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July 19, 2011

Small and Rural Critical Access Hospitals. July 19, 2011. Agenda. Denise Flook and Lorna Martin Applying CUSP in the Small and Rural Critical Access Hospital Using CUSP Beyond CLABSI and CAUTI Critical Access Hospital Team Leaders Paul Frigoli, Grant Regional Health Center

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July 19, 2011

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  1. Small and Rural Critical Access Hospitals July 19, 2011

  2. Agenda • Denise Flook and Lorna Martin • Applying CUSP in the Small and Rural Critical Access Hospital • Using CUSP Beyond CLABSI and CAUTI • Critical Access Hospital Team Leaders • Paul Frigoli, Grant Regional Health Center • Illinois Critical Access Hospital Team Leader • Suggestions for future calls

  3. Applying CUSP in the Small and Rural Critical Access Hospital Denise M. Flook, RN, MPH, CIC Director, Workforce Development & Infection Prevention Lorna Martin, RN Patient Safety & Quality Improvement Specialist

  4. Quality and Safety are Now Key to Hospital Success • Payers, including the Government and the public, demand more efficient, safer care • Limited resources will necessitate efficiency

  5. The Challenge • How do we provide and sustain the highest quality and safest care for every patient, every time in the current environment of diminishing resources? • It is easy to think that simply implementing a checklist is the path to better outcomes, but Changing culture is the key to sustained safety and improved outcomes for patients

  6. Safety/Quality Improvement is a Two-Part Process

  7. What is CUSP? • Comprehensive Unit-based Safety Program • An intervention to learn from mistakes and improve safety culture for sustained improved patient outcomes

  8. The CUSP Steps • Develop a team • Assign executive to adopt unit • Educate staff on science of safety • Identify and prioritize defects • Implement teamwork tools • Provide timely feedback • Learn from defects – Have staff investigate each occurrence Adapted from Pronovost, Patient Safety, 2005

  9. CUSP is a Continuous Effort • Add science of safety education to orientation • Learn from one defect per quarter; share or post lessons • Use quality improvement and teamwork tools that best meet the hospital/unit’s needs • Feed back timely data; investigate each event

  10. Walking Through the Process Eliminate Hospital-Acquired Stage 3/4 Pressure Ulcerson the Unit • Develop a team -- Include staff nurses • Gather baseline data • Have first team meeting; educate on science of safety, data, goals • Research the evidence-based practices that eliminate pressure ulcers

  11. The CUSP/Improvement Intervention

  12. It Goes Back to Leadership – On All Levels • Engage, commit • Communicate • Provide education • Provide resources • Be visible and transparent • Give feedback • Investigate and own outcomes and improvement

  13. Keep the Focus • There are challenges ahead, but everyone must not lose sight of our North Star – the patient -- who must be kept in the center of all we do • Your commitment, leadership, and persistence are essential to patient quality and safety

  14. References • Pronovost P, Weast B, Rosenstein B, et al. Implementing and validating a comprehensive unit-based safety program. J Pat Safety. 2005; 1(1):33-40. • Pronovost P, Berenholtz S, Dorman T, et al. Improving communication in the ICU using daily goals. J Crit Care. 2003; 18(2):71-75. • Pronovost PJ, Weast B, Bishop K, et al. Senior executive adopt-a-work unit: A model for safety improvement. JtComm J QualSaf. 2004; 30(2):59-68. • Thompson DA, Holzmueller CG, Cafeo CL, et al. A morning briefing: Setting the stage for a clinically and operationally good day. JtComm J Qual and Saf. 2005; 31(8):476-479.

  15. Denise M. Flook, RN, MPH,CIC Director, Workforce Development/Infection Prevention 770-249-4518 dflook@gha.org.

  16. CUSP Resources • Contact your State Hospital Association quality director for more information about CUSP initiatives • Visit the On the CUSP: Stop HAI project Web site: www.onthecuspstophai.org

  17. Hearing From Your Peers

  18. Paul Frigoli Quality Director Grant Regional Health Center Lancaster, WI

  19. Agenda • Why we joined the CLABSI & CAUTI projects • Barriers and successes • Key lessons

  20. Val Pfoutz, RN ICU Director KSB Hospital Dixon, IL

  21. Agenda • Why we joined the CLABSI & CAUTI projects • Barriers and successes • Key lessons

  22. CUSP Resources • Contact your State Hospital Association quality director for more information about CUSP initiatives • Visit the On the CUSP: Stop HAI project Web site: www.onthecuspstophai.org

  23. Hearing From You • What should future small & rural critical access hospital supplemental calls address? • What resources can you share with others? • What additional resources would help you improve patient safety?

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