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Intermountain-led CMS Hospital Engagement Network Preventing Pressure Ulcers October 22, 2013 Affinity Call Marlyn Conti - Intermountain, Patient Safety.

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Presentation on theme: "Intermountain-led CMS Hospital Engagement Network Preventing Pressure Ulcers October 22, 2013 Affinity Call Marlyn Conti - Intermountain, Patient Safety."— Presentation transcript:

1 Intermountain-led CMS Hospital Engagement Network Preventing Pressure Ulcers October 22, 2013 Affinity Call Marlyn Conti - Intermountain, Patient Safety Coordinator Gina Honermann-Garinger—Baylor Scott & White Health, Center for Clinical Innovation

2 Outline for Discussion
HEN Pressure ulcer data What have you implemented this past year? What are your challenges? What’s next for your facility/system?

3

4 Intermountain HEN 2012-13 submitting Hospitals

5 Braden Risk Assessment Intermountain HEN
Rate going up. Braden & Skin Assessment required within 24 Hours of admit

6 Ulcers below national best practice benchmark and trending down

7 Is this coding artifact? Are we charting better?

8 Intermountain HEN PrU =>3

9 HEN Pressure Ulcer Measures
Metric specification resource manual Submission schedule: November 20, 2013: for data through September 2013

10 Intermountain PrU Prevalence Trends
All stages per quarterly prevalence survey, 22 hospitals

11 Intermountain Hospitals
The same data is available in SPC charts via web for system, region, facility and department

12 Intermountain Hospitals

13 Intermountain Hospitals
Call drill down to the patient and do cause analysis

14 Intermountain Hospitals Pressure Ulcer Prevention Tools
Working Harder Intermountain Hospitals Pressure Ulcer Prevention Tools Care plan for kardex Bed & surface algorithm Skin care product posters Patient fact sheets The Braden Scale consists of six subscales that evaluate a patient’s sensory perception, activity level, mobility, nutritional status, and the skin’s exposure to moisture, friction, and shear forces. Patients can receive scores from 1 to 4, with 4 representing the highest. The subscale for friction and shear is a score from 1 to 3. The six subscale scores yield a total Braden Score ranging from 6 to 23. The lower scores are associated with a greater risk of developing pressure ulcers.

15 Baylor All Saints Hospital Acquired Pressure Ulcers PUT new data here please
January 2013 February 2013 March 2013 4 155 162

16 Baylor All Saints Pressure Ulcers > Stage 3 2013 Q1 & June Comparison Run Chart
January 2012 February 2013 March 2013 1 155 162

17 Baylor All Saints AHRQ PSI #3 2013 Q1 & June Comparison Run Chart
January 2013 February 2013 March 2013 365 288 298

18 What have you implemented What are your challenges
Participant Poll System What have you implemented What are your challenges What’s next Intermountain Pressure ulcer bundles Hard coding interventions in computer charting based on Braden scores ‘Getting to Zero’ Complacency Known complication Competing priorities Bundle compliance tracking Baylor Policy & procedures to back-up protocol Bedside reporting Present on admission reporting is improving EHR support for risk assessment Documentation of present on admission Participants Trial of iPad app for picture documentation in EHR Pressure Injuries Identify areas needing most attention & appoint a leadership supported “lead” to drive improvement & education SWAT (or champion) teams that includes unit nurse/ Adopt decision algorithms for RNs to select appropriate surfaces make decisions independently of surface decisions. Establish monthly prevalence studies or incidence rates from electronic medical records then feed that data back to the SWAT teams. What to do for: Getting Started Working Harder Ahead of the Curve

19 Pressure Ulcer Elimination “Bundle” = SKIN (Ascension Health)
Manage Nutrition and Hydration Manage Incontinence Keep Patients Moving Selection of Appropriate Support Surfaces Tissue injury can be more than skin deep…

20 Access Available Tool Kits
Getting Started Getting Started Access Available Tool Kits Preventing Pressure Ulcers in Hospitals: A Toolkit for Improving Quality of Care National Pressure Ulcer Advisory Panel AHRQ PSNet AHRQ Web M&M AHRQ Health Care Innovations Exchange Plenty of best practice content available on line

21 Next Affinity Call Pending
What questions or topics would you like addressed? Send questions to Access HEN webinars and resources at


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