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Growing A Culture of Safety. The Beginning Landscape. County-Run Level I Trauma Center, Lion’s Burn Center, Transplant Center, and Teaching Hospital with the largest free-standing trauma center west of the Mississippi 26 Operating Suites and Procedure Rooms 1500+ cases per month (24/7, 365)
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The Beginning Landscape • County-Run Level I Trauma Center, Lion’s Burn Center, Transplant Center, and Teaching Hospital with the largest free-standing trauma center west of the Mississippi • 26 Operating Suites and Procedure Rooms • 1500+ cases per month (24/7, 365) • Approximately 210 full-time employees • Affiliation with Univ. School of Med. So. NV • Four-state catchment, includes: SW Utah; NW Arizona; parts of Southern California; and Nevada • Las Vegas: Major transient and tourist population • Recent EHR implementation
Presentation Objectives • Structural Support • Team selection • Leadership Support • Expert Champions • Developing and growing SUSP concepts • Staff engagement • Enacting change • Lessons Learned
Structural SupportTeam Selection • Identify Team Requirements • Members: • Strengths • Technical Knowledge • Personality Characteristics • Member Availability: • Heavy OR days / times • Leadership • Foster support at all levels of leadership • Procure Expert Champions • Physicians, ancillary department heads, etc.
Growing SUSP ConceptsStaff Engagement - Learning Can Be FUN! • Develop educational opportunities relevant to employee population • Education Day(s) • Identify windows of opportunity • Weekend In-Services • Contest(s) with incentive(s) • Partner with professional organization(s) • Offer CEU’s
Growing SUSP ConceptsStaff Engagement - Learning Can Be FUN! • Staff Education Day • 12 Education stations • Science of Safety Video • Staff Safety Assessment Survey • Numerous other educational opportunities • Staff volunteered for presentations at stations • Employee-driven subject matter • Certificates of Appreciation awarded
Growing SUSP ConceptsStaff Engagement - Learning Can Be FUN! • Tidbit Trivia Contest • Tidbits of SUSP information emailed weekly • Monthly “Trivia Contest” about emailed tidbits • Score 100% to be entered in drawing • Entrant name placed in drawing for $25 gift card • Winners drawn at monthly staff meeting • Handouts with trivia questions and answers available at staff meeting
Growing SUSP ConceptsStaff Engagement - Learning Can Be FUN! • Partnered with local AORN Chapter • Encouraged educational awareness • Offered free CEUs • Patient Positioning Safety • Normothermia • Sterile Technique
Staff Engagement OutcomesLearning Can Be FUN! • Education Day • Reinforced team concepts and boosted morale • Employee enthusiasm and participation • Tidbit Trivia • Apathetic response • Decreased quantity of trivia and question complexity • Posted hard copies of trivia and questions • Cancelled due to lack of participation • Workstation access? • AORN Partnership / Educational Seminar • Employee enthusiasm and participation • Weekend In-Services • Employee enthusiasm and participation
Nurturing New GrowthAdding Nutrients • Utilize Staff Safety Assessment Survey Results • Act on issues identified by staff • Share evidence-based SUSP information • Knowledge improves acceptance • Develop Cheerleaders! • Garner employee support to promote SUSP concepts
Watching It Grow! • Added physician champions • Incorporated new WHO timeout guidelines • Incorporated Central Line Bundles in OR • Improved Hand-off Communication • Beta Blocker • Isolation • Moved clipping from OR to Pre-Op • Improved patient education • Easier access to hand sanitizers • Integrated charge RN meetings • Implemented PUP in pre-op holding
Watching It Grow! • Senior leadership empowers RN’s as patient advocate • Distribution of SUSP Concepts • Surgery Residents • Monthly Meetings • Surgery Committee Meeting • CAUTI Meetings
Weeding Out The Unwanted • Hasty departures from pre-op holding • Poor communication habits • PPE excursions outside the OR • Poor hand hygiene • Knowledge deficits • “Silo” mentality • Operative positioning tissue injuries
What Have We Learned? • SUSP Project • Success = Dedication! • Initial enthusiasm begins to wane in 2nd year • Need revitalizing booster shot • Not everything works as planned • i.e. Tidbit Trivia • Surgical Site Infections (SSIs) • ↑ Rate of CABG SSIs after EHR implementation • Suspect: WOW usage / Inadequate hygiene • Improved knowledge [may not]translate to practice (SSI’s can ↑) Expect Resistance - Old habits die hard !
UMC’s Future Landscape • Sprouted new initiatives! • SUSP “Tidbits” Repurposed • Infection Control Committee Meetings • Skin Council Meeting • Articles in • WOW pop-up hygiene reminders
More To Come…. • Posters promoting xxxdays without an SSI • Posters promoting xxxprocedures without an SSI • Service Line Incentive Competition
Thanks for joining us! Questions?