghe, Patient Care Coordinator, Surgical Unit Jan Huggan, Surgical Manager & Team Sponsor Darlene Jager, Surgical Clinical Reviewer Dr. Jean-Noel Mahy, Surgeon Champion Melody Pan, Surgical Clinical Reviewer Christa Parkin, Clinical Care Coordinator, Preadmission Kamaljit Sahota, Clinical Nurse Educator, Surgery, & Team Leader November 16, 2012 Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team 4

5. Why preventing pneumonia matters Pneumonia can be life- threatening for surgical patients Results in increased morbidity and mortality Costly to treat (~$50,000 per patient with major complications) (Dimick et al., 2004) November 16, 2012 Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team 5

6. Rationale for Team NSQIP data for BH postsurgical pneumonia shows higher than average rates November 16, 2012 Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team 6

7. Team Goals Prevent/Reduce pneumonia in postsurgical patients Promote best nursing practices through staff engagement and their active involvement in translating those into action Provide nurses, patients and their families with educational tools November 16, 2012 Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team 7

8. Measures PDSA cycles to assess how well we are implementing best practices NSQIP risk & non-risk adjusted data Staff engagement November 16, 2012 Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team 8

9. Initiatives to date Development of a team charter Biweekly focused team meetings Implementation of NSQIP Best Practices PDSA cycles Patient and nurse education November 16, 2012 Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team 9

10. Other initiatives Patient & staff educational materials Lit Research - chlorohexidine for oral care Investigate benefits of disposable blood pressure cuffs to time for patient care & mobilization. Review patient charts for symptoms, actions taken/not taken November 16, 2012 Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team 10

11. Whenever something goes wrong, I just push this little button and restart. I wish my whole life was like this!

12. Challenges Getting all the players involved Coordinating meeting schedules/Release time for members to attend meetings/staff coming in for meetings on days off Great expectations November 16, 2012 Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team 12

13. Lessons Learned Invaluable to have a supportive manager and a knowledgeable, engaged surgeon champion participating Very helpful to have facilitated, documented meetings Share resources (e.g. learn from others, share with others) Recognize change takes time. Be patient. Persevere. November 16, 2012 Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team 13

14. The trouble with success is that the formula is the same for a nervous breakdown. November 16, 2012 Fraser Health – Burnaby Hospital Detectives NSQIP Pneumonia Prevention Action Team 14