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Kentucky Hospital Improvement
Innovation Network
February 2019
Agenda
1. Welcome!
2. K-HIIN Data/Info: VAE: VAC, IVAC
3. Deb’s Info-Nuggets: VAE
a) VAE Information from Deb Campbell
b) Hospital Highlight – Baptist Health Madisonville
c) Hospital Highlight – Methodist Hospital
d) Hospital Highlight – Saint Joseph London
e) Hospital Highlight – TJ Samson Health
4. Follow up Report – Wound Care Certification Course
5. Upcoming Events
a) KHA Quality Conference – Next Week!
b) K-HIIN Webinars and Events
c) HRET HIIN Webinars
6. Questions and Wrap Up
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VAE -1 VAC Rate
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VAE-1 Ventilator-Associated Condition
K-HIIN Rate HRET Rate K-HIIN Baseline HRET Baseline K-HIIN Goal
VAE-2 IVAC Rate
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3.5
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VAE-2 Infection-Related Ventilator-Associated Complication
K-HIIN Rate HRET Rate K-HIIN Baseline HRET Baseline K-HIIN Goal
VAE Sprint
HRET HIIN VAE Sprint
December 2018- February 2019
4 content webinars
Pre and post assessments
Use of a Process Discovery Tool
1-2 Coaching Calls with Deb C
Provision of supporting literature, toolkits, order set examples, etc.
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VAE Sprint
• Participating Hospitals
–Baptist Health Madisonville
–Hardin Memorial Health
–Methodist Hospital
–St. Joseph Hospital London
–TJ Regional Health Glasgow
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VAE Sprint
Kentucky VAE mini-sprint
*Invitations went out the week of 2/4/19
– Encourage use of Process Discovery Tool
– Offer support material
– Offer coaching calls/visits
– Focuses on ACTUAL gaps
– Provides documentation
of need for change
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VAE Sprint Report Out Baptist Madisonville
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• Opportunities for improvement found from the mini-RCA:
a. Subglottic suction ETT
b. Daily coordinated SAT & SBT
c. Delirium screen each shift
• Intervention(s) chosen to work on:
a. Daily coordinated SAT & SBT
c. Delirium screen each shift
• Small test of change performed:
a. Discussed Delirium screen with a few nurses
b. Daily coordinated SAT & SBT discussed with Nurse and Resp. Therapy
• what we Learned:
a. documentation issue – SAT & SBT - reeducation , auditing
b. Systems & UBC working on implementing Delirium screen
• Current state:
– Continuing to work on implementing Delirium screen
– Working on education for staff and Providers on ABCDEF bundle, VAE drill down, monitoring audits
– Requesting additional Transport monitor
– Purchased a chair - the Sara Combilizer – and are working with PT on Early Mobility Program
VAE Sprint Report Out Methodist Hospital
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• What did you find from your mini-RCAs?
No consistent SBT or SAT
Consistent use of benzodiazepines
No sedation boluses prior to infusions
Portable ventilator not utilized
Very little patient/family involvement at hand off
VAE Sprint Report Out Methodist Hospital
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• What intervention(s) did you choose?
Education of importance of portable ventilator use
Will set up default time for SBT and SAT Patient/Family engagement during report and
included in patient care.
VAE Sprint Report Out Methodist Hospital
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What small test of change did you
perform and what did you learn?
Currently getting our processes finalized to send to our Critical care committee’s and our nursing practice council. Have the names of Nurses and respiratory therapies for Champions and will have a request for physician Champion at the next meeting.
VAE Sprint Report Out Methodist Hospital
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• Current State?
Talk and more talk. Trying to get the staff involved and excited regarding upcoming changes. The reason for change and how it will benefit our patients. Just one prevented VAE will make it worth it.
VAE Sprint Report Out Saint Joseph London
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Report using the ABCDEF bundle
• E: Need for increase in patient activity while on vent
• C: Decrease in sedation use(Benzos)
• Discussion between general surgery and pulmonology
• Future efforts: trial subglottic suctioning
VAE Sprint Report Out TJ Samson
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• What did you find from your mini-RCAs?
– Found SAT / SBT protocol already created not in use.
– Respiratory doing SBT only when ordered
– Nursing doing SWT (not constantly documented)
– Found a timing issue (one time not good for RT another time not good for RN)
• What intervention(s) did you choose?
–Respiratory to initiate protocol daily and collaborate with nursing
VAE Sprint Report Out TJ Samson
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• Current state?
• Currently 100% on SAT / SBT protocol unless Pulmonologist states otherwise
• Looking into the subglottic suction ETT
Events – Wound Care Certification Course!
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Upcoming Events – K-HIIN and in-state
1. KHA Quality Conference is Next Week! Hopefully many of you are already registered and set to attend.
a) Wednesday 3/6, 12noon-5pm – Leadership, Teamwork, and Workplace Violence information for Leaders, Poster Session and Reception 5pm-6pm
b) Thursday 3/7, 8am-4:30pm – Clinical and HIIN topics including Sepsis, CAUTI, U/S Infection Prevention, Patient and Family Engagement, and Readmissions
c) Friday 3/8, 8am-1:30pm – Opioid Crisis and Stewardship, Antimicrobial Stewardship, Caring for Disruptive Patients
Holiday Inn Louisville East
We will also be celebrating the progress we’ve/YOU’VE made so far and talking about Why We’re HIIN!
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Upcoming Events cont’d. 2. February 27-28, 2019 – Kentucky IP Conference:
Contemporary Topics in Infection Prevention, Hilton Lexington/Downtown, see Andrea Flinchum for details
3. March 19-21, 2019 – CHEST Train the Trainer Course, Saint Joseph Office Park, Chase Room, Building D, Lexington, class closed
4. HRET HIIN Readmissions MVP Webinar #6, March 1, 12 noon – 1pm ET
5. HRET HIIN Post –Op Sepsis SNAP Final Summary Webinar, March 6, 12noon- 1pm ET
6. HRET HIIN CAUTI Fishbowl #4, March 12, 12 noon-1pm ET
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Upcoming Events cont’d.
7. HRET HIIN VTE PFE SNAP Final Summary Webinar,
March 18, 2pm-3pm ET
8. HRET HIIN Readmissions MVP Webinar #7, March 22, 12 noon – 1pm ET
9. Antibiotic Stewardship: Conquering Measurement, March 22, 1:30pm – 2:30pm ET
10. HRET HIIN HAPI PFE Sprint Wrap-Up Summary Webinar, March 27, 1:30pm – 2:30pm ET
To find and register for these webinars, go to
www.hret-hiin.org/events/index.dhtml
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Upcoming Events – K-HIIN and in-state
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Upcoming Events cont’d.
The March K-HIIN Monthly Update Webinar will be held on March 27, at 11am ET
Topic: Readmissions, and hopefully information about
Option Year!!
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More K-HIIN Opportunities--
• TeamSTEPPS workshops are available! Contact us if you are interested in a Master Trainer Workshop or an Essentials course at your hospital!
• Patient Safety Hero – who do you need to recognize??
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Kentucky Hospital Improvement Innovation Network
Thanks for being part of our team!
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Timeline and Next Steps
• Continue entering Monitoring Data into KQC
• Join the events as your schedule allows
>
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KEEP
CALM
AND
HIIN
ON
Questions?
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