C. Difficile Prevention Partnership Collaborative: Leadership Call

1. C. Difficile Prevention Partnership Collaborative: Leadership Call Audio Conference Call January 4, 2012 www.macoalition.org

2. Our Team Massachusetts Department of Public Health Al DeMaria, MD, Medical Director, Bureau of Infectious Disease Eileen McHale BSN, HAI Coordinator Nora McElroy, MS epidemiologist Expert consultants Phenelle Segal RN CIC, RN Infection prevention Sharon Benjamin, Ph.D. Organizational change Massachusetts Coalition for the Prevention of Medical Errors • Paula Griswold, MS Executive Director • Susanne Salem-Schatz Sc.D. Collaborative Director Massachusetts Senior Care Foundation • Helen Magliozzi, RN, BSN Director of Regulatory Affairs • Laurie Herndon, MSN, GNP-BC, ANP-BC Director of Clinical Quality Masspro • Denise Selfridge, CPHQ

3. Agenda Susanne Salem-Schatz, Sc.D. Collaborative Director Doreen Hutchinson, RN, BSN, MBA, CNAA-BC , Fairview Hospital Ellen Candlish, RN, Laurel Lake Center for Health and Rehabilitation Bill Graves, St. Camillus Health Center Ellen Candlish Doreen Hutchinson Susanne Salem-Schatz Introductions Value of cross continuum collaboration Leaders supporting quality improvement: strategies for success Upcoming events

4. LONG-TERM CARE FACILITY AND ACUTE CARE HOSPITAL COLLABORATION Doreen M. Hutchinson, RN, BSN.,MBA.,CNAA-BC Vice-President of Operations / Chief Nursing Officer Fairview Hospital – Great Barrington, MA Ellen Candlish, RN Director of Nursing Services Laurel Lake Center for Health & Rehabilitation – Lee, MA

5. Long-Term Care / Acute HospitalCollaboration • Educational Programs: • Physical Assessment • Recognizing Sepsis • Diabetes Care • Anticoagulation Management • All programs taped and DVD’s supplied to each facility • Orientation Program: • Two month one-on-one with Preceptor in Acute Care • Preceptor Program: • Eight-hour program given to staff development role and seasoned Long-Term Care nurses.

6. Outcomes • Seventeen Long-Term Care nurses have rotated through the programs. • Directors of Nursing Feedback – Positive • Fifty percent reduction in patients admitted with severe sepsis • Length of Stay decreased from 5.3 to 3.7 days • Admission to CCU with sepsis decreased • Savings to our Long-Term Care colleagues

7. Value of the Collaboration • Patients gain better prepared nurses • Gain mutual respect across the continuum • Learn from each other – different perspective on similar issues • Learn to leverage our resources for the greater good

8. Strategies to Support Improvement Teams Clear Objective Timeframe for Results Choosing the Right People for the Team Regular Feedback Mechanism Established Support – With Time and Tools Discussion – What else do they need from Leadership (ex: Leverage our Relationship with LTC Leaders)

9. Effective Leadership in the Quality Improvement Process Bill Graves, Administrator, St. Camillus Health Center

10. What makes an effective Leader? • Time Management • It is impossible for us to EFFECTIVELY chair every QI subcommittee • Know What you Don’t Know • Many of us aren’t clinical • Some have a better handle on one department’s issues than on others • We DON’T have all the answers!! • Ultimately, Being an Effective Leader isn’t about having CONTROL over every decision, it’s about creating others that can lead.

11. Effective Leaders Allow others to Make Decisions • In order to allow other’s to make decisions, you need to teach them how to make decisions • This can be a long and tedious process • In Jim Collins’ “Good to Great” he talks about “leading with questions, not answers”

12. How do People Learn? • People learn the right way to do things by doing them wrong first! • Think about how you learned to drive a car • To teach people to make decisions, you often have to allow them to make mistakes • When they do make a mistake, we need to look at it as an opportunity to teach, not as conformation that we are smarter than they are.

13. So if others are going to make decisions, What do I do? • The Leader’s Role is to provide solid parameters to subcommittees • Hold them accountable to those parameters • The Parameters need to be established early in the process, and be clearly defined • Parameters could be: • Money (budget) • Regulations • Equipment/Materials/People • Time

14. So if others are going to make decisions, What do I do? • Follow up with each subcommittee Leader • A brief 5-10 minute conversation – NOT AT the Quarterly QI meeting!! • This conversation should help you to • Gauge the progress and PROCESS of the committee • Determine if there are obstacles to achieving the goal • Assist the subcommittee Chair to break down those obstacles

15. Conclusion • Stick with this process • You WILL feel like going back to your old ways • This process (INITIALLY) takes longer than if you make the decisions • Over time, you will have a much more competent, confident staff that will amaze you with their ability to process issues.

16. Coming your Way • Registration for January Regional Workshops • http://www.regonline.com/cdifficilepreventioncollaborativeregionalworkshops • Measurement tools • Announcement for open measurement call

17. Regional Workshops: Register now Lowell General Hospital Lowell, MA Tuesday January 24th 1-4PM Baystate Medical Center Holyoke, MA Wednesday January 25th 9AM-Noon Jordan Hospital Plymouth, MA Thursday January 26th 2-5PM University of Mass. Medical Center Worcester, MA Tuesday January 31st 9AM-Noon