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American Hospital Association (AHA)/ Health Research & Educational Trust (HRET) Hospital Engagement Network (HEN)

American Hospital Association (AHA)/ Health Research & Educational Trust (HRET) Hospital Engagement Network (HEN). National Improvement Leader Fellowship (ILF) Wednesday April 16, 2014. AHA Disclaimer.

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American Hospital Association (AHA)/ Health Research & Educational Trust (HRET) Hospital Engagement Network (HEN)

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  1. American Hospital Association (AHA)/ Health Research & Educational Trust (HRET) Hospital Engagement Network (HEN) National Improvement Leader Fellowship (ILF) Wednesday April 16, 2014

  2. AHA Disclaimer Participation in this webinar is by express written invitation of the AHA only. Unauthorized participants and/or any party that assists unauthorized participants may be subject to substantial criminal and civil penalties. If you have not been invited to take part in this webinar, please disconnect at this time.

  3. AHA/HRET (HEN) Improvement Leader Fellowship (ILF) Live virtual webinar– Summary Disclosure & Accreditation Stmt. April 16, 2014 The planners and faculty of the AHA/HRET (HEN) Improvement Leader Fellowship (ILF) have indicated no relevant financial relationships to disclose in regard to the content of this activity. This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical education through the joint sponsorship of the American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) and the Health Research & Educational Trust. ABQAURP is accredited by the ACCME to provide continuing medical education for physicians. The American Board of Quality Assurance and Utilization Review Physicians, Inc. designates this live activity for a maximum of 2.0 AMA PRA Category 1 Credits.™ Physicians should only claim credit commensurate with the extent of their participation in the activity. The American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) is an approved provider with the Florida Board of Nursing to provide continuing education for nurses. ABQAURP designates this activity for 2.0 Nursing Contact Hours through the Florida Board of Nursing, Provider # 50–94. CMEsolutions is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This program is approved for 2.0 contact hours (.20 CEUs). ACPE Program Number: 0274-9999-14-011-H04-P.

  4. Overview of Today Live-streamed from Florida: • 1:00 – 1:15 PM CST: Welcome • 1:15 – 1:45 PM CST: Governance and Leadership, Hospital Speakers Virtual Environment: • 1:45 – 2:45 PM CST: Leadership and A Culture of Safety • 1:45 – 2:00 PM CST: Fieldwork and Closing

  5. WebEx Quick Reference Please use Chat to “All Participants” for questions For technology issues only, please Chat to “Host” Raise your handto unmute your line To make a comment, select “All Participants” Enter Text

  6. To download the selected presentation, begin here. Downloading a given presentation to your electronic device

  7. Select Save or Save As, then document.

  8. Click Save Choose .pdf format. Name file

  9. Presentations and Materials For all Fellowship materials, visit the Fellowship section on the private side of the AHA/HRET HEN website hret-hen.org

  10. Continuing Education Units • 1 hourof the virtual event attended • Following the session an email sent to all registered participants with instructions • Email sent by Hospital Engagement Network (hen@aha.org) • Check any spam or junk folders if you do not receive the instructions • Complete the ABQAURP survey listed in the email

  11. Continuing Education Units: Viewing as a Group

  12. Continuing Education Units: Viewing as a Group • Complete “CME/CEU Event Group Listing” form • Username and password required • List name and email address for each individual who viewed the offering • Submit to Jamal Turner (jturner@aha.org) no later than 24 hours after the event • Include “Group Listing” in the subject line • Expectation that the group facilitator meets the 1 hour viewing requirement

  13. AHA/HRET Hospital Engagement Network National Improvement Leader Fellowship Florida & Alabama LIVE STREAMED April 16, 2014

  14. Objectives • Welcome/Overview • Overview of the 2014 National ILF • Highlight numbers and successes • Introduce the AHA/HRET Governance Video Series, resources and tools • Governance/Senior Leadership • Discuss the role of the Board in eliminating Harm Across the Board (HAB) and improving patient care • Review how the Board and senior leadership at local hospitals • Explain leadership behaviors that support a culture of safety • Call to action - specific areas of focus • Energy, ideas and relationships

  15. Data Submission- Acute/CAH/Children’s Data Source: Comprehensive Data System 4/01/14

  16. Overall Achievement of Targets- Feb 2014 Data Source: Comprehensive Data System 2/24/14

  17. Overall Achievement of Targets- March 2014 Data Source: Comprehensive Data System 4/01/14

  18. Topic Comparison Scatterplot

  19. Overall Achievement of Targets CAH- Feb 2014 Data Source: Comprehensive Data System 2/24/14

  20. Overall Achievement of Targets CAH- March 2014 Data Source: Comprehensive Data System 4/01/14

  21. Overall Achievement of Targets Rural (non-CAH)- Feb 2014 Data Source: Comprehensive Data System 2/24/14

  22. Overall Achievement of Targets Rural (non-CAH)- March 2014 Data Source: Comprehensive Data System 4/01/14

  23. HAB Submission Tracking Option Year Goal: 1000 HAB Templates by November • July 2014 Goal: 500 HAB Templates As of April 1, 2014: 46 HAB Templates Submitted ONLY 954 HAB TEMPLATES TO GO!

  24. Thank You!

  25. IHI Open School Pre-work Recommendations (per Fellow “level)

  26. Years 1 and 2, Fellows learned about: Deming’s System of Profound Knowledge The Model for Improvement (three fundamental questions) and PDSA cycles The Sequence of Improvement (from testing to implementation to spread) Run and Control Charts (e.g. using data to guide improvement) Designing Reliable Systems Refreshers available through Open School and On-Demand Videos on IHI.org. Our process is to PDSA our national education based upon feedback from you!

  27. The Guide serves as a tool: • For all Trustees, as they work towards the goal of eliminating all patient harm within their organizations • To assist with focusing on a number of key areas • Enhance the Boards’ ability to make connections between the discussions in the Boardroom and the impact on quality and safety within their organization • The Guide includes modules, associated preview questions for the videos, videos. a workbook and key takeaways per module for discussion, and can be located at www.hret-hen.org, under Resources / Governance Eliminating Harm, Improving Patient Care: A Trustee Guide

  28. Modules • Module 1: Role of Board in Quality Improvement and Eliminating Patient Harm • 2: How to be Effective in Improving Quality and Eliminating Patient Harm • 3: Alignment of Safety and Quality with Financial Performance • 4: Collect and Review of Meaningful Data • 5: Importance of Measuring Harm Across the Board

  29. Modules • 6: Clear Organizational Approach and Process for Improving Quality • 7: Clinician Engagement in Eliminating Patient Harm • 8: Importance of a Strong Quality Culture • 9: Importance of Patient, Family and Community Engagement • 10: Diversity in the Board Room

  30. Workbook

  31. Video of Module 9 Please view Module 9 as a part of your fieldwork before our next May 29th virtual Fellowship meeting.

  32. Video of Module 5

  33. Presented by: Jane Taylor, IHI Governance and leadership

  34. Prep Question Reflection We asked you to ask yourselves the following questions: • Does your organization have a strategic quality improvement plan, with clear goals for improvement that use data and benchmarks? • Does the Board know your total patient harm rate for the first quarter of 2014? • What are your organization's biggest strategies to reduce harm?

  35. Governance/Leadership Some Things We Know…. Better outcomes are associated with hospitals in which: • The Board spends more than 25 percent of its time on quality issues; • The Board receives a formal quality performance measurement report; • There is a high level of interaction between the Board and the medical staff on quality strategy; • The senior executives’ compensation is based in part on quality performance; and • The CEO is identified as the person with the greatest impact on quality, especially when so identified by the executive in charge of quality. Vaughn, Koepke, Kroch, Lehrman, Sinha, Levey, 2006.

  36. Jupiter Medical Center:The Board’s Role in Quality and Patient Safety Gail Harrigan, RN BSN, CPHQ Director, Quality Improvement/Patient Safety April 16, 2014

  37. 163-bed Acute Medical Surgical Facility located in Jupiter, Florida

  38. Board Quality Committee • Comprised of Board Members, Physicians and Senior Leaders • Reports directly to the Board of Trustees • Goal to achieve and sustain World Class performance in process and outcome measures • Monthly reporting of status on over 30 indicators

  39. Snapshot Reporting

  40. Action Plan Reporting

  41. Benefits • Succinct, focused presentation • Keeps interest of audience • Answers questions • Holds the organization accountable for improvements and for sustaining success

  42. South Seminole Hospital The Board’s Role in Quality and Patient Safety Cindy Stone, RN, MSHA, NE-BC South Seminole Hospital Chief Nursing Officer

  43. Hospital Profile • Serving Seminole County and surrounding areas • 204 Bed Hospital • Adult acute care and behavioral health services • Part of Florida’s most comprehensive private, not-for-profit healthcare networks • The Only Hospital in Seminole County with an “A” safety rating from Leapfrog • Health Care Model; Patient First

  44. Engaging the Board in Quality and Safety • What is the Board’s role in quality and patient safety? • Quality focus started from a patient story • Lead to achieve quality outcomes • Data and outcomes driven • Support, guide and challenge leadership • How do you work with your Board? • Develop Quality committees • Become experts in quality and safety • Promote goal development and alignment • Report significant quality trends, harm events and patient stories • Conduct Quality Rounds

  45. November 2010 Board Mandate to decrease harm and readmissions across the Board • Reduce overall mortality (excluding inevitable mortality) by 50% by 2015 • Reduce all cases of patient harm by 80% by 2015 • Provide ‘right care’ to 100% of patients by 2015 • Reduce unplanned readmissions by 80% by 2015 • Achieve top 10% patient satisfaction scores by 2016

  46. Orlando Health Board Quality Goals * Data still being evaluated • Readmissions excluding chemotherapy • Mortality excluding Inevitable mortality

  47. Orlando Health Board Quality Goals Progress Between 2010-2013 Updated 1/3/2014 Preliminary Perfect Care Numbers

  48. Quality Improvement Principles • What are some strategies/approaches taken by the board/senior leadership to promote quality improvement? • Adopt a culture of engagement, mindfulness, and ownership • Use science of safety to reduce harm • Create a Just Culture • Develop highly reliable processes • Create a learning system • Be transparent • Continuous Quality Improvement • Recognition of team members

  49. SSH Scorecard 2014

  50. Quality Structure, Processes and Patient Outcomes • What advice would you give to hospitals who are working on allocating a percentage of the agenda to quality? -Board and Quality Retreats -IHI Education -Multidisciplinary Quality Committees -Triads Structure -Technology -Safety Alerts -Harm Reports -Best Practices -Daily Huddles -Hospital Scorecards -Unit Scorecards

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