Patient/Family Centered Safe Care Putting Patients First 40/20 by ‘13

Patient/Family Centered Safe Care

Putting Patients First 40/20 by ‘13

What Executive Leaders Need to Know About

Patient/ Family Safe Care

Learn. Act. Improve. Spread. Keep the Drum Beat Going.22

HHS Partnership for Patients (PfP)

The Partnership for Patients has set an ambitious goal for all U.S. hospitals: reduce preventable

all-cause harm rates by 40% and readmissions by 20% in our organization by the end of 2013.


Partnership for Patients: A Movement

Our hospital is part of a national movement for the triple aim to Put Patients First and make patient care: • safer• more reliable• less costly


As part of PfP Our Hospital Pledges To:

• Make achieving the goals of Putting Patients First, harm reduction and improved care transitions to reduce readmissions a priority of our Board of Directors, senior leaders, clinicians, and staff;

• Support clinicians and staff • Engage patients and families in order to make care safer,

improve communication, and increase coordination by implementing proven systems and processes; and

• Learn from and share with others our experiences with Putting Patients First, making care safer and more coordinated.


Aim: To Reduce All Cause Harm

All preventable harm must be addressed to reach the goal but these are the areas of focus to begin: (Hospital can star their priorities) • Adverse Drug Events (ADE)• Catheter-Associated Urinary Tract Infections (CAUTI)• Central Line Associated Blood Stream Infections (CLABSI)• Injuries from Falls and Immobility• Obstetrical Adverse Events (First: Early Elective Deliveries) • Pressure Ulcers• Surgical Site Infections• Venous Thromboembolism (VTE)• Ventilator-Associated Pneumonia (VAP)• Reducing preventable readmissions

Learn. Act. Improve. Spread. Keep the Drum Beat Going.

Putting Patients First: 40/20 by ‘13Georgia Hospital Engagement Network Program for the PfP

Goals: Change culture to be

Patient Focused, Staff Driven

Reduce hospital acquired conditions by 40%

Reduce readmissions by 20%

Increase patient/family engagement

Reduce all cause harm


Safe Care Not Only Important to Our Patients…. but also to Hospital Success

Payment for care is now based on quality not volume• Value Based Purchasing

– Medicare payment incentives/penalties to promote:• Achievement/Improvement of high quality care• Annual Market update increased or reduced beginning up to 2% by 2017

– Payment based on quality measures and Patient satisfaction (HCAPHS)– Better scores = higher payments, low scores = lower payments

• Nonpayment for Hospital Acquired Conditions– Higher payment withheld if condition not present on admission

• Payment penalties for excessive readmissions


The Hospital's Reputation is Transparent

• Public Reporting of Quality and Patient Satisfaction Scores• Patients/families using Social Media to discuss care


Where We Are Today

Show Hospital's Quality Data(You can obtain hospital data from PHA web site .Contact your Quality Director for instructions and password or contact Faizah Muheb [email protected])


Our Hospital's Goals

• (Consult with your Quality staff for goals. Quality director can consult with PHA staff for assistance in developing your goals).


The Costs If We Do Not Meet Our Goals

• Patients Will Be Harmed• Provide VBP Report on hospital’s projected payment • Provide data on HAC cost(You can obtain hospital data from PHA web site .Contact your Quality Director for instructions and password or contact Faizah Muheb at [email protected]. )

mailto:[email protected]


In Order to Provide Patient/Family Centered Safe Care Everyone Must:

Work Together to Promote: Patient/Family focus and engagement Boundarilessness, seamless care Unconditional team work Speed and agility of change Decreased cycle time to improvement Repetition, testing, and evolving in real time Reliability, standardization and spreading what works

If you’re not working together, you’re not doing your job!


Leaders Must Create A Patients First Culture

• Align Goals• Align Behavior• Align Processes

Hold everyone accountable and spread a culture of accountability throughout the organization

Learn. Act. Improve. Spread. Keep the Drum Beat Going.

Leadership - Execution FrameworkEvidence-Based LeadershipSM

Standardization AcceleratorsMust Haves®

Performance Gap

Objective Evaluation

System

Leader Development

Foundation

STUDER GROUP®:

Agreed upon tactics and behaviors to achieve goals

Re-recruit high and Middle/solid performers

Move low performers up or out

Processes that are consistent and standardizedProcess Improvement

PDSALeanSix Sigma Baldrige Framework

Software

Aligned Goals Aligned Behavior Aligned ProcessCreate process to assist leaders in developing skills and leadership competencies necessary to attain desired results

Implement an organization-wide staff/leadership evaluation system to hardwire objective accountability (Must Haves®)

Rev 4.8.11

Breakthrough


Two Step Process

• The Why: – When everyone sees their role and their importance in being

accountable for Safe Patient Care they are truly engaged• The How:– Evidence shows that partnering with and supporting staff

with tools and resources, especially RNs, leads to better patient outcomes and higher patient satisfaction

– Let us know what tools and resources are needed to meet the goals

– Hold everyone accountable for outcomes


Alignment of Goals and Staff To Put Patients First

• Align Goals– Putting Patients First is a strategic goal– Clearly and frequently voicing the goals – Executive Rounding (assessing how things are going, what

is working and resources needed)• Align Behavior– Manager Rounding– Performance Evaluation


Align Processes to Put Patients First (Include QI approach tools your hospital uses)

• PDSA• Reliable Systems Design• Comprehensive Unit-Based Safety Program (CUSP)

• Daily Patient Goals• Learning from Defects

• TeamSTEPPS• Huddles • Briefs/Debriefs • SBAR• CUS (Speaking Up)

• Lean/Six Sigma• Other Quality Processes

– Hourly Patient Rounding– Bedside Report


Leader Actions Are Key to Success

• We already have successes to celebrate!• Our Vision and goals include (add statements related to quality care)• Our Expectations are communicate to employees through (add

methods)• Accountability is re enforced through rounding and listening to

everyone from frontline staff to environmental services etc.• We provide support for the work

– How can time and resources to do the work be improved?– Rounding, asking staff about the improvement, knowledge, what is needed

• Assess progress and measures through regular review at key meetings• Feedback to staff, highlight, celebrate and spread success


Leading the Way to Patient/Family Safe Care

• What is your perception of Board and leadership commitment-how can it be strengthened?

• What more can we do to create energy and urgency by defining success and identifying clear goals and timelines

• How can the WILL to execute be demonstrated more?• Our expectations are for a fast-moving, iterative work

environment-how can you help with that?• Identify potential staff “champions”, physician and

community “champions”


Teams Will Get Us to Better Care

• Improvement teams will be used and supported by leaders to address focus areas of harm – give me ideas for team leaders

• We are tasking our quality teams to measure results quickly and report them back to hospital staff and partners

• Communicate to executive leaders needs related to the performance improvement skills and knowledge of staff


You Are Key in Putting Patients First

• Lead the Patients First movement in our hospital – create a sense of urgency

• Become a partner with all senior leaders, physicians, other leaders/managers, staff and patients to be relentless about putting patients first

• Look for good candidates to involve as patient advocates• Include our patients and their families in all of our

interactions regarding their care-rounding is mandatory if you work here

• Evaluate and communicate what additional support and resources are needed for teams to improve care and increase efficiency


Create An Environment to Put Patients First

• Provide a Just Culture where errors and near misses are freely reported and learned from to prevent patient harm

• Sustain an environment where everyone can speak up for Safe Patient Care

• Hold all in the organization accountable for safe patient care• Support an environment where everyone can speak up for Safe

Patient Care


All Hands on DeckFocusing on Our North Star – the Patient


Renew Your Sense of Purpose

When we do what’s right for the patient the numbers will follow…..


Hospital Executive Team Takes the Putting Patients First Pledge

We pledge to:• Make achieving the goals of Putting Patients First, harm

reduction and improved care transitions to reduce readmissions priority of our Board of Directors, senior leaders, clinicians, and staff;

• Support and working each other in engaging patients and families in order to make care safer, improve communication, and increase coordination by implementing proven systems and processes; and

• Learn from and share with others our experiences with Putting Patients First, making care safer and more coordinated.

Patient/Family Centered Safe Care Putting Patients First 40/20 by ‘13

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