1. 10 © 2010 TMIT Charles Denham, MD Chairman, TMIT Co-chairman, NQF Safe Practices Consensus Committee Chairman, Leapfrog Safe Practices Program Safe Practices Webinar March 18, 2010 Safe Practice Overview

2. 11 © 2010 TMIT Harmonization – The Quality Choir

3. 12 © 2010 TMIT The Patient – Our Conductor

4. 13 © 2010 TMIT 34 Safe Practices Criteria for Inclusion Specificity Benefit Evidence of Effectiveness Generalization Readiness 2010 NQF Safe Practices for Better Healthcare: A Consensus Report

5. 14 © 2010 TMIT 2010 Final Report: Format Structure Preserved Problem Statement and Implementation Guide Thoroughly Updated Minor Specification Changes Updated References Corrections and Clarifications Care Setting Clarification Using CMS Classification Measures Section Updated Thoroughly with NQF-Endorsed and Other Practical Measures for Consideration Soft Copy Document Hyperlinks Crosswalk Tables Glossary History of NQF Safe Practices for Better Healthcare 2009 Final Report: From 30 to 34 practices Culture Practice Elements Broken Up into 4 Practices 2 Practices Discontinued 4 Medication Management Practices Combined into 1 2 Communication Practices Combined into 1 8 New Practices Added CMS Care Settings Defined Patient and Family Involvement Section Added

6. 15 © 2010 TMIT 2003, 2006, and 2009 Update Versions

7. 16 © 2010 TMIT Information Management and Continuity of Care Medication Management Healthcare-Associated Infections Condition- & Site-Specific Practices Consent & Disclosure Culture Workforce Consent and Disclosure 2010 NQF Report

8. CHAPTER 7: Hospital-Associated Infections Hand Hygiene Influenza Prevention Central Venous Catheter-Related Blood Stream Infection Prevention Surgical-Site Infection Prevention Care of the Ventilated Patient and VAP MDRO Prevention UTI Prevention Information Management and Continuity of Care Medication Management Healthcare-Associated Infections Condition-, Site-, and Risk-Specific Practices Consent & Disclosure Wrong-site Sx Prevention Press. Ulcer Prevention DVT/VTE Prevention Anticoag. Therapy VAP Prevention Central V. Cath. BSI Prevention Sx-Site Inf. Prevention Contrast Media Use Hand Hygiene Influenza Prevention Pharmacist Systems Leadership: High-Alert, Std. Labeling/Pkg., and Unit-Dose Med. Recon. Culture CPOE Read-Back & Abbrev. Discharge System Patient Care Info. Labeling Studies Culture Meas., FB., and Interv. Structures and Systems ID and Mitigation Risk and Hazards Team Training and Team Interv. Nursing Workforce ICU Care Direct Caregivers Workforce CHAPTER 4: Workforce Nursing Workforce Direct Caregivers ICU Care CHAPTER 2: Creating and Sustaining a Culture of Patient Safety (Separated into Practices]  Leadership Structures and Systems  Culture Measurement, Feedback, and Interventions  Teamwork Training and Team Interventions  Identification and Mitigation of Risks and Hazards CHAPTER 5: Information Management and Continuity of Care  Patient Care Information  Order Read-Back and Abbreviations  Labeling Studies  Discharge Systems  Safe Adoption of Integrated Clinical Systems including CPOE CHAPTER 6: Medication Management  Medication Reconciliation  Pharmacist Leadership Role Including: High-Alert Med. and Unit-Dose Standardized Medication Labeling and Packaging CHAPTER 8: Wrong-Site, Wrong-Procedure, Wrong-Person Surgery Prevention Pressure Ulcer Prevention DVT/VTE Prevention Anticoagulation Therapy Contrast Media-Induced Renal Failure Prevention Organ Donation Glycemic Control Falls Prevention Pediatric Imaging Informed Consent Life-Sustaining Treatment Disclosure CHAPTER 3: Informed Consent and Disclosure Informed Consent Life-Sustaining Treatment Disclosure Care of the Caregiver Consent and Disclosure Care of Caregiver MDRO Prevention UTI Prevention Falls Prevention Organ Donation Glycemic Control Pediatric Imaging 2010 NQF Report

9. 18 © 2010 TMIT LEADERSHIP STRUCTURES and SYSTEMS Values Systems Structures Behaviors Outcomes Culture Measurement, Feedback, and Intervention Teamwork Training and Skill Building Identification and Mitigation of Risks and Hazards Leadership Structures and Systems Patients and Community NQF 34 Safe Practices

10. 19 © 2010 TMIT HAI Guidelines