CLABSI Content Call

1. CLABSI Content Call How Leveraging CUSP Improves Staff Engagement and Communication Lending to an Improved Health Care Team and Patient Experience Tuesday, June 12 Kathy Schumacher, MSA, CPHQ System Director, Quality and Patient Safety Initiatives Beaumont Health System

2. Beaumont Health System

3. Beaumont Health System • Major teaching facility with 37 accredited residency and fellowship programs • Private medical school opened 2011 • Level 1 trauma center • Private practice medical staff • “Best Hospitals” in the annual rankings by U.S. News and World Report

4. Keystone, the Foundation for Change • The MHA Keystone Center for Patient Safety and Quality is a non-for-profit division of the Michigan Health and Hospital Association (2003) • Formed in response to growing concerns about patient safety and healthcare quality • Partnership between MHA member hospitals

5. Keystone, the Foundation for Change GOALS: • Evidence-based practices to reduce complexity, and increase reliability • Developed measures to gauge performance and document results • Developed the business case for providing better and safer care • Keystone Programs • ICU • HAI • Organ Donation • Stroke • OB • ER

6. Keystone, the Foundation for Change • Voluntary for Michigan Hospitals to participate: right thing to do • Built relationships around the state to provide better and safer care: “non-competitive” • Clinicians empowered at the local level to lead change within their hospital and the State of Michigan Keystone provided infrastructure for change: - Engage - Educate - Execute - Evaluate

7. Beaumont Health SystemSteps of CUSP • Safety Culture Assessment • Educate staff and leadership on Science of Safety Assertion Situational awareness Disclosure Communication Decision making Josie King story Embedded into orientation • Executive partnership • Implement teamwork tools ICU daily goals Surgical briefings/debriefings Central line insertion checklist Culture debriefing tool • Learn from Defects Tracking/reporting of defects in surgery

8. CUSP “People Bundle”Staff Engagement • How do you create a “safety culture” – people bundle • Safety Culture Assessment • Do you know what the numbers mean? • Does your leadership understand what the numbers mean? • Look for trends • Deep dives into the data • Share results with staff • Engage them in action plans • Safety culture in your organization: What does it look like? Creating and sustaining a culture of safety: Culture(kuhl’ cher) n. an integrated pattern of human knowledge, belief and behavior; the set of shared attitudes, values, goals and practices that characterizes an institution, organization, or group.

9. CUSP “People Bundle” • Culture is local; culture assessment needs to measure the frontline caregiver’s perception • Local safety culture is a powerful influence on our daily work • Teamwork and safety climate have been associated with clinical and operational outcomes • When teams exhibit infrequent team behaviors, patients are more likely to experience complications or death Sexton, Brian “Estimating Jelly Beans and Assessing Safety.” Keystone ICU Conference, October 10, 2006 Mazzocco et al. “Surgical Team Behaviors and Patient Outcomes,” The American Journal of Surgery (2008)

10. The Comorbidities of Poor Safety Culture • Poor handoffs • Toxic work environments • Caregiver burnout/depression • Caregiver self-injury • Disruptive Behavior • Staff Turnover • Patient harm • Defensive and distrustful staff • Repeat Sentinel Events • Innovation fatigue • Loss of sense of purpose/meaning (Sexton, J.B. “Safety Culture 101 Working with Culture Data”)

11. CUSP – Science of Safety Education • Hard-wire into your system • Orientation • Define who needs the education • Make the Science of Safety education accessible • Online • Classes • What's relevant to your culture • Use your safety culture data to guide you • Content modified to fit clinical setting • Assertion techniques • Communication • Situational awareness • Decision making • Disclosure • Josie King story

12. CUSP – Executive Partnership Building Trust and Staff Engagement • Define expectation of executive • Do they understand their role/time commitment? • Science of Safety training • Who is the best executive partner for your area? • Educate them about the unit • Unit turnover rates • Sentinel events • Unit clinical performance • Unit operational performance • Educate the executive partner on the Safety Culture Assessment results

13. CUSP – Teamwork Tools to Improve Team Communication For a Patient Outcome • Research supports the benefits of using checklist • The Checklist Manifesto (must read) • Daily Goals Rounding tool (inside and outside the ICU) • Surgical briefings/debriefings • Central Line Insertion checklist • Huddles

14. CUSP – Learn From Defects – Staff Engagement to Minimize Future Patient Harm • Identify Defects through • Sentinel event • Root cause analysis • “Eagle eye” Recognition • Patient Safety/Quality Reports • Surgical team briefings/debriefings • Educate staff on how to conduct an investigation, “non-punitive” learning opportunity • Ask • What happened? • Why did it happen? • What can we do to prevent this from happening again? • Implementation • Share results with other units

15. CUSP – Infrastructure for Change Lessons Learned • Culture is local • How does your organization define culture of safety • Change will not happen overnight • Staff engagement is critical: “staff empowerment” • Senior leadership commitment is important • Do something with your safety culture data, let it guide you • Own your safety culture data • Don’t be afraid to change • Sustainability

16. Contact Information Kathy Schumacher, MSA, CPHQ (248) 551-9707 Kschumacher@beaumont.edu

17. Your Feedback is Important! The evaluation can be found at: https://www.surveymonkey.com/s/Z6FJ28T