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It Starts At The Top: Trinity Health’s Patient Safety Initiative

It Starts At The Top: Trinity Health’s Patient Safety Initiative. Judy Pelham President and CEO. Our Scope of Services. Trinity Health At - A - Glance.

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It Starts At The Top: Trinity Health’s Patient Safety Initiative

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  1. It Starts At The Top: Trinity Health’s Patient Safety Initiative Judy Pelham President and CEO

  2. Our Scope of Services

  3. Trinity Health At - A - Glance * MHS is also affiliated with an additional 13 acute care facilities through Mercy Health Network (a joint operating company in Iowa with Catholic Health Initiatives.)

  4. Our Mission We serve together in Trinity Health, in the spirit of the Gospel, to heal body, mind and spirit, to improve the health of our communities and to steward the resources entrusted to us.

  5. Patient Safety and Quality: Begins with Board-level Commitment • Quality Committee focuses on improving clinical outcomes • Based on goals set forth in our Strategic Plan

  6. Our System Strategic Plan: Creating the Health System of the 21st Century

  7. Strategic Focus: Improving Clinical Outcomes • National quality standards movement • Core Clinical Indicators • Tool Kits • Share best practices • Project Genesis

  8. Our Involvement:National Quality Movement • National Quality Forum • Agency for Healthcare Research and Quality • American Hospital Association • National Patient Safety Foundation

  9. Balanced ScorecardCore Quality Indicators Aligned with National Standards • AMI • - Aspirin within 24 hours • - Beta blocker at discharge • Heart Failure • - Left ventricular function assessment • - ACEI at discharge • Pneumonia • - Oxygenation assessment within 24 hours • - Timeliness of antibiotic administration • OB • - 3rd / 4th degree lacerations

  10. Balanced ScorecardAdditional Core Quality Indicators • OB • - First time C-section • Medication safety • - Height & weight documentation • - Medication profiles with allergy documentation

  11. Balanced ScorecardCore Quality Indicators “Tier II” • Orthopedics • - Hip implant average length of stay (ALOS) • - Hip replacement discharge status • - Readmission of hip replacement patientswithin 20 days • OB • - Percent of low birthweight babies

  12. Balanced ScorecardCore Quality Indicators “Tier II” • Respiratory • - Severity adjusted inpatient pneumonia mortality • - ALOS of complicated pneumonia patients • - Pediatric asthma patients readmitted within 30 days • Cardiovascular • - CHF days / year

  13. Long Term Care Indicators Recently re-aligned with CMS published data • Chronic care measures • - Activities of daily living • - Use of restraints • - Prevalence of pain • - Prevalence of infection • - Risk adjusted pressure ulcers • Short stay measures • - Prevalence of risk adjusted delirium • - Prevalence of pain • - Improved walking

  14. Clinical “Tool Kits” • Pneumonia • Heart failure • Maternal child • Orthopedics • Patient safety • AMI

  15. Sharing Best Practices:The “Intelligent Network” • Clinical collaboration • Annual clinical conference • - 36 breakout sessions • - 125 poster exhibits

  16. Sharing Best Practices:Data Transparency • I2S2: Integrated Information Shared Services • PEERS(Patient Error Event Reporting System) • Balanced Scorecard • - Includes all Core Quality Indicators

  17. Computerized Physician Order Entry • Patient Administration • Adverse Drug Event Alert

  18. Clinical System Benefits Enhance Patient Safety and Care For the physician: • On-line order entry with standard order sets and real-time, evidence-based rules/alerts • Electronic signature • Remote access from home/office

  19. Clinical System BenefitsEnhance Patient Safety and Care • For the nurse: • Daily Patient Access List (PAL) shows assigned patients and organizes patient care activities • Point-of-care access to the electronic chart through wireless devices, workstations • Streamlined, on-line charting and documentation

  20. ADE Benefits 65,085 Total ADE Alerts July - December 2002 Alerts Associated with Clinical InterventionsNumber of Times Physician Contacted Pharmacist-Initiated Interventions (per protocol) Number of Times Physician Consented to Change Intervention Rate 7,322 4,843 2,479 3,926 (81%) 11.25%

  21. Conclusion • Trinity Health: Creating the health system of the 21st Century • Guided by our Mission, Boards and Management • Patient Safety: The foundation for clinical quality • Improving Quality of Care and Safety: Fundamental to the Mission of Trinity Health

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