Patient Safety and Quality in Washington Hospitals

Washington Hospitals: Basic Facts

Washington Hospitals 98 hospitals in Washington State

Hospitals: The Ultimate Safety Net Hospitals are there when you need them, providing excellent care every day and at any hour Hospitals don’t turn emergencies away – everyone gets treated regardless of ability to pay In 2004, Washington hospitals provided over $180 million in charity care

Your Hospitals at Work 580,000 admissions in million outpatient visits in 2003 One-fourth of all inpatients are maternity and newborns Cardiac care Orthopedics General surgery

Hospitals Provide Jobs Hospitals are one of the largest employers in the state Washington hospitals employ 74,000 people 65,000 full-time equivalent positions Average compensation is $64,000 (salary + benefits)

Hospitals’ Economic Impact Hospitals are major contributors to Washington’s economy –Purchasing goods and services locally –Paying taxes (state, local, sales, B&O) –For every dollar spent by hospitals about $2.40 in business activity is created – totaling $17.5 billion

Hospitals Provide Excellent Care “Based on what you know or have heard, how satisfied are you with the quality of health care available at most hospitals in Washington State, very satisfied, fairly satisfied, not too satisfied, or not at all satisfied?” Poll of 600 Washington residents/May ’05 (due to rounding, numbers may not add to 100%)

Making Great Care Better Washington hospitals are working to make great care even better through: –New science and technology –Numerous patient safety and quality initiatives –Empowering and educating patients

Washington Hospitals Work on Quality Collaboratively Washington hospitals are sharing information and resources to improve care High quality care across the state is our shared goal

Quality and Safety: Washington Hospitals’ Strategies

A national, voluntary campaign aimed at saving lives through improving patient safety All Washington hospitals are participating – a tremendous commitment Helps hospitals adopt new medical practices/ procedures proven to save lives and improve care Already showing measurable results 100K Lives Campaign

Washington 100K Lives Campaign Has Many Partners Partnership of hospitals, doctors, nurses, pharmacists, and others Endorsed by professional groups and professional unions All working together to improve safety

Campaign Recommends Six New Interventions 1.Improve care for acute myocardial infarction (heart attack) 2.Reduce adverse drug events 3.Prevent surgical site infections 4.Prevent infections from lines inserted into patient bloodstreams 5.Prevent pneumonia for patients on ventilators 6.Implement teams to provide rapid response to patients who appear to be deteriorating

Example: Prevention of Adverse Drug Events Hospitals are working to reconcile medications at: –Admission –Transfers –Discharge Ensures patients are given the right medication at the right time List of patient medications is important

Example: Preventing Surgical Site Infections Giving patients the right antibiotics at the right time Appropriate hair removal (avoiding shaving) Glucose control

Example: Preventing Ventilator Associated Pneumonia Elevate head of the bed to 30 degrees Treat conditions that could lead to pneumonia Provide suction of secretions Provide routine breaks from sedation Give daily assessment of patient’s ability to come off the ventilator

Example: Preventing Central-Line Bloodstream Infections Half of ICU patients have central lines Hospitals are preventing central-line infection by: –Increasing hand hygiene –Using gown, mask, gloves when inserting the central-line –Using appropriate antisepsis solution –Using appropriate types of tubing –Using only when necessary and removing as soon as possible

Example: Rapid Response Teams Multi-disciplinary, expert “swat” team Summoned when patient is failing before cardiac arrest –Change in heart rate or blood pressure –Change in respiration –Change in conscious state –When staff are worried More effective to help a patient before a crisis Potential to save the most lives

Example: Improving Care for Heart Attack Patients Aspirin at admission and discharge Beta-blocker at admission and discharge ACE-inhibitor or ARB at discharge Timely removal of heart blockage Smoking cessation counseling

Hospital Quality Initiative Spearheaded by the Centers for Medicare and Medicaid Services (CMS) Launched April 1, 2005 Hospitals submit data to CMS Provides data on quality of care for all acute-care hospitals in Washington -

Rural Healthcare Quality Network Statewide project to improve quality at “critical access hospitals” (hospitals with fewer than 25 acute care beds) The Network’s doctors promote nationally recognized treatment guidelines The Network also builds local skills to lead quality improvement initiatives in local facilities Currently, the network is working to improve treatment for heart failure Also working to bring new technologies to rural hospitals, such as tele-medicine and tele-pharmacy

Safe Table Learning Collaboratives Led by the state’s hospital association Hospital staff come together to: –Share best practices –Learn from each other’s medical errors –Learn from each other’s near misses Sharing of information improves care for all

First Safe Table: Infection Control Hospital staff across the state are coming together to implement the best ways to reduce infections in hospitals National experts and best practices are being used Hospitals in Washington will become national leaders in preventing infections

New Technology Can Improve Care Computerized physician orders Barcoding prescriptions Tele-medicine and tele-pharmacy Electronic medical records

Patient Safety and Quality Initiatives Work Hospitals are reporting progress on the “100K Lives Campaign” New interventions and medical findings make better care possible

The Right Thing to Do... And It Saves Money The right care at the right time means patients: –Stay healthier –Need less care –Are discharged earlier –Are re-admitted less frequently This impacts health care costs and reduces health care spending

Partners in Quality Washington State Department of Health Washington State Medical Association Professional Nursing Organizations Qualis Health Joint Commission for the Accreditation of Health Care Organizations (JCAHO) And many other partners...

The Role of the Patient Patients play a critical role Hospitals are committed to empowering and educating patients Hospitals and doctors in Washington have produced a patient safety brochure so patients can play an active role in safe care The brochure is available at hospitals and physician offices

Patient Safety Brochures (English and Spanish)

Overview Poster

Hand Washing Poster

Medication Poster

Walking / Fall Prevention Poster

The Commitment of Hospitals Patient safety is a top priority for Washington hospitals We are committed to continuously improving the quality of care in our hospitals We want patients to be our partners in safety and quality