1. CUSP 4 MVP – VAP Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Centered Care and a Business Case for Quality Improvement in the ICU ARMSTRONG INSTITUTE FOR PATIENT SAFETY AND QUALITY Johns Hopkins University

2. 2 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Perspective & Business Case Housekeeping Notes Once you are on the webinar, choose the "Call Me" option and enter your phone number to be connected to audio. If you cannot join the webinar online, please call in with the information below: US Toll Free 1-855-797-9480 Access code: 667 669 646 Your phones are on mute, but we want to hear from you! Please use the chat box to ask questions or write comments during the call. The recording file and presentation slides will be uploaded to the project website in the next two weeks.

3. 3 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Perspective & Business Case Polling Question Who is on the call? IP – infection preventionist RN – registered nurse RT – respiratory therapist PT – physical therapist OT – occupational therapist MD – physician Quality improvement professional Healthcare executive Educator Coordinating entity representative National project team Other 

4. 4 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Perspective & Business Case CUSP 4 MVP - VAP Comprehensive Unit-based Safety Program for Mechanically Ventilated Patients and Ventilator-Associated Pneumonia

5. 5 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Perspective & Business Case Today’s Discussion Bill Ward, MBA Guest Speaker Rhonda Wyskiel, RN, BSN Guest Speaker

6. The Expert In The Room: Engaging Family in Direct Care ARMSTRONG INSTITUTE FOR PATIENT SAFETY AND QUALITY Rhonda Malone Wyskiel rmalone1@jhmi.edu

7. 7 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Perspective & Business Case How many of you have been a patient or had a loved one in the hospital? What kinds of things did you do while you were visiting? –Likely watched T.v, read newspaper, computer

8. 8 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Perspective & Business Case What Could Have Improved the Experience? What if the nurse had invited you to help? What if you built a relationship where you were a trusted member of the healthcare team?

9. 9 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Perspective & Business Case Why Are You Doing This? Exercise: Imagine your mother, father, loved one in this ICU. What would you want for them? For you as a family member?

10. 10 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Perspective & Business Case Clinical practice guidelines for support of the family in the patient- centered intensive care unit: American College of Critical Care Medicine Task Force 2004–2005 “endorsement of a shared decision-making model, early and repeated care conferencing to reduce family stress and improve consistency in communication, honoring culturally appropriate requests for truth-telling and informed refusal, spiritual support, staff education and debriefing to minimize the impact of family interactions on staff health, family presence at both rounds and resuscitation, open flexible visitation, way-finding and family-friendly signage, and family support before, during, and after a death.”

11. 11 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Perspective & Business Case What Do We Have In Place Currently? What are current patient-centered care practices? What patient-centered care practices or behaviors have you witnessed or participated in? Any practices/behaviors as either active or passive engagement?

12. 12 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Perspective & Business Case Family Involvement Menu

13. 13 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Perspective & Business Case Development of Family Involvement Menu Developed the Family Involvement Menu using results from nurse exercise and family survey Educated nursing staff on the availability and intended use of the menu Displayed the Family Involvement Menu on a reusable white board in each patient room and encouraged its use

14. 14 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Perspective & Business Case Barriers and Early Wins Early adopters versus late adopters (never users) Nursing perspective Patient-provider relationships Documentation Sharing

15. 15 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Perspective & Business Case Next Steps Evaluation process/research National recognition Betty and Gordon Moore Foundation Support –Project Emerge Development of toolkit for implementation

16. 16 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Perspective & Business Case Remember your experience

17. 17 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Perspective & Business Case Making Families Part of Patient- centered Care Example: Family involvement menu Developed by Rhonda Wyskiel, RN Implementation strategies: What might your team put on the menu?

18. 18 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Perspective & Business Case References Mahoney D. Nurturing a collaborative culture. Partners 2014 Oct/Nov: 20-23. Wyskiel RM, Weeks, K, Marsteller, JA. Inviting Families to Participate in Care: A Family Involvement Menu. The Joint Commission Journal on Quality Improvement. 2015. 41(1):43- 46. PMID: 25976723 Wyskiel, RM, Chang BH, Alday AA, Thompson D. A., Rosen, M. A., Dietz, A. S., & Marsteller, J. A. (2015). Towards Expanding the Acute Care Team: Learning How to Involve Families in Care Processes. PMID: 26148096 Mitchell ML, Chaboyer W. Family Centered Care—A way to connect patients families and nurses in critical care: A qualitative study using telephone interviews. Intensive and Critical Care Nursing. 2010;26:154-160. PMID: 20430621 Davidson JE. Family-Centered Care: Meeting the needs of patients’ families and helping families adapt to critical illness. Critical Care Nurse. 2009;29(3): 28-34. PMID: 19487778

19. Next Steps CUSP 4 MVP – VAP Improving Care for Mechanically Ventilated Patients

20. 20 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Perspective & Business Case Wednesday, October 14, 2015 2:00 PM – 3:00 PM ET Executive Engagement Join Peter J. Pronovost, MD, PhD, FCCM for a candid discussion on patient safety: Role of engaged executives and successful efforts to improve patient safety Business case for patient safety Creating an infrastructure to improve organizational quality A practicing anesthesiologist and critical care physician, Dr. Pronovost is the Senior Vice President for Patient Safety and Quality and Director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine. Invite Your Hospital Executives

21. 21 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Perspective & Business Case Progress List Enrollment documents due dates Letter of CommitmentComplete! Data Use Agreement Due as soon as possible Online Registration Due by August 31 st Choose a track on the online registration form: Daily care processes Early mobility BOTH

22. 22 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Perspective & Business Case Tune in to the content webinars for evidence supporting each intervention Content webinars are 90 minutes and occur at 2:00 PM ET DATETOPIC Sept 8, 2015Project Kickoff! Mark Your Calendar: Upcoming Sessions

23. 23 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Perspective & Business Case CUSP 4 MVP – VAP Website Visit: https://armstrongr esearch.hopkinsm edicine.org/cusp4 mvp.aspx https://armstrongr esearch.hopkinsm edicine.org/cusp4 mvp.aspx Project site will be password protected on Aug 31 st, 2015.

24. 24 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients Onboarding 5: Patient Perspective & Business Case