SPSP Fellow US Trip – Institute for Healthcare Improvement

1. SPSP Fellow US Trip – Institute for Healthcare Improvement Dr Kevin Rooney 9th February 2010

2. IHI Strategic Plan • Who are they? • Guidelines for Citizenship • What IHI will accomplish • No needless list • What IHI will become

3. Don Berwick • Birthday club • Like minded individuals • “If you build it they will come” • Data • Waste • Involve Finance Officer

4. Maureen Bisognano • Advice for working with executives • Data • Keep the burden • “Hot button” • Business case • Be helpful • Be prepared. • Succinct communication (SBAR)

5. Maureen Bisognano • Saving Lives while Saving Money • Muda (50% of HCW time) • Value Stream Mapping (donuts) • Reduce costs while maintaining or improving quality • Set a waste reduction target 1-3% (operating expenses) • Dark green dollars

6. Strategic Partner Portfolio • Indian Health Service • Primary care bundles e.g. DM, cancer screening • Ascension Health • QUEST • More lives saved, more $ saved and more patients receiving evidenced based care • Nursing Home Quality Campaign • Know your number, set your target

7. Progress Toward National Goal After One Year:Target setters improve faster SLOW FAST Improvement Toward Goal Percent Improvement Source: This material was prepared by Quality Partners of Rhode Island, the Medicare Quality Improvement Organization for Rhode Island, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the US Department of Health & Human Services. The contents presented do not necessarily reflect CMS policy. Data through one year (four quarters).

8. Error Reduction at Ascension Preventable Error Reduction in rate Goal of preventing 900 unnecessary deaths by Summer 2008. In fact prevented 2700 deaths! Pressure Ulcer 95% Neonatal mortality 79% Birth Trauma 74% Ventilator-acquired pneumonia 56% Falls with serious injury 54% Blood-stream infections 32%

9. Improvement Map • 70 key process improvements that lead to exceptional care • Grouped into 3 domains or IOM’s aims • Processes to support care • Patient care processes • Leadership & management processes • Process attributes • Details • Reasons & Implications • Resources • Cost to implement • Time to implement • Difficulty to implement • Level of evidence

10. Improvement Map Examples • Safe • Surgical Checklist • Delirium • Effective • Patient Transition & hand-overs • Equitable • Heart Failure Core Processes • Efficient • Patient Flow for efficiency and safety • Patient centred • Communication with patient & families after an adverse event • Timely • Early warning systems

11. Virtual School Campus based, local, interdisciplinary chapters Multinational, 5 Scottish chapters Online modern “Web 2.0” technologies Web based content delivery (Podcasts) Social networking (Facebook) Simulations (Second Life)

12. Creates energy with frontline staff • Harnesses their knowledge • Results in a timely manner • Few resources • Scalable & sustainable

13. Fellow Fellows • www.clinicalmicrosystem.org • Dartmouth • Clinical microsystem • Meeting rules • Tool kits