MA Safe Care InitiativeMA Safe Care InitiativeCUSP-CLABSI-CAUTiCUSP-CLABSI-CAUTi

December 15, 2011December 15, 20118:00 am – 4:00 pm8:00 am – 4:00 pm

Meeting Objectives

Build skills among care team members that will improve teamwork, communication, and create a patient safety culture in your unit

Hear from local and national experts the strategies to eliminate CLABSI, and ensure that improvements can be sustained

Learn strategies to prevent Catheter Associated Urinary Tract Infections (CAUTI)

CUSP and CLABSI Interventions

Improving the culture of safety:

1. Educate on the science of safety

2. Identify defects

3. Learn from defects

4. Assign executive to adopt unit

5. Implement teamwork tools

CUSP CLABSI

Primarily technical interventions:

• CVC line insertion

• CVC line management

Communication Among Care Providers:Percent Understanding Patient Care Goals

00.10.20.30.40.50.60.70.80.9

1

1 2 3 4 5 6

ResidentsNurses

5

Perc

ent u

nder

stan

ding

pati

ent c

are

goal

s

Daily Goals

Impact of Daily Goals on ICU Length of Stay

0

0.5

1

1.5

2

2.5

June

July

August

Sept

Oct

Nov Dec Jan

Feb

Mar

chApril

May

Avg

. LO

S (d

ays)

ICU LOS

6

654 New Admissions = $7 Million Additional Revenue

Daily Goals

Culture of Safety- Michigan

0

10

20

30

40

50

60

70

80

90

100

2006

2004

Teamwork Climate Across Michigan ICUs

 

0

10

20

30

40

50

60

70

80

90

100

2006

2004% o

f res

pond

ents

with

in a

n IC

U re

porti

ng g

ood

safe

ty c

limat

e

Safety Climate Across Michigan ICUs

Culture of Safety- Michigan

20 40 60 80% Reporting Good Teamwork Climate

0

10

20

30

40

50

RN

Tu

rno

ver

in Y

ear

1

1# R

Ns

wh

o le

ft t

he

ICU

RN Turnover and Teamwork Climate: 26 Keystone ICUs reporting

r=-.650, r=-.650, p<.001p<.001

Time period Median CLABSI rate

Baseline 2.7

Peri intervention 1.6

0-3 months 0

4-6 months 0

7-9 months 0

10-12 months 0

13-15 months 0

16-18 months 0

Pronovost NEJM 2006

2 yr CLABSI Results from ICUs in Michigan

4 yr CLABSI Results from ICUs in Michigan

Time period Median CLABSI rate

19-21 months 0

22-24 months 0

25-27 months 0

28-30 months 0

31-33 months 0

34-36 months 0

Pronovost BMJ 2010

Results

Lives Saved – 1,729*

Patient Days Saved – in excess of 127,000*

Dollars Saved – 0ver $246 Million*

Culture of Safety improved 28%

Teamwork improved 15%* Based on the Johns Hopkins Opportunity Estimator

Massachusetts Teams

Current Teams Baystate Medical Center Berkshire Medical Center Fairview Hospital Jordan Hospital Melrose Wakefield Hospital Marlborough Hospital Morton Hospital & Medical

Center Mount Auburn Hospital Noble Hospital Tufts Medical Center

New TeamsBay state Franklin Medical CenterBaystate Mary LaneCambridge Health Alliance Harrington Hospital Holyoke Medical CenterNew England Baptist HospitalSouthcoast Hospitals Group Spaulding Rehabilitation Network (CAUTI)

Framework for MA ICU Safe Care Initiative Improvement Collaborative

MHA and Coalition Work together as state leads Recruitment of hospital teams and resources to the teams State “hub” for managing ongoing participation and improvement

Role of National Project Team Two Year Collaborative for each cohort Data Collection – CareCounts website Improvement

Monthly Content Calls Monthly Coaching Calls

Resources at:

www.onthecuspstophai.org/Stop-7611.html

CLA - Blood Stream InfectionMassachusetts

10/1/2009 - 10/31/2011

CLA - Blood Stream InfectionMassachusetts cf. CUSP nationally

10/1/2009 - 10/31/2011

CUSP - Preventing CLABSI – Preventing CAUTI

Coordinating related work in Massachusetts CUSP/CLABSI CMS/HRET –

Safety culture Preventing CLABSI Preventing CAUTI

Masspro Scope of work – CUSP/CAUTI

The QIO Program is the largest federal program dedicated to improving health quality

at a community level. Independently contracted QIOs are in every state and

territory, united in a network administered by CMS and have the flexibility to respond to

local needs.

MASSPROA Quality Improvement

Organization

Improve Individual Patient CareReducing Healthcare Acquired

Infections(HAI)

The MASSPRO Learning and Action Network provides hospitals throughout Massachusetts with the opportunity to come together to learn and share the latest evidence-based measures to prevent HAIs.

CAUTI (catheter associated urinary tract infection) is MASSPRO’s initial focus of this initiative.

The Benefits…

Recognition as a facility dedicated to improving patient outcomes

Receive facility specific data and analytical reports

HAI surveillance can be incorporated into existing HAI teams

Utilize participation with this initiative as part of your implementation strategy to comply with The Joint Commission’s 2012 NPSG 07.06.01. catheter associated urinary tract infections. The Joint Commission plans full implementation of this NPSG as of January 1, 2013

The Benefits…