Charles Denham, MD Chairman, TMIT Co-chairman, NQF Safe Practices Consensus Committee

1. Safe Practice Overview Charles Denham, MD Chairman, TMIT Co-chairman, NQF Safe Practices Consensus Committee Chairman, Leapfrog Safe Practices Program Safe Practices Webinar March 18, 2010

2. Harmonization – The Quality Choir

3. The Patient – Our Conductor

4. 2010 NQF Safe Practices for Better Healthcare: A Consensus Report 34 Safe Practices • Criteria for Inclusion • Specificity • Benefit • Evidence of Effectiveness • Generalization • Readiness

5. History of NQF Safe Practices for Better Healthcare 2009 Final Report: • From 30 to 34 practices • Culture Practice Elements Broken Up into 4 Practices • 2 Practices Discontinued • 4 Medication Management Practices Combined into 1 • 2 Communication Practices Combined into 1 • 8 New Practices Added • CMS Care Settings Defined • Patient and Family Involvement Section Added 2010 Final Report: • Format Structure Preserved • Problem Statement and Implementation Guide Thoroughly Updated • Minor Specification Changes • Updated References • Corrections and Clarifications • Care Setting Clarification Using CMS Classification • Measures Section Updated Thoroughly with NQF-Endorsed and Other Practical Measures for Consideration • Soft Copy Document Hyperlinks • Crosswalk Tables • Glossary

6. 2003, 2006, and 2009 Update Versions

7. Culture Consent & Disclosure Consent and Disclosure Workforce Information Management and Continuity of Care Medication Management Healthcare-Associated Infections Condition- & Site-Specific Practices 2010 NQF Report

8. Culture CHAPTER 2: Creating and Sustaining a Culture of Patient Safety (Separated into Practices] • Leadership Structures and Systems • Culture Measurement, Feedback, and Interventions • Teamwork Training and Team Interventions • Identification and Mitigation of Risks and Hazards Structures and Systems Culture Meas., FB., and Interv. Team Training and Team Interv. ID and Mitigation Risk and Hazards Consent & Disclosure Consent and Disclosure CHAPTER 3: Informed Consent and Disclosure • Informed Consent • Life-Sustaining Treatment • Disclosure • Care of the Caregiver Informed Consent Life-Sustaining Treatment Disclosure Care of Caregiver Workforce CHAPTER 4: Workforce • Nursing Workforce • Direct Caregivers • ICU Care 2010 NQF Report Nursing Workforce Direct Caregivers ICU Care CHAPTER 5: Information Management and Continuity of Care • Patient Care Information • Order Read-Back and Abbreviations • Labeling Studies • Discharge Systems • Safe Adoption of Integrated Clinical Systems including CPOE Information Management and Continuity of Care Patient Care Info. Read-Back & Abbrev. Labeling Studies Discharge System CPOE Medication Management CHAPTER 6: Medication Management • Medication Reconciliation • Pharmacist Leadership Role Including: High-Alert Med. and Unit-Dose Standardized Medication Labeling and Packaging Med. Recon. Pharmacist Systems Leadership: High-Alert, Std. Labeling/Pkg., and Unit-Dose CHAPTER 7: Hospital-Associated Infections • Hand Hygiene • Influenza Prevention • Central Venous Catheter-Related Blood Stream Infection Prevention • Surgical-Site Infection Prevention • Care of the Ventilated Patient and VAP • MDRO Prevention • UTI Prevention Healthcare-Associated Infections Hand Hygiene Influenza Prevention Central V. Cath. BSI Prevention Sx-Site Inf. Prevention VAP Prevention MDRO Prevention UTI Prevention CHAPTER 8: • Wrong-Site, Wrong-Procedure, Wrong-Person Surgery Prevention • Pressure Ulcer Prevention • DVT/VTE Prevention • Anticoagulation Therapy • Contrast Media-Induced Renal Failure Prevention • Organ Donation • Glycemic Control • Falls Prevention • Pediatric Imaging Condition-, Site-, and Risk-Specific Practices Wrong-site Sx Prevention Press. Ulcer Prevention DVT/VTE Prevention Anticoag. Therapy Contrast Media Use Organ Donation Glycemic Control Falls Prevention Pediatric Imaging

9. Values Systems Structures Behaviors Outcomes LEADERSHIP STRUCTURES and SYSTEMS Patients and Community Leadership Structures and Systems Culture Measurement, Feedback, and Intervention Teamwork Training and Skill Building Identification and Mitigation of Risks and Hazards NQF 34 Safe Practices

10. HAI Guidelines