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Pre-Mortems and Action Plans

Pre-Mortems and Action Plans. VAP Coaching Call January 3, 2013. Objectives. Share key responses and considerations from pre-mortems Share key components and unique ideas from action plans Discussion Next Steps. Pre-Mortems. A select summary of key responses and considerations.

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Pre-Mortems and Action Plans

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  1. Pre-Mortems and Action Plans VAP Coaching CallJanuary 3, 2013

  2. Objectives • Share key responses and considerations from pre-mortems • Share key components and unique ideas from action plans • Discussion • Next Steps

  3. Pre-Mortems A select summary of key responses and considerations

  4. Pre-Mortem • Step 1 • Imagine we are 2 years in the future. Things have gone completely wrong. What could have caused this? • Step 2 • Generate a list of all the reasons failure occurred. • Step 3 • Address the 2 or 3 items of greatest concern and list what you will do differently now that you have considered them.

  5. BUILD the TEAM’S CAPACITY to adapt to new technology or clinical evidence • Re-focus unit by administering the 2 question safety assessment – staff select 2 high priorities areas to work on • Use of unit-based “CUSP” team • EDUCATE LEADERSHIP on VAP effort, benefits of participation • Offer CME for VAP education • Define ROLE and expectations of LEADERSHIP

  6. BUILD the TEAM’S CAPACITY to adapt to new technology or clinical evidence • Invite staff to unit CUSP-VAP meetings • Include staff in data collection • EDUCATE STAFF • Healthcare payment and reform • Impact of HAI’s, VAP • In-depth VAP case review • Reinforce the positive results with CLABSI, CAUTI • Convey administrative support

  7. PROMOTE “TEAM” & improved work relations • Bi-monthly dinners • Themed lunches at work • Promote participation in organized activities • RECOGNIZE STAFF • VAP Bundle compliance awards • Personalized thank you cards • Wake Up and Breathe Protocol • Nurses driven • Ensure multidisciplinary team- assign responsibility • Coordinate efforts to ensure success

  8. Define DATA COLLECTION process • Define multidisciplinary team goals during rounds • Quality team “tests” data collection process • Engage charge nurses and Intensivists • Implement 4 hours of staff dedicated time weekly to support data collection • Enlist subgroup to investigate electronic data collection • Ask staff what would increase data collection compliance

  9. TAILOR MESSAGE to audience • Well-defined roles for team members • Monthly progress meetings and routine staff updates • EDUCATION • Inservice all staff • NEW STAFF • VAP “fast facts” • Add VAP content to critical care core curriculum • INTENSIVISTS • New VAP surveillance definitions

  10. Strategic PARTNERS - FINANCE • Use STAFF INCENTIVES • Develop YEARLY COMPETENCY • Add VAP education to AGENCY ORIENTATION • Monitor and Audit VAP BUNDLE COMPLIANCE • SHARED RESPONSIBILITY • Vary daily assignments • Include “non-clinical” staff • High-census plans

  11. Action Plans A select summary of the components of strong action plans

  12. Action Plans • A good Action Plan sets the stage for achieving the goal – it maps out the work process with a detailed schedule of key activities needed to accomplish the goal (i.e., sustainability and cultural competence). Action Plans

  13. Campaign Zero http://www.campaignzero.org/safety-checklists/ Institute for Patient- and Family-Centered Care http://www.ipfcc.org/tools/downloads-tools.html

  14. Discussion • What ideas and actions are most appealing to you? Why? • What will you do with information shared today? • What does it mean to engage patients and families? • How can you include patients and families in this effort?

  15. Next Steps • Continue Collecting Data • VAE algorithm • Daily Rounding • Quarterly Interview • Will be conducted regularly with team leaders throughout the effort. Interviews will take about 30 minutes. Someone will contact team leaders to arrange dates and times. • January 10 Content Call at 2:00 PM • Audio: 800-779-9891 • Pass code: 4757941 • Web link: https://connect.johnshopkins.edu/vaecontent01102013/ • Science of Safety • Be prepared to discuss how you ensured staff watched the video, how you assessed their knowledge of the message and content, and your plans to further learning in this area. • Staff Safety Assessment • Be prepared to discuss what harm staff identified and suggestions for preventing or minimizing the harm.

  16. Questions? • Maryland Participants • Karol G. Wicker, MHS • Phone 410-540-5056 • kwicker@mhaonline.org • Pennsylvania Participants • Mary Catanzaro RN BSMT CIC • Phone 717-756-3958 • mcatanzaro@haponline.org

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