Best Care – Best Way – Every Patient – Every Day

1. Improving Harm Across the BoardSt. Francis HospitalAngela King, BSN, CPHQ, CPHRMAdministrative Director, Patient Safety and Quality Best Care – Best Way – Every Patient – Every Day

2. Cut “harm across the board” by 37%

3. 2012 Breakthrough in Readmission: From 246 to 144

4. Reduced 30 Day Readmission RateFrom 9% to 5%

5. Pearls • Drivers of safety that produce these results include: • Patient and family engagement • - Caught You Washing” cards • - “Turn” signals throughout hospital • - Joint Camp/Heart Camp • Physician led improvement efforts. • Empowering staff to “speak up” in the interest of safety leads to a culture of safety.

6. Pearls (continued) • Development of best practice protocols and checklists. This can lead to recognition for disease specific certifications. • Providing data to direct caregivers and involving them in developing improvement plans. For instance, stratifying why patients are non-compliant leads to process changes that impact their care. For example: The Heart Failure patient readmitted because they do not have funds to fill prescriptions or do not have a private physician to follow up with for care.

7. DefiningMoment In Our Journey A landmark was reached with VAP compliance when we went 884days with ZERO VAP cases! • Staff realized they could get to zero • Staff realized they could reduce harm • We began tracking on our Intranet in real time – this was a commitment to transparency

8. Slide 8 Risk Profile: The Areas of Risk We Are Committed To Controlling Annual discharges: 10,756 HAC risk opportunities/discharge: 5.55

9. Slide 9 Our improvement journey Number of risk areas (0-9) at each stage Improvement Scale:The stages we move through _____4_____ _____2_____ _____0____ _____3_____ • IDEAL: level represents zero harm • At Target: level represents meeting improvement target • Progress: level shows movement but not yet at target • Opportunity: level is an opportunity to launch aggressive action

10. Improving Harm Rates (per discharge) • Areas of strength at the beginning were CLABSI and VAP • Areas that represented biggest challenges were all others

11. Improving Harm Rates (per discharge)

12. Slide 10 Our Hospital Risk Score Card

13. Hospital CEO and Safety Team

14. Next Big Step to Reduce Harm Hardwiring safety tools to impact daily operations • Teamwork training utilizing proven patient safety methodologies • Training in clinical processes to impact patient safety and quality, creating greater efficiency and reliability