+ All Categories
Home > Documents > PfP 2014: Priorities and Expectations

PfP 2014: Priorities and Expectations

Date post: 25-Feb-2016
Category:
Upload: oren
View: 22 times
Download: 1 times
Share this document with a friend
Description:
PfP 2014: Priorities and Expectations. Agenda. Welcome new Oregon hospitals Provide overview of 2014 PfP activities and programs AHA/HRET Improvement Leader Fellowship Patient/Family Engagement Data expectations and measures Oregon Lean Other resources Listserv update - PowerPoint PPT Presentation
Popular Tags:
39
PfP 2014: Priorities and Expectations
Transcript
Page 1: PfP 2014:  Priorities and Expectations

PfP 2014: Priorities and Expectations

Page 2: PfP 2014:  Priorities and Expectations

2

Agenda• Welcome new Oregon hospitals• Provide overview of 2014 PfP activities and

programs– AHA/HRET Improvement Leader Fellowship– Patient/Family Engagement

• Data expectations and measures• Oregon Lean • Other resources

– Listserv update– Optional topics

• Travel funds

Page 3: PfP 2014:  Priorities and Expectations

3

New hospitals: Welcome!

• Ashland Community • Kaiser Westside • Pioneer Heppner• St Anthony• West Valley• Vibra

Page 4: PfP 2014:  Priorities and Expectations

4

2014 Oregon PfP Map + Improvement Advisors

Page 5: PfP 2014:  Priorities and Expectations

5

PfP Overview

Page 6: PfP 2014:  Priorities and Expectations

6

Partnership for Patients

• Goal: 40% Reduction in Preventable Hospital Acquired Conditions

• Goal: 20% Reduction in Hospital Readmissions • Ultimately to provide safer care and decrease cost

Page 7: PfP 2014:  Priorities and Expectations

7

Oregon PfP working together to achieve a bold aim

• On our way to the 40/20 goal by Dec 2014• 2014 year focus:

– Reporting and analyzing data for all applicable areas

– Patient and family engagement (PFE)– Leadership support – Healthcare disparities– Teamwork and communication

Page 8: PfP 2014:  Priorities and Expectations

8

National HEN Targeted Harms

• Adverse drug events• OB Adverse Events• Elimination of Early Elective Deliveries• Central line-associated blood stream infections• Catheter-acquired urinary tract infections• Falls with injury• Surgical infections and complications• Venous thromboembolism• Pressure ulcers• Readmissions• Ventilator-associated events

Page 9: PfP 2014:  Priorities and Expectations

PfP Option Year: 2014

ADE + (at minimum) opioid safety, anticoagulation safety, and glycemic management

CAUTI + all hospital settings, including avoiding placement of catheters in the ER

CLABSI + all hospital settings (not just ICU)

OB Adverse Events + Management of postpartum hemorrhage and pre-eclampsia (probably obstetric hypertension)

VTE + all surgical settings

VAP/VAE + Infection-related Ventilator-Associated Complications (IVAC) and Ventilator-Associated Pneumonia (VAP)

SSI + multiple classes of surgeries

Falls, HAPU,Readmissions

Same focus

Page 10: PfP 2014:  Priorities and Expectations

10

Overview of PfP activities and programs

• National: – Boot camps– Webinars

• State: – CAUTI program Feb. 27,2014 @ the Grand Hotel

Bridgeport – State meetings:

• Friday April 4th, Portland• Fall 2014, Medford

Page 11: PfP 2014:  Priorities and Expectations

11

Resources• Updated change packages and checklists for all CORE

topics will be reflected in the AHA/HRET HEN website (www.hret-hen.org) by early February.

• The website will also include new sections for information and resources regarding all OPTIONAL topics.

• Make sure to review the topics Resource sections to find tools, checklists and other resources shared on topic-specific LISTSERVs

Page 12: PfP 2014:  Priorities and Expectations

12

AHA/HRET Improvement Leader Fellowship

Page 13: PfP 2014:  Priorities and Expectations

13

Fellows Across the Country

Page 14: PfP 2014:  Priorities and Expectations

14

Delivering the Fellowship• In-Person Regional Meetings• 22 different state meetings March through November• On site meetings specifically designed to combine clinical

knowledge with improvement techniques• Monthly Live Streamed Meetings• Fellowship Topics: 1:00 – 3:00 PM CST every third or

fourth Wednesday of the month

Page 15: PfP 2014:  Priorities and Expectations

15

In-Person Regional Meetings

• Promote shared discussion and learning• All Fellows in one room• Didactic• Hospital story sharing• Coaching• Topic Specific Mini Collaborative: led by Cynosure IA• Fellowship Topic: led by IHI faculty• Oregon PfP: our state meeting is being scheduled for this

spring

Page 16: PfP 2014:  Priorities and Expectations

16

Tracking & Evaluating Participation

• Attendance– 1 in-person meeting– 8 out of 10 virtual meetings

• Commitment to the Program (endorsed by Sr. Leader at their organization)

• Harm Across the Board (HAB)completion• Pre-work assignments• Specific requirements for each Fellowship Level: Junior,

Senior, and Champion• Open School module completion

Page 17: PfP 2014:  Priorities and Expectations

No More Progress Reports! • HAB will replace the monthly progress

reports. • HAB is being revised to include 6 slides

– Webinar in Feb. 2014, date TBA

• Complete a Harm Across the Board (HAB) report by March 31, 2014

• HAB report due quarterly to your IA

17

Page 18: PfP 2014:  Priorities and Expectations

18

Patient & Family Engagement (PFE)• The AHA/HRET HEN team will collaborate with Institute

for Patient- and Family-Centered Care (IPFCC) to provide:• Six educational webinars will take place in: February,

March, April, June, August and October• Each webinar will be approximately one hour, and will

incorporate two hospitals (focused on their PFE actions)• 30-minute Office Hours• In-state PFE Roadshows• Monthly content for the Weekly SHA Newsletter

Page 19: PfP 2014:  Priorities and Expectations

19

Data and Measurement

Page 20: PfP 2014:  Priorities and Expectations

20

Measures

• We are ahead of many states since we already had aligned measures

• Some changes plus additions necessary due to push to reach PfP goals

• Baseline data needed for all new measures– Preferably 2013 data; could use Jan 2014 if

necessary– Indicate baseline time frame. Notify your IA.

Page 21: PfP 2014:  Priorities and Expectations

21

Adverse Drug Events

2014 Oregon PfP focusCategory Measure Name Definition Numerator Denominator Source

ADE

Hypoglycemia in inpatients receiving insulin

Hypoglycemia in inpatients receiving insulin or other hypoglycemic agents

Hypoglycemia in inpatients receiving insulin or other hypoglycemic agents (e.g. hypoglycemia defined as plasma glucose concentration of 50 mg per dl or less)

Inpatients receiving insulin or other hypoglycemic agents

ASHP Safe Use of Insulin

ADE

Excessive Anticoagulation with Warfarin

All inpatients who had excessive anticoagulation with warfarin

Inpatients experiencing excessive anticoagulation with warfarin (e.g. INR > 6)

Inpatients receiving warfarin anticoagulation therapy

ISMP

ADE

ADEs due to opiods Naloxone reverses opioid intoxication. For this reason, naloxone administration can be used to identify patients who may have experienced an adverse drug event due to an opioid.

Number of patients treated with opioids who received naloxone during the review period.

Number of patients who received an opioid agent during review period.

ISMP and PA-HEN

Page 22: PfP 2014:  Priorities and Expectations

22

Catheter Associated Urinary Tract Infection (CAUTI)

2014 Oregon PfP focus

Category Measure Name Definition Numerator Denominator Source

CAUTI

Catheter-Associated Urinary Tract Infections Rate - All Tracked Units (CDC NHSN)

Rate of patients with a catheter-associated urinary tract infections per 1000 urinary catheter days- all tracked units

Catheter-associated urinary tract infections based on CDC NHSN definition (all tracked units)

Total number of urinary catheter days for all patients that have an indwelling urinary catheter in all tracked units

CDC NHSN CAUTI

*OPTIONAL* CAUTI-ED

Emergency Department CAUTI Measure/s- TBD

TBD TBD TBD CUSP: CAUTI

Page 23: PfP 2014:  Priorities and Expectations

23

Central Line Associated Blood Stream Infection (CLABSI)

Category Measure Name Definition Numerator Denominator Source

CLABSI

CLABSI Rate - All Tracked Units (Device Days)

CLABSI rate (healthcare-associated primary bloodstream infection (BSI)) in a patient that had a central line within the 48-hour period before the development of the BSI and that is not related to an infection at another site

The Primary Bloodstream Infection (BSI) form (CDC 57.108) is used to collect and report each CLABSI that is identified during the month selected for surveillance

Number of all units device days (Central line days)

CDC NHSN

2014 Oregon PfP focus

Page 24: PfP 2014:  Priorities and Expectations

24

Falls 2014 Oregon PfP focus

Category Measure Name Definition Numerator Denominator Source

Falls

Falls With Injury (minor or greater) (NSC-5)

All documented patient falls with an injury level of minor or greater

Total number of patient falls of injury level minor or greater (whether or not assisted by a staff member) during the calendar month.

Patient days NQF

Page 25: PfP 2014:  Priorities and Expectations

25

OB Adverse Events 2014 Oregon PfP focus

Category Measure Name Definition Numerator Denominator Source

OB

Elective Deliveries at >= 37 Weeks and < 39 Weeks (JC PC-1)

Patients with elective vaginal deliveries or elective cesarean sections at ≥ 37 and < 39 weeks of gestation completed

Patients with elective deliveries

Patients delivering newborns with ≥ 37 and < 39 weeks of gestation completed

Joint Commission

OB

C-Section Delivery Rate (JC PC-2)

Nulliparous women with a term, singleton baby in a vertex position delivered by cesarean section

Patients with cesarean sections

Nulliparous patients delivered of a live term singleton newborn in vertex presentation

Joint Commission

OB-Hemorrhage

Total OB blood transfusions

Total number of blood products used per 100 women giving birth

Total number of units of blood products (RBCs, FFP, Platelet packs, Cryo)

All women giving birth ≥20 weeks (birth hospitalization)

ACOG and CMQCC

OB-preeclampsia

Timely treatment for severe hypertension

Treatment within 60 minutes per 100 mothers with preeclampsia and severe hypertension (either Systolic >=160 OR Diastolic >=110)

Women who are treated within 60 minutes with first-line medications (IV labetalol or IV hydralazine or PO nifedipine if IV access has not been established)

All women giving birth ≥20 weeks (birth hospitalization) with a diagnosis of Severe Preeclampsia (Eclampsia (642.6x), Severe Preeclampsia (642.5x), or Preeclampsia superimposed on pre-existing HTN (642.7x)) AND who had severe hypertension (either Systolic ≥160 OR Diastolic ≥110) Exclusions: women with gestational hypertension or chronic hypertension without superimposed preeclampsia (642.0x, 642.1x, 642.2x, or 642.3x)

CMQCC

Page 26: PfP 2014:  Priorities and Expectations

26

Hospital Acquired Pressure Ulcers

2014 Oregon PfP focusCategory Measure

Name Definition Numerator Denominator Source

PU

Pressure Ulcer (MCR FFS) (CMS HAC)

Number of occurrences with a Hospital Acquired Pressure Ulcer at Stage III or IV

Number of occurrences with Pressure ulcer stages III and IV (707.23 (MCC)707.24 (MCC)) as a secondary diagnosis (diagnoses 2-9 on a claim) with a POA code of ‘N’ or ‘U’

Number of acute inpatient discharges

CMS HAC

Page 27: PfP 2014:  Priorities and Expectations

27

• Need to expand to include more classes of surgeries

• Adding procedures: – CABG– Colon– Hysterectomy

• We will be asking you to continue to confer rights in NHSN.

Surgical Site Infections (SSI)

Page 28: PfP 2014:  Priorities and Expectations

28

Surgical Site Infections (SSI)

2014 Oregon PfP focus

Category Measure Name Definition Numerator Denominator Source

SSI

Total Hip Procedures - SSI (in-hospital) (CDC NHSN subset)

Surgical site infection rate among total hip replacement procedures

Total number of total hip surgical site infections based on CDC NHSN definition

All patients having total hip replacement operative procedures

CDC NHSN SSI

SSI

Total Knee Procedures - SSI (in-hospital) (CDC NHSN subset)

Surgical site infection rate among total knee replacement procedures

Total number of total knee surgical site infections based on CDC NHSN definition

All patients having total knee replacement operative procedures

CDC NHSN SSI

SSIColon SSI CDC NHSN SSI

SSIHysterectomy SSI CDC NHSN SSI

SSICardiac/CABG SSI CDC NHSN SSI

Page 29: PfP 2014:  Priorities and Expectations

29

Venous Thromboembolism (VTE) 2014 Oregon PfP focus

Category Measure Name Definition Numerator Denominator Source

VTE

Potentially Preventable VTE (VTE-6)

The number of patients diagnosed with confirmed VTE during hospitalization (not present at admission) who did not receive VTE prophylaxis between hospital admission and the day before VTE diagnostic ordering date

Patients who received no VTE prophylaxis prior to the VTE diagnostic test order date

Patients who developed confirmed VTE during hospitalization

Joint Commission Specifications Manual for National Hospital Inpatient Quality Measures

Page 30: PfP 2014:  Priorities and Expectations

30

Ventilator Associated Pneumonia/ Ventilator Associated Events (VAP/VAE) 2014 Oregon PfP focus

Category Measure Name Definition Numerator Denominator Source

VAP

Ventilator-Associated Pneumonia Rate - All Units (CDC NHSN)

Pneumonias that are ventilator-associated (i.e. patient was intubated and ventilated at the time of, or within 48 hours before, the onset of the event)

Ventilator-associated pneumonia rate (incidence of VAP)

Number of ventilator days (collected daily)

CDC NHSN VAP

VAE

VAC Rate- All Units (CDC NHSN)

Ventilator-Associated Condition (VAC); including those that meet the criteria for IVAC and Possible/Probable VAP rate

Number of events that meet the criteria of Ventilator-Associated Condition (VAC); including those that meet the criteria for IVAC and Possible/Probable VAP rate

Number of ventilator days CDC NHSN VAE

VAE

VAC Rate- All ICU Units (CDC NHSN)

Ventilator-Associated Condition (VAC) in ICU units; including those that meet the criteria for IVAC and Possible/Probable VAP rate

Number of events that meet the criteria of Ventilator-Associated Condition (VAC) in ICU units; including those that meet the criteria for IVAC and Possible/Probable VAP rate

Number of ventilator days in the ICU

CDC NHSN VAE

VAEPossible/Probable VAP Rate- All Units (CDC NHSN)

Possible/Probable VAP rate Number of events that meet the criteria of Possible/Probable VAP

Number of ventilator days CDC NHSN VAE

VAEPossible/Probable VAP Rate- All ICU Units (CDC NHSN)

Possible/Probable VAP in ICU units rate

Number of events that meet the criteria of Possible/Probable VAP in ICU units

Number of ventilator days in the ICU

CDC NHSN VAE

VAE

IVAC Rate- All Units (CDC NHSN)

Infection-Related Ventilator-Associated Condition (IVAC); including those that meet the criteria for Possible/Probable VAP rate

Number of events that meet the criteria of Infection-Related Ventilator-Associated Condition (IVAC); including those that meet the criteria for Possible/Probable VAP

Number of ventilator days CDC NHSN VAE

VAE

IVAC Rate- All ICU Units (CDC NHSN)

Infection-Related Ventilator-Associated Condition (IVAC) in ICU Units; including those that meet the criteria for Possible/Probable VAP rate

Number of events that meet the criteria of Infection-Related Ventilator-Associated Condition (IVAC) in ICU Units; including those that meet the criteria for Possible/Probable VAP

Number of ventilator days in the ICU

CDC NHSN VAE

Page 31: PfP 2014:  Priorities and Expectations

31

Readmissions

2014 Oregon PfP focus

Category Measure Name Definition Numerator Denominator Source

READ

Potentially Preventable Readmissions (PPR)

As calculated by Apprise Health Insights, using 3M algorithm

Number of readmission chains

Number of at-risk readmissions

State-defined measure (Apprise Health Insights)

READ

Readmission within 30 days (All Cause)

Inpatients who were readmitted within 30 days for any reason

Inpatients returning as an acute care inpatient within 30 days of date of discharge

Total inpatient discharges (excludes expired patients)

Based on CMS Hospital Compare measure

Page 32: PfP 2014:  Priorities and Expectations

32

Possible Advanced Options

Things to think about…..

Severe Sepsis/Septic Shock

C-Diff including antibiotic stewardship

Hospital Acquired Acute Renal Failure

Airway Safety

Iatrogenic Delirium

Procedural harm (pneumothorax, blood)

Undue Exposure to radiation

Failure to Rescue

Culture of Safety (patient/ worker)

Expanding outreach to community for all topics

Page 33: PfP 2014:  Priorities and Expectations

Optional Sustainability Measures

• New sustainability measures are available• These optional measures may be valuable

for:– CAHs – Rural Hospitals– Hospitals that have sustained 0’s for extended

periods of time– Any organization interested in tracking their

progress

33

Page 34: PfP 2014:  Priorities and Expectations

34

Oregon Lean

We are offering Lean in 2014 through Purdue Healthcare Advisors• Additional green belt training (2 days)• New! Black Belt training (1 day)

Monthly Lean webinarsMonthly office hours with Purdue trainers

Page 35: PfP 2014:  Priorities and Expectations

35

Other Resources

• Resources coming later to address– Disparities– Optional topics– Listserv updates

Page 36: PfP 2014:  Priorities and Expectations

36

Resources

• HRET – HEN website: www.hret-hen.org including private side – Top Ten Process Checklists/posters– HRET PfP Change packages– HRET webinars/boot camps

• OAHHS – OAHHS improvement advisor– PfP advisory committee – PfP newsletter– PfP website: www.oahhs.org/quality/initiatives/partnership-for-patients

Page 37: PfP 2014:  Priorities and Expectations

37

Travel Funds

• We will provide assistance for travel to in-state PfP & Improvement Leader Fellowship meetings

• Details pending

Page 38: PfP 2014:  Priorities and Expectations

38

Next Steps

• Submit your 2014 commitment form ASAP• Submit baseline data for new measures• Continue to submit data on all harms

monthly• Continue improvement work in all areas to

strive for the 40/20 goal

Page 39: PfP 2014:  Priorities and Expectations

39

OREGON PFP LEADERSHIP TEAM:

• Diane Waldo, director of quality and clinical services

[email protected] 503.479.6016

• Jodie Elsberg, associate director of [email protected] 503.479.6028

• Lyndsey Shaver, quality coordinator [email protected] 503.479.6022


Recommended