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December 2010. Surgical Care Improvement Project Teamwork-Key to Success. What are Core Measures?. Evidence based care AMI Heart Failure Pneumonia SCIP-Surgical Care Improvement Project Stroke VTE ED Outpatient AMI/chest pain Outpatient Surgery
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December 2010 Surgical Care Improvement ProjectTeamwork-Key to Success
What are Core Measures? • Evidence based care • AMI • Heart Failure • Pneumonia • SCIP-Surgical Care Improvement Project • Stroke • VTE • ED • Outpatient AMI/chest pain • Outpatient Surgery • Goal- decrease complications, readmission, mortality
Why Core Measures are Important Provide evidence based standards of care • Ultimately we all want to provide our patients with the best care possible Our data is publicly reported • Medicare's website: www.hospitalcompare.hhs.gov • Joint Commission's website: www.qualitycheck.org Pay linked to our Performance • Core Measures • Reduced or nonpayment for certain complications • Insurance companies may offer incentives for reaching set levels of performance
SCIP Goal-Reduce Surgical Complications • Reduce surgical site infections • Prophylactic antibiotic timing, selection, & stopping antibiotic within 24 hours postop (total hips, total knees, hysterectomies, vascular, colorectal) • Hair removal • New-Urinary catheter removed POD1 or POD2 • New-Perioperative temperature management • Reduce heart attacks during and after surgery • Beta-blockers • Reduced development of blood clots in legs and lungs after surgery • VTE ordered • VTE Received
SCIP Core Measures Checklist • Preop • □ Complete home med list including dates and times • □ Complete Preop Checklist (Meditech) • □ If patient takes a beta blocker at home but not ordered, ask surgeon if order would be appropriate • □ If beta blocker is held, document reason(s) and link with a physician order. • □ Send prophylactic antibiotics to Preop • Examples: “on call to OR”, “preop”, “30 minutes preop” • □ Give scheduled antibiotics for treatment of possible or actual infection as ordered. • Example: Zosyn q 8 hrs IVPB • □ Complete nurse section of Adult VTE Prophylaxis Order Set
SCIP Core Measures Checklist • Postop • □ Verify prophylactic antibiotic are completed within 24 hours postop • □ Verify first dose of chemical VTE prophylaxis is given with 24 hours postop, if ordered. • □ Complete nursing section of VTE order set if not already done • □ Document TEDs and PAS as ordered • □ Verify foley cath is removed within 48 hours postop or physician has documented reason for continued need for foley • Questions?? • Quality Resources Delynn-2633 or 731-5704
Keys to Core Measure Success • Teamwork-everyone has a vest interest in Perfect Care • Use the checklists for Core Measures • Every time we fail a measure, we look for opportunities to improve • Do we have the right process? • Do we have the right education? • Do we have the right feedback? • Do we have accountability? • Our patients have entrusted us to provide the best care possible-we must not let them down.