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Patient Safety at SSM Health Care Paul Convery MD EVP/CMO SSM Health Care – St. Louis PowerPoint Presentation
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Patient Safety at SSM Health Care Paul Convery MD EVP/CMO SSM Health Care – St. Louis. SSM Health Care. SSM Health Care St. Louis Cardinal Glennon Children’s Hospital St. Joseph Health Center St. Joseph Health Center West DePaul Health Center St. Joseph Hospital

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slide1
Patient Safety at

SSM Health Care

Paul Convery MD

EVP/CMO

SSM Health Care – St. Louis

slide3

SSM Health Care

SSM Health Care St. Louis

Cardinal Glennon Children’s Hospital

St. Joseph Health Center

St. Joseph Health Center West

DePaul Health Center

St. Joseph Hospital

St. Mary’s Health Center

SSM Rehab

Managed Care Organization

Physician Organization

SSM Home Care

SSM Health Care of Wisconsin

St. Clare Hospital, Baraboo WI

St. Marys Care Center

St. Marys Hospital Medical Center

Blue Island, IL

St. Francis Hospital Health Center

Maryville, MO

St. Francis Hospital & Health Services

SSM Health Care of Oklahoma

St. Anthony Hospital

Bone & Joint Hospital

Centralia, IL

St. Mary's Hospital

Mt. Vernon, IL

Good Samaritan Regional Health Center

Jefferson City, MO

St. Marys Health Center

Villa Marie Skilled Nursing Facility

slide7

Baldrige Framework for Organizational

Excellence

Strategic

Planning

Staff

Focus

Organizational

Performance

Results

Leadership

Focus on Patients,

Other Customers,

and Markets

Process

Management

Information and Analysis

lessons from the mbnqa process
Lessons from the MBNQA Process
  • Framework
  • Focus
  • Balance
  • Discipline
  • Linkages
  • Accountability
slide9

Our Mission

Through our exceptional

health care services,

we reveal the

healing presence of God.

our mission statement
Our Mission Statement

Through our exceptional health care services,

we reveal the healing presence of God.

Exceptional

clinical

outcomes

Exceptional

Patient, Employee

& Physician

Satisfaction

Exceptional

financial

performance

cascading indicators

System

Network

Performance Indicators

Exceptional Results

Entity

Department

Cascading Indicators
deploying our mission
Deploying Our Mission

Passports

Poster

a culture of patient safety
A Culture of Patient Safety
  • Safety Comes First / Organizational Commitment
  • All Leadership Involved
  • Standards Are High and Well Communicated
  • Line Management Accountability
  • If Work Cannot be Done Safely…
  • Openness and Transparency
  • Safety Systems, Processes in Place with Consistent Training

Jack Silversin, DMD, DrPH

IHI National Forum on Quality 2003

patient safety at ssm
Patient Safety at SSM
  • 1999 - IOM Report “To Err is Human”
  • 2000 - “Enhancing Patient Safety”
  • 2001 - IOM Report “ Crossing the Quality Chasm”
  • 2001 - SSMHC Patient Safety Plan
  • 2002 - “Achieving Exceptional Safety”
  • 2003 - Clinical Transformation / Technology
ssmhc patient safety plan
SSMHC Patient Safety Plan
  • System Wide Approach to Patient Safety
  • SSM Patient Safety and Performance Improvement Plan
  • Philosophy of the Patient Safety Plan
    • Provide and Enhance a Safe Environment
    • Errors are Due to Breakdown in Systems and Processes
    • Leadership Commitment to Patient Safety
    • Blame Free Culture
  • System Wide Safety Reports to Senior Management and Regional Boards
ssm disclosure policy
SSM Disclosure Policy
  • System wide policy to disclose serious, unanticipated, adverse outcomes and sentinel events
  • An event that results in significant change in patient’s condition; significant new level of monitoring; need for unforeseen medical care; could have contributed to a patient’s unanticipated injury or death
  • Assure that the patient is treated fairly
  • Support for the physician and staff involved
  • Support of Risk Management, Social Service, Pastoral Care, Ethics Committee
  • System wide Disclosure Education for physicians, nurses, staff
ssmhc clinical collaboratives
SSMHC Clinical Collaboratives
  • AES Collaborative
  • One of Series of Clinical Collaboratives begun in 1998
  • Collaboratives Mission is to Advance Clinical Improvements Across SSM
clinical collaboratives
Clinical Collaboratives
  • The Collaborative mission
    • To provide an environment conducive to the discovery and development of clinical improvements that can be easily and rapidly diffused so that all entities and SSMHC patients can benefit from the improved value of care
clinical collaboratives19

Design

Collaborative

Prework Phase

Send out invitation

Learning session #1

Team formation and data collection

Project work and completion

Active phase

Learning session #2 (and if applicable, #3, #4, etc)

Data collection every 3 months

Continuous Improvement Phase

Conference calls every 2 months

Clinical Collaboratives

Start of Collaborative

achieving exceptional safety in health care recommended practices
Achieving Exceptional Safety in Health CareRecommended Practices
  • Implement a near miss reporting system
  • Eliminate dangerous abbreviations
  • Design and implement an accurate patient medication list at admission and discharge; avoid “blanket orders”
  • Implement an effective disclosure of unanticipated outcomes process
  • Provide and use protocols for high risk medications
  • Implement a fall reduction program
  • Implement a sentinel event review process
  • Establish an entity Safety Center
achieving exceptional safety in health care recommended practices con t
Achieving Exceptional Safety in Health CareRecommended Practices (con’t)
  • Provide pharmacy rounding in ICU’s
  • Implement all recommended safety information technology
  • Implement 24 hr pharmacy coverage
  • Provide a quarterly “State of Safety Report”
  • Develop and use a protocol for proper timing of surgical antibiotic prophylaxis
  • Institute a “needleless” IV system
  • Implement a protocol for glucose management of diabetic patients under going surgery
achieving exceptional safety in health care recommended practices con t22
Achieving Exceptional Safety in Health Care Recommended Practices (con’t)
  • Develop and implement an effective surgical site marking procedure to avoid wrong site surgery
  • Reduce risk of health care-acquired infections by complying with current CDC hand hygiene guidelines
  • Medication reconciliation process at hand offs
  • Central line bundles
  • Ventilator care bundles to prevent ventilator associated pneumonias
  • Deploy rapid response teams
quarterly state of safely report
Quarterly “State of Safely Report”
  • All entities have established a “Safety Center”
  • All entities provide quarterly “State of Safety” reports to their entity leadership, medical staff, employees and governing boards
implement 24 hour pharmacy coverage
Implement 24 Hour Pharmacy Coverage
  • This practice was implemented in November 2003
  • Relevant for 20 hospitals
  • Baseline data indicates that 14 have 24 hour coverage
  • Processes in place to extend coverage to all hospitals
slide32
I Work in an Environment Where I Can Communicate My Opinions About Patient Care Practices – Physician Survey
technology and patient safety clinical transformation
Technology and Patient Safety / Clinical Transformation
  • Pharmacy Computerized Alerts
  • Pyxis Systems for Medications
  • Medication Bar Coding
  • Physician and Nursing Technology Committees
  • Physician and Nursing Portals
  • Protocols Available Electronically
  • PDA’s for Labs and Results
  • Clinical Transformation Executive Steering Team
  • Implementation of System Wide EHR and CPOE
the future of patient safety
The Future of Patient Safety
  • Leadership Commitment
  • Eliminate the Barriers
  • Strong Safety Culture
  • Process Improvements
  • The Role of Technology