The Comprehensive Unit-Based Safety Program: How Will This Work? Chris George, R.N, M.S Sam Watson, M.S.A Pat Noga, R.N

The Michigan Experience

Workshop Learning Objectives Describe the purpose and vision of the ICU Safe Care Initiative/Comprehensive Unit-Based Safety Program. Describe the process used to identify and eliminate system defects.   List three tools or strategies used to improve teamwork and build a safety culture. State research and best practices in reducing infections, preventing central line infections, and going beyond the bundle.

Session Learning Objectives Review the purpose and vision of the ICU Comprehensive Unit-Based Safety Program/CLABSI Initiative. Understand how your ICU and your hospital will benefit from participation. Build the skills of physicians, nurses, and other care team members in identifying and eliminating system defects that can result in patient harm, and improve teamwork and build a safety culture. Engage in discussion with national experts on research and best practices in reducing infections, preventing central line infections, and going beyond the bundle.  Discuss how to apply in your hospital. Identify opportunities to reduce central line infections and the impact it will have on costs and patient days. Discuss steps and timeline in implementation of the initiative.

ICU Safety Culture 2004 - 2008

ICU Teamwork Culture2004-2008

Teamwork Climate & Annual Nurse Turnover   % reporting positive teamwork climate High Turnover 16.0% Low Turnover 7.9% Mid Turnover 10.8%

Median Central Line Associated Bloodstream Infection Rate Time period Median Central Line Associated Bloodstream Infection Rate Baseline 2.7 Intervention 1.6 0-3 months 4-6 months 7-9 months 10-12 months 13-15 months 16-18 months

Results Lives Saved – 1,729* Patient Days Saved – in excess of 127,000* Dollars Saved – 0ver $246 Million* Culture of Safety improved 28% Teamwork improved 15% * Based on the Johns Hopkins Opportunity Calculator

On the CUSP Data Collection Form Frequency of Completion How to submit Reports generated Exposure survey Once Survey Monkey (Link will be sent via email) Descriptive Culture assessment (AHRQ Hospital Survey on Patient Safety) Baseline and 18 months HSOPS administered via MHA Care Counts or thru existing process such as Press Ganey (will accept surveys within 6 month window from state administration date) Unit reports and comparative reports from Westat CLABSI *Monthly www.mhacarecounts.org ComparativeAvailable in MHA Care Counts Team Check-Up Form Available in MHA Care Counts Staff Safety Assessment survey ‘How is the next patient going to be harmed’ Baseline and biannual Not submitted No report Learning From Defects Monthly *Due by the 15th of the Month following data collection. (Ex: January MTCT is due by February 15)

Workshop Learning Objectives Describe the purpose and vision of the ICU Safe Care Initiative/Comprehensive Unit-Based Safety Program. Describe the process used to identify and eliminate system defects.   List three tools or strategies used to improve teamwork and build a safety culture. State research and best practices in reducing infections, preventing central line infections, and going beyond the bundle.

Questions