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Session 3: Biting the Elephant Mary Perloe RN, MS, GNP & Adrienne Mihelic PhD

Session 3: Biting the Elephant Mary Perloe RN, MS, GNP & Adrienne Mihelic PhD. August 1, 2013. Catching up. Overview and introduction to the AE Safely Reduce Hospitalization Tracking Tool. Recordings of practicum webinars Slide decks Cumulative Q&A from first & second practicum.

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Session 3: Biting the Elephant Mary Perloe RN, MS, GNP & Adrienne Mihelic PhD

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  1. Session 3: Biting the Elephant Mary Perloe RN, MS, GNP & Adrienne Mihelic PhD August 1, 2013

  2. Catching up • Overview and introduction to the AE Safely Reduce Hospitalization Tracking Tool. • Recordings of practicum webinars • Slide decks • Cumulative Q&A from first & second practicum Click link while in ‘slide show’ mode OR copy and paste the url into your browser. http://www.nhqualitycampaign.org/star_index.aspx?controls=HospitalizationsIdentifyBaseline

  3. Q&A Tips from Users • For leadership and corporations

  4. Poll • Progress report • Select all that apply • I have entered required fields for some transfers & admissions • We have used the INTERACT QI Review Tool on one or more transfers. • I have entered the 3 additional fields from the INTERACT QI Review Tool into the AE Hospitalization Tracking Tool (in addition to the required fields) • I have accessed the Probing Questions from the AE website

  5. Data and the Quality Improvement Process How do I know where I am?

  6. Data and the Quality Improvement Process What processes should we target?

  7. This flight is headed for … Session 3: Getting started with the AE Hospitalization Goal: Time to Act (or ‘Biting the Elephant’) Prioritizing AND starting with manageable bites are both important quality improvement principles. INTERACT is an entire program that includes many excellent tools to help standardize processes associated with changes in condition and optimize communications – but where to start? Data from the Tracking Tool helps us start small, but start smart.

  8. Biting the Elephant

  9. INTERACT: Overview

  10. Advance Care Planning • See the Common Q&A within your Excel workbook for a succinct discussion about Advance Care Planning and links to resources • Advancing Excellence resources for Advance Care Planning http://www.nhqualitycampaign.org/demo/star_index.aspx?controls=resByGoal • INTERACT resources for Advance Care Planning http://www.interact2.net/tools.html • Advancing Excellence resources for resident and family education on the impact of hospital transfer http://www.nhqualitycampaign.org/demo/star_index.aspx?controls=HospitalizationsLeadership

  11. Stop and WatchThe Early Warning Tool

  12. Change in Condition File Cards

  13. Change in Condition File Cards

  14. Care Paths

  15. SBAR

  16. Transfer Form

  17. Transfer Form

  18. Nursing Home Capabilities List

  19. INTERACT QI Review Tool

  20. Homework 2RCA each transfer and record in Workbook For EACH transfer to hospital, complete the INTERACT QI Review Tool, and record 3 additional items in your Tracking Tool:

  21. Use Data to • Track Process Measures

  22. Use Data to Explore Patterns • Tool Tip • INTERACT Change in Condition File Cards • INTERACT Care Paths • AE Goal Packages and Tracking Tools

  23. Use Data to Explore Processes • Tool Tip • AE & INTERACT Advance Care Planning • INTERACT SBAR • INTERACT NH Capabilities Checklist

  24. Homework 3 • Continueto: • Enter required fields for all transfers to hospital and all admissions to your home with a recent hospital discharge. • RCA each transfer to hospital using the QI Review Tool • Summarize your RCA on the RCA Summary Form • Enter the 3 additional pieces of information into your AE Hospitalization Tracking Tool for each transfer (Primary Clinical Reason for Transfer, Primary Contributing Reason for Transfer, Root Cause Analysis Complete (“Yes,” if you did QI Review Tool and Summary sheet))

  25. Homework 3 2. With your team: • Look at your bar charts for primary clinical and primary contributing reasons • Review the AE Probing Questions: http://www.nhqualitycampaign.org/star_index.aspx?controls=HospitalizationsExamineProcess • Choose one or two processes to focus on, including implementing the corresponding INTERACT Tools and materials • Track implementation of the process change/tool with in your AE Hospitalization Tracking Tool

  26. Optional Fields Help Identify Next Steps & Monitor Process

  27. Use Data to Explore Patterns

  28. Use Data to Explore Patterns

  29. Track Process Implementation

  30. Involving Partners with Data Share data with staff Share data with hospitals

  31. Involving Partners with Data

  32. Creating ChangeInvolving Partners with Data

  33. How am I doing?Monitor Progress

  34. Enter Summary Data on the AE Website

  35. Poll How Can We Help? Select all that apply Extend this series? (If yes, send us a chat with ideas of what that would cover.) b) Weekly office hours to discuss progress on the project, perhaps including brief demos of useful functions and tricks?

  36. Thank You For making our nursing homes better places to live, work, and visit! Adrienne Mihelic help@nhqualitycampaign.org 303-931-0027

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