1. CDI Prevention in Long Term Care Collaborative Welcome and Project Overview Deborah Quetti RN, MBA, BSN, CPHQ April 9, 2014

2. Qualidigm at a Glance Mission- driven, health care consulting company Experts in quality improvement and patient safety across the continuum of care Neutral convener/ facilitator Local and national contract and grant work 2

3. Vision and Mission… Our Vision: Quality health care for all. Our Mission: Improving the quality, safety, and cost-effectiveness of healthcare through transformational change. 3

4. Background CT-based, brand recognized, healthcare consulting company with 30+ years of experience Medicare Quality Improvement Organization (QIO) for CT Patient Safety Organization designated by the CT Department of Public Health 4

5. Our Services 5 Healthcare Quality Consulting Change Management Patient- Centered Medical Home Patient Safety Care Transitions Data Evaluation & Analysis Consumer & Provider Education Quality of Care Reviews

6. Our Customers Diverse group of healthcare stakeholders in government, industry and clinical practice Other clients include: – Agency for Healthcare Research and Quality – Rhode Island Department of Human Services – eHealthConnecticut (Regional Extension Center) – Academic institutions – National and international healthcare consulting firms – Local and national foundations – Healthcare providers in all settings – Payers and purchasers 6

7. 7 Objectives for today’s session 1. Provide an update on CT HAI program initiatives and emerging infection program data. 2.Describe the consequences to nursing home residents of CDI and MDRO infections. 3. Describe the pathophysiology and treatment options for CDI. 4. Identify key elements of an infection prevention program that can prevent the spread of CDI and MDROs.

8. 8 Objectives for today’s session 5.Describe the role of the CDC in infection prevention efforts, the resources available to the public, and the purpose of the NHSN data reporting system. 6. Describe the goals of the Qualidigm CDI long term care collaborative, work plans, outcome measures, and role of NHSN. 7. Utilize the results of the CDI self-assessment tool to identify opportunities for improvement within the organization, and to plan interventions for improvement in resident safety.

10. Project Goal 10 To assist long term care facilities to work together through July, 2014 to reduce Clostridium difficile and multi- drug resistant infections, using rapid cycle quality improvement techniques.

11. Project Timeline 11 Kick-off April, 2014 Knowledge transfer: scope of the problem and evidence-based practices Perform “environmental scan” Develop AIM statement Activities Site visit #1 to use QI tools to target and complete a quality improvement plan Site visit #2 to review data collection and analysis process, PDCA application Submission of monthly C. difficile data to Qualidigm and/or NHSN Monthly conference calls with all facilities hosted by Qualidigm and DPH for peer to-peer learning Application of publicly available resources from CDC and others Technical assistance by Qualidigm as needed Wrap-up July, 2014 Re-do “environmental scan “ Review successes, barriers, and outcomes Celebrate !

12. Participant Expectations Complete “environmental scans” Write an AIM statement Recruit PI team members at your facility Schedule two face-to-face, two hour sessions with Qualidigm facilitator Work with facilitator to create an action plan Implement plan and collect data to gauge progress; apply PDCA as needed Utilize QI tools throughout the process Report data to Qualidigm Participate in monthly conference calls Attend July 2014 wrap-up session

13. Target areas Early diagnosis and rapid containment Hand hygiene Environmental cleaning Antimicrobial stewardship

14. Handouts Long term care CDI assessment tool AIM statement template Work plan template Ask/offer form Dr. Stone’s presentation CDCs “12 steps to address antimicrobial resistance” in LTC Evaluation form

15. 15 Tools Implementation Strategies Support Structure Networking Peer-to-Peer Learning (All teach, all learn)

16. Questions?