Collaborative Effort by mikesanye

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									                 Ohio Children’s Hospitals SPS Learning Network Update – What You Need to Know October/November 2010
Collaborative        What we are Trying to Accomplish               Key Contacts                                           Key Deliverables Update
    Effort
SSI – Surgical     AIM: Pursue zero surgical site infections in   Leader – Anne         Current Rate – 1.2 SSI’s/100 Cases (As of October 2010)
Site Infection     designated cardiac, neurosurgery,              Lyren, MD
Reduction          orthopedic procedures                          Rainbow Babies        Key Decisions:
                                                                  anne.lyren@uhhosp          Collaborative level sustainability goals:
                   July through December 2010 Goals               itals.org                     o SUSTAIN Rate of 1.7 SSI’s per 100 cases without any special cause
                    100% Reliability with Re-Dosing of           216-844-8651                  o SUSTAIN % of reliability with initial antibiotic timing at 97% per 100 cases without
                        Antibiotics across all 8 hospitals.                                         special cause
                    100% of hospitals achieve their                                            o SUSTAIN % reliability with re-dosing of antibiotic timing at 83% per 100 cases
                        AIM/Goals related to “1 other hospital                                      without special cause
                        specific area”                                                       SSI Sustain Leader – Dr. Dennis Cunningham of Nationwide Children’s Hospital will lead
                    Achieve or Sustain 100% Reliability                                        the SSI work during the sustain phase.
                        with the “Basic Care Bundle”
                                                                                        Next Steps:
                                                                                             Each hospital will report out on 12/31/2010 milestone goals during the last workgroup
                                                                                                call in January 2011. The January call will close out the current work.
                                                                                             Sustainability Planning – quarterly sustainability calls will take place throughout 2011 to
                                                                                                check in with teams and keep track of progress in sustain mode.

                                                                                        Reminders:
                                                                                            Teams (Quality Improvement Staff and/or Team Leader) need to submit Monthly Report
                                                                                                                                                                   th
                                                                                               (including Key Driver Diagram, Latest Data, PDSA Cycles, etc.) by 15 of the month to
                                                                                               Jason Olivea.
                                                                                            There are no workgroup calls in November or December. The final workgroup call will
                                                                                               take place on January 25, 2011 from 9-10am.

                                                                                        Point of Interest:
                                                                                             Please note that OCHSPS SSI Leaders are planning a rationale document to remove shunt
                                                                                                 revisions from Ohio Public Reporting for Surgical Site Infections. This document will be
                                                                                                 presented and discussed at the Hospital Measures Advisory Council on December 10,
                                                                                                 2010 in Columbus Ohio. Anne Lyren and Dennis Cunningham will participate in the
                                                                                                 meeting via teleconference and will advise us after the meeting whether the reporting
                                                                                                 for the state and OCHSPS can be aligned.
ADE – Adverse      AIM: Eliminate injury or harm to any child     Leader – Mike Bird,   Current Rate – 13 ADE’s/1000 patient days (As of October)
Drug Event         due to preventable adverse drug events by      MD

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            Ohio Children’s Hospitals SPS Learning Network Update – What You Need to Know October/November 2010
Reduction     March 2012 (i.e., accomplish a 33%               Akron Children’s   Key Decision(s):
              reduction each year for 3 years; initial focus   Hospital                Collaborative level sustainability goals:
              opiate over sedations)                           mbird@chmca.org            o SUSTAIN Rate of 13.4 ADE’s per 1000 patient days without any special cause
              July through December 2010 Goals                 330-543-8296               o SUSTAIN Rate of 4.0 Constipation Events per 1000 patient days without special
                                                                                                cause
                 50% Reduction of events of opiate                                       o SUSTAIN Rate of 0.8 Naloxone Events per hospital without special cause
                  related constipation and Reduction of                                ADE Sustain Leader – Dr. Rick McClead of Nationwide Children’s Hospital will lead the
                  Overall ADE rate by an additional 9%                                    ADE work during the sustain phase.
                  by 8/30/2011                                                    Next Steps
                 50% Reduction of Opiate Related Over                                 Each hospital will report out on 12/31/2010 milestone goals during the last workgroup
                  Sedations by 12/31/10                                                   call in January 2011. The January call will close out the current work.
                                                                                       Sustainability Planning – quarterly sustainability calls will take place throughout 2011 to
                                                                                          check in with teams and keep track of progress in sustain mode.

                                                                                  Reminders:
                                                                                   Teams (Quality Improvement Staff and/or Team Leader) need to submit Monthly Report
                                                                                                                                                         th
                                                                                     (including Key Driver Diagram, Latest Data, PDSA Cycles, etc.) by 15 of the month to Jason
                                                                                     Olivea. Many teams did not submit their Monthly Reports in September.
                                                                                   There are no workgroup calls in November or December. The final workgroup call will take
                                                                                     place on January 27, 2011 from 1-2pm.




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               Ohio Children’s Hospitals SPS Learning Network Update – What You Need to Know October/November 2010

Eliminating      Global Aim:                                      Leader –           Key Decisions:
Serious Harm     Eliminate all Serious Harm across the 8 Ohio     Rich Brilli, MD,    To be consistent, participants at the 10/25 Planning Meeting agreed to coordinate all of the
                 Children’s Hospitals                             Nationwide             new work under the heading, ‘Eliminating Serious Harm.’ A New organizational chart and
                                                                  Children’s             charter were developed to reflect the streamlined approach.
                                                                  Hospital
                 Strategic Aim1:                                                        There was consensus to create an OCHSPS High Reliability Organization (HRO) Leadership
                  To reduce the number of State                   Steve Muething,        Group to guide the Eliminating Serious Harm work. Members of the group are listed in the
                 wide Serious Harm Events by 50                   MD                     leader column.
                 % by 12/31/13. Then further                      Cincinnati
                 reduce the number by a total of                  Children’s            All 8 hospitals have agreed to the following SERIOUS Harm Index Domains:
                 95% by 12/31/15.                                 Hospital and                o Blood Stream Infections
                                                                  Medical Center              o Urinary Tract Infections
                 Strategic Aim 2:                                                             o Pressure Ulcers (Severity 3-4)
                 To reduce the 12 month rolling average rate of   Anne Lyren, MD              o Serious Falls
                 SSE’s by 50% from the highest rate detected in   Rainbow Babies              o Ventilator Associated Pneumonia
                 the first year of measurement across the 8                                   o Serious Safety Events
                 Ohio Children’s Hospitals by 12/31/12. Then      Mike Bird, MD               o Codes outside the ICU
                 further reduce the rate by a total of 75% by     Akron Children’s            o Adverse Drug Events (Severity 6-9)
                 12/31/15.                                        Hospital                    o Surgical Site Infections
                                                                                        All 8 hospitals have agreed to the following ALL Harm Index Domains:
                                                                  Lori Ferguson               o Blood Stream Infections
                                                                  Toledo                      o Urinary Tract Infections
                                                                  Children’s                  o Pressure Ulcers (Severity 2-4)
                                                                  Hospital                    o Infiltrates (PIV) (Severity 2-4)
                                                                                              o Serious Falls
                                                                  Terry Davis, MD             o Ventilator Associated Pneumonia
                                                                  Nationwide                  o Serious Safety Events
                                                                  Children’s                  o Codes outside the ICU
                                                                  Hospital                    o Adverse Drug Events (Severity 5-9)
                                                                                              o Surgical Site Infections
                                                                  Vera Hupertz,
                                                                  MD                    By November 19, 2010 all of the HPI Diagnostic prep calls with individual institutions will
                                                                  Cleveland Clinic       have taken place.


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             Ohio Children’s Hospitals SPS Learning Network Update – What You Need to Know October/November 2010
                                                                  Thomas Murphy,        Thus far, the multi-day Diagnostic Assessments with HPI are scheduled as follows:
                                                                  MD                         o Akron Children’s – December 6-9, 2010
                                                                  Dayton                     o Dayton Children’s – January 4-7, 2011
                                                                  Children’s                 o Rainbow Babies – January 18-21, 2011
                                                                  Hospital                   o Cleveland Clinic – January 24-27, 2011
                                                                                             o Mercy – February 1-2, 2011
                                                                  Carole Wise                o Toledo Children’s - TBD
                                                                  Dayton
                                                                                     Next Steps:
                                                                  Children’s
                                                                                      Finalize dates for HRO Leadership Meeting in mid December and monthly throughout 2011
                                                                  Hospital
                                                                                       In December, HRO Leadership group will determine :
                                                                  Charla Ulrich               o Final Harm Index definitions
                                                                  Mercy Medical               o What data to collect
                                                                                              o How to collect the data
                                                                  Center
                                                                                              o Develop data collection methodology
Assessing        Research Aims:                                   Project Manager    Hospital Interviews
Organizational   1. Determine the extent to which each            – Brooke Mullett      As of 11/19 all hospital interview will be completed
Capacity for         organization succeeds in achieving the       Cincinnati
                                                                                     Next Steps:
Improvement          improvement goals expected from              Children’s
                                                                                      Boston University Staff will have Individual Hospital Feedback Sessions with each site by the
                     implementing the OCHSPS patient safety       Hospital &
                                                                                         end of the year.
                     initiatives - ADE and SSI                    Medical Center
                                                                  Brooke.mullett@
                                                                                     Aggregate Results:
                 2.   Identify facilitators and barriers that     cchmc.org
                                                                                      On January 7, 2011 members from the Boston University team will present the aggregate
                      contribute to the success or failure of     513-803-2108
                                                                                         results to OCHSPS leaders and staff.
                      each organization with a focus on the
                      organizational components of the OTM –
                      Organizational Transformation Model

                 3.   Determine the extent to which hospitals
                      characterized by concordance with
                      elements of the OTM are better able to
                      meet their goals. Determine the extent to
                      which implementation of the two OCHSPS
                      patient safety initiatives impact the
                      capacity for transformational change.

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             Ohio Children’s Hospitals SPS Learning Network Update – What You Need to Know October/November 2010

Overall         We are working collaboratively across the      Leader – Nick Lashutka                               What’s New:
Learning        state to eliminate serious harm in Ohio’s      Ohio Children’s Hospital Association                  Learning Session 5 – On November 12, the last learning
Network         children’s hospitals and in the course of      nlashutka@ohiochildrenshospitals.org                    session for the SSI and ADE work took place. Teams shared
                doing so, make Ohio the safest place in the    614-228-2844                                            successes and their sustain plans for continuing the
                country for children to receive health care.                                                           improvement work indefinitely. Also, LS5 served as a
                In addition, we hope to reduce the overall     Quality Improvement Consultant – Jason Olivea           jumping off point for introducing the Eliminating Serious
                cost of health care in the state, develop an   Cincinnati Children’s Hospital & Medical Center         Harm work and teams learned more about the new work
                ongoing learning network, and build a          Jason.olivea@cchmc.org                                  from collaborative leaders and representatives from HPI,
                sustainable state-wide infrastructure that     513-636-5497                                            the consultant group performing diagnostic assessments at
                makes Ohio the national leader in pediatric                                                            each site.
                quality and safety                             *Project Manager – Missy Shepherd
                                                               Cincinnati Children’s Hospital & Medical Center         MOC’s (Maintenance of Certification Credits): Our Current
                                                               Melissa.shepherd@cchmc.org                               Work (ADE and SSI Improvement) are on a wait list for
                                                               859-802-1092                                             MOC’s via Cincinnati Children’s Hospital Medical Center’s
                                                                                                                        Portfolio for 2011. We surveyed participating physicians
                                                               Project Specialist – Abbie Chandler                      and none of their certification’s were up for renewal in
                                                               Cincinnati Children’s Hospital & Medical Center          2010. Therefore, we are working towards providing MOC’s
                                                               Abigail.Chandler@cchmc.org                               for 2011.
                                                               513-803-2223
                                                                                                                    Upcoming Events:
                                                               Data Analyst – Tracey Bracke                          Learning Network Meetings – dates are being identified for
                                                               Cincinnati Children’s Hospital & Medical Center         scheduling quarterly face-to-face Learning Network
                                                               Tracey.bracke@cchmc.org                                 meetings in 2011
                                                               513-803-0784
                                                                                                                     Tentatively, there is a Pediatric Quality Summit for the CEOs
                                                               SPS Project Website:                                    and other cabinet members scheduled for March 4, 2011
                                                               http://ohio-childrens-
                                                               collaborative.qiteamspace.com/



  *Missy Shepherd is the Main Point of Contact for the Collaborative – If you have questions about any aspect of the project, you can contact Missy and if she doesn’t have the
  answer, she will find the answer.


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