Transcript Including TeamSTEPPS in Hospital Engagement Network Planning

Including TeamSTEPPS in Hospital
Engagement Network Planning
What the HEN Program Is
• Background: Key part of HHS Partnership for Patients
• Parameters: 2-3 years, 3,000+ participating hospitals, 26 HEN
contractors, $218M in funding from CMS to HENs
• Focus: Adverse drug events, catheter-associated urinary tract
infections, central line-associated blood stream infections, injuries
from falls and immobility, obstetrical adverse events, pressure
ulcers, surgical site infections, venous thromboembolism,
ventilator-associated pneumonia & preventable readmissions
• Goals: 40% reduction in healthcare acquired conditions & 20%
reduction in preventable readmissions
HENS and TeamSTEPPS
• HENs must address three cross-cutting issues:
leadership, safety culture, teamwork, etc.
• TeamSTEPPS helps:
– Provide resources for engaging leaders
– Create a culture of safety within hospitals
– Improve teamwork in units and facilities
– Equip hospital staff working to address all 10 areas
HENS are targeting
Session Goals
• Expose attendees to range of approaches for using
TeamSTEPPS to reinforce HEN activities
– Training entire facilities to use TS for all aspects of their
work
– Introducing specific tools from TS to help staff in hospitals
or units address specific challenges
– Embedding TS tools or resources into HEN topic-specific
change packages
• Learn challenges facing four separate HENS using TS
and how they are overcoming them
• Foster dialogue with presenters and audience
members about how TS can contribute to efforts by
HENS and other groups to improve substantial quality
improvement
Presenter Introductions
• All presenters:
– Are representatives from HENS
– Are incorporating TS into their
• Nancy Landor, RN, MS, CPHQ (HANYS)
• Betsy Lee, RN, BSN, MSPH (IN Hospital Assoc)
• Patricia Noga, RN, PhD, MBA (MA Hospital
Assoc)
• Darlene Swart, RN, BSN, MS (TN Hospital
Assoc)
• Sheri Winsper, RN, MSN, MSHA (HRET)
TeamSTEPPS National Conference
Nashville, Tennessee
A partnership of the Healthcare Association of New York State
and the Greater New York Hospital Association
NYS PARTNERSHIP FOR PATIENTS
Multi-Prong
Approach
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NYS PARTNERSHIP FOR PATIENTS
AHRQ
o
o
Culture of Safety Survey
Readiness for Change
> 40% response rate (> 43,000 surveys)
Participation (NYSPFP n=173 hospital sites)
RFC
AHRQ
COS
Exclusive through the NYSPFP
62%
60%
66%
87%
80%
Total
-Submitted current survey results into the NYSPFP
-System or Hospital currently has hospital-wide CRM
Program
Team
STEPPS
NYS PARTNERSHIP FOR PATIENTS
NYSPFP TeamSTEPPS
Phase One: Executive Coaching Training
Phase Two: Hospital Master Training
Phase Three: Individualized Hospital
TeamSTEPPS Strategic Roll-out Plans
NYS PARTNERSHIP FOR PATIENTS
Phase One: Executive Coaching Training
For NYSPFP Project Managers 5/12
Day 2
TeamSTEPPS Simulation
8:30 – 8:45
Check-in and Simulation Set-up
8:45 – 9:45
Setting the Stage: Scenario 1 (Urgency)
9:45 – 10:30
Setting the Stage: Scenario 2 (The Change Team)
10:30 – 10:45
Break
10:45 – 12:00
Deciding What to Do: Scenario 3 (The Assessment)
12:00 – 1:00
Lunch
1:00 – 2:30
Making It Happen: Scenario 4 (Targeted Improvement Plan)
2:30 – 3:00
Additional TeamSTEPPS Resources
3:00– 3:15
Break
3:15 – 4:00
Making it Stick: Scenario 5 (Making the Patient the Center of the Team)
4:00 – 4:30
Wrap-Up and Evaluations
NYS PARTNERSHIP FOR PATIENTS
NYSPFP
Phase Two: Regional Master Trainer Programs
•Two day Training
(Lesson Learned: Modified from 3 to 2 days after 1st Session)
• Project Managers coach on Day II - Hospital Action Plans
• Mid-May through Mid-July
• One lead staff per hospital
(Lesson Learned: Open up to more than one per hospital)
NYS PARTNERSHIP FOR PATIENTS
Phase Three: Hospital Level TeamSTEPPS Roll-Out
Plan:
•
•
•
Hold two-day sessions at each participating hospital
Hospital Lead Master Trainer
Hospital NYSPFP Project Manager
NYSPFP Experienced Faculty
Lesson Learned - Current Status
• Expert consensus Issue on one or two day Master
Training
• Variation per Hospital on preference for educational
TeamSTEPPS roll-out
• Currently adjusting planning and curriculum to meet
multiple needs, approaches, and tactics
NYS PARTNERSHIP FOR PATIENTS
Hospital Action Plans
o
o
o
o
Roll-out in Key Service Areas (OB, OR)
Roll-out in NYSPFP HAC Initiative Teams
Roll-out top 4-6 TeamSTEPPS tools from Board to
Floor
Hybrid of Above
NYS PARTNERSHIP FOR PATIENTS
NYSPFP
NYSPFP Response to Hospital TeamSTEPPS
o
o
o
o
Two-day hospital – based programs
One-day hospital – based programs
Additional regional programs (mainly in NYC)
Specialty programs for key areas OB, Critical Care
Anticipate prior to (as able) or if we go to Year III
o
o
One-two hour frontline and physician staff program
Individualize hospital programs
Utilizing hospital trained staff and NYSPFP project managers
Indiana Coalition for
Care: Integrating
TeamSTEPPS
Betsy Lee, RN, MSPH
Director, Indiana Patient Safety Center
Indiana’s Bold Aim:
To make Indiana
the safest place
to receive health
care in the
United States,
if not the world
Inaugural Indiana Patient
Safety Summit - March 2010
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How Might We Do This?
• Transform cultures to promote safe care
• Embrace both the personal and collective
nature of change
• Drive out fear in our organizations
• Recognize the difference between system error
and human error
• Practice human-centered design
• Improve communications at handovers
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TeamSTEPPS History in Indiana
• Patient Safety Improvement Corps –
TeamSTEPPS Master Training (2007-08)
• Two one-day TeamSTEPPS educational
sessions (SSM trainer) – 2008
• Elements integrated into IHI TCAB Teamwork
and Vitality content and How-to Guide for
Optimizing Teamwork and Communications
• Select Indiana hospitals implemented
TeamSTEPPs – not widespread
Ten regional coalitions cover Indiana
Members agree not to compete on patient
safety
Create layered model of regional coalitions
and affinity groups – Indiana’s “transformation
grid” to support dissemination
Benefits:
• Innovate at the front lines
• Align with state and national efforts, and
standardize when beneficial
• Model builds local and hospital-specific
capacity for improvement and innovation
• Encourages safety leadership at all levels
across multiple professions
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Leading Transformation
Leadership
TransformationininIndiana
Indiana
Assessing and
Organizing
Building Lasting
Capacity
Driving
Improvement
Individual hospital plan
based on the needs
assessment
T WebMedication/ Safety
based CEU/certification (10
per hospital)
HAI Focus (CLABSI, CAUTI,
SSI, VAP)
IHA – Sepsis mortality
Safety Coalition and affinity
group support
Lean executive overview
(5 per hospital)
HRET content offerings
Lean Six Sigma certification
(2 green belts, 1 black belt
per hospital)
IHA/Purdue coaching
Joint programs with Health
Care Excel and other HENs
Innovation and Transforming
Care
Leadership for Safety
(CEOs, Trustee, and Safety
Leaders)
Obstetric Adverse Events
(IHA/ISDH/FSSA/March of
Dimes – with IHI support)
Transforming Care at the
Bedside – Pressure Ulcers,
Falls, Teamwork)
Medication Adverse Events
and Readmissions
+
Culture/Leadership/TeamSTEPP
S/ Patient & Family Centered
Care
All Cause Harm
Capacity Building (Purdue
Healthcare TAP)
• Lean Six Sigma Certification & Training:
• Executive Training ( up to 5 people per hospital) – 2
days
• Hospitals will identify 3 project areas from 10 HAC’s
• Black Belt Training (up to 1 person per hospital)
• Green Belt (up to 2 people per hospital)
• Plan to integrate TeamSTEPPS elements
• Medication Safety
• On-line course (10 people per hospital)
• Encourage inter-professional team
STATEWIDE
What is your interest in working with IHA in these areas if content and hands on technical
assistance would be provided at no charge to your facility?
Preventable Readmissions
Injuries for Falls and Immobility
Unit-Based Teamwork/Communication
Culture of Safety Improvement
Venous Thromboembolism (VTE)
Leadership for Quality/Safety
Pressure Ulcers
Catheter-Associated Urinary Tract Infections (CAUTI)
Adverse Drug Events (ADE)
Lean/Six Sigma for Process Redesign
Surgical Site Infections
Central Line-Associated Blood Stream Infections
All Cause Harm Using the IHI Global Trigger Tool
Ventilator-Associated Pneumonia (VAP)
Obstetrical Adverse Events
Partnership for Patients
Interest Survey - 7/2011
Total Responses = 142
0%
10%
Percent Very Interested + Interested
20%
30%
40%
50%
Percent Somewhat Interested
60%
70%
80%
90%
AHRQ Hospital Survey on Patient
Safety Culture
• Offered to Indiana hospitals for free since
2007 through Georgia Hospital Association
• Over 75,000 employee responses from about
90 hospitals in 5 years
• Biggest opportunities for improvement:
– Non-punitive response to error
– Handoffs and transitions
Designing for Results
• Regionalize technical assistance and
education
• Align measures to mark progress
• Utilize Lean/Six Sigma training to drive
results in topic areas
• Build teamwork and communication
competencies
• Focus on patients and families
• Make it personal
Contacts
Betsy Lee, RN, MSPH
Director, Indiana Patient Safety Coalition
Indiana Hospital Association
[email protected]
(317) 423-7795
Kathy Wallace
Director, Performance Improvement
Indiana Hospital Association
[email protected]
(317) 423-7740
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Implementation of TeamSTEPPS
June 21, 2012
Massachusetts
Hospital Engagement Network
with Advisory Group Partners MA Coalition, Masspro, MA DPH
BORM QPSD, IHI, MA Senior Care Association
HEN Goals
The 40/20 Goal
• Keep patients from getting injured or sicker.
Reduce preventable hospital-acquired conditions by 40%.
1.8 million fewer injuries to patients, with more than
60,000 lives saved over the next three years.
• Help patients heal without complication.
Reduce hospital readmissions by 20% .
1.6 million patients will recover from illness without
suffering a preventable complication requiring
re-hospitalization within 30 days of discharge.
Opportunity for MA Hospitals
“The 40/20 Goal”
• Leverage local expertise and national resources
• Target improvements towards common goals (reduce
harm and readmissions)
• Coordinate patient safety efforts with statewide
partners
• Accelerate the adoption of best practices through
peer learning networks
• Build capacity for creating a culture of patient safety
Massachusetts HEN 31 Teams
•
•
•
•
•
18 Community Hospitals
4 Long Term Acute Care Hospitals
4 Rehabilitation Hospitals
3 Rural Hospitals
2 Specialty Hospitals
MHA HEN Approach
• Network Model: peer-to-peer learning
• Learning Events: collaboratives, webinars, training sessions,
conferences, forums
• Hospital Affinity Peer Networks: affinity groups for sharing best
practices on patient safety focus areas and improving transitions in
care
• Safety Culture: series of events and training opportunities to
highlight system improvements for patient safety
• Technical Assistance: coaching, peer mentoring, and site visits
(peers and coaches)
• Measurement: hospitals track aggregate results on 40/20 scale to
benchmark performance and identify best practices
AIM
Aim: Provide an integrated approach for hospitals to work together in multiple
forums and structured programs to improve performance and create a culture
of patient safety within facilities and across the transitions of care.
Learning
Collaboratives
Webinar Series
Learning-in-Network
Hospital Affinity
Peer Networks
Safety Culture
Forums
Learning Collaboratives
Collaborative Learning Events using a combination of in-person meetings,
regional events, and distance learning technologies to support shared learning on
the science of improvement and the application of evidence-based practices
SUSP (SSI)
CUSP/CLABSI
CUSP/CAUTI
AHRQ
MHA/Mass
Coalition/AHRQ
MHA/AHRQ
Pressure Ulcer
Collaborative
MHA/MSC/HCA/
Masspro
OB
Collaborative
MOD/DPH
Avoidable
Readmissions
MHA/Mass
Coalition/DPH/MMS
Webinar Series
Learning Programs and Events highlighting successful practices for
implementing evidence-based change strategies and rapid action cycles for
improvement
ADE Webinar
Series
Falls
Collaborative
Masspro/MHA
DPH/MSC/HCA/M
HA
VTE Webinar
Series
VAP Webinar
Series
MHA
MHA
Leadership Affinity Networks
Affinity groups representing leadership from peer organizations
to share best practices and highlight opportunities for improving
the culture of patient safety
Avoidable
Readmission
Hospitals
Community
Hospitals
Rural
Hospitals
Post-Acute
Care Facilities
Specialty
Care Facilities
Safety Culture Forums
Training and events designed to introduce strategic initiatives and
system improvements for creating a culture of patient safety
Patient Safety
Toolkit
TeamSTEPPS
Training
Learning
from Defects
Events
Just Culture
Training
MA HEN Approach
•
•
•
•
Educate Master Trainer – State Lead
Educate Master Trainers – HEN Coaches
Educate Master Trainer for each hospital
Incorporate TeamSTEPPS training
concepts and components into HEN
programs
– Patient Safety Topic Areas
– Safety Culture Forums
MA HEN Timeline & Plan
• Complete Master Training by State Lead
• Assess Need for Training among Hospital
Leads and Teams
• Plan for 2 Hospital Master Training
Sessions during December 2012 and
January 2013
• Provide technical assistance and
mentoring to teams re: TeamSTEPPs
MA HEN Challenges
How to effectively train in TeamSTEPPS and
facilitate culture change –
– Diverse culture & focus of HEN hospitals
– Delivery of effective TeamSTEPPS
programming & mentoring
– Many learning programs and events
– Short timeline of HEN initiative
Thank you
Tennessee Hospital Association
Hospital Engagement Network
(THA HEN)
• The THA HEN program activities are carried out
through THAs Tennessee Center for Patient Safety
(TCPS), established in 2007.
• The THA HEN has 66 member hospitals enrolled in
the program.
Tennessee Hospital Association
Hospital Engagement Network
(THA HEN)
• The THA HEN will roll out TeamSTEPPS ® to the 66
member hospitals.
• We will provide the “Train the Trainer” program
regionally.
• 10 hospitals have already shown interest in
implementing TeamSTEPPS ® training.
Tennessee Hospital Association
Hospital Engagement Network
(THA HEN)
Challenges:
• Initiative overload
Successes:
• TCPS has offered, free of charge, the AHRQ Hospital
Survey on Patient Safety (HSOPS) to our 122 safety
partners since 2008.
• The TCPS has been collecting data since 2008 on
CLABSI, MRSA and SCIP.
Tennessee Center for Patient Safety
THA Board Aim: Zero Preventable Harm
Partnership for Patient Goals:
Decrease hospital-acquired conditions by 40%
Reduce hospital readmissions by 20%
Leadership
Culture
HAI
HAC
MDROs
VAP
MRSA
CDI
OB
FALLS
CAUTI
SSI
CLABSI
HEN TOPICS
TCPS State Initiatives
Readmissions
VTE
ADE
PU
HEN – Hospital Engagement Network
HAI – Healthcare-Associated Infection
HAC – Hospital-Acquired Condition
MDRO – Multi-Drug Resistant Organism
MRSA – Methicillin-Resistant Staphylococcus aureus
CDI – Clostridium Difficile
SSI – Surgical-Site Infection
CLABSI – Central Line-Associated Bloodstream Infection
CAUTI – Catheter-Associated Urinary Tract Infection
VAP – Ventilator Associated Pneumonia
VTE – Venous Thromboembolism
PU – Pressure Ulcer
ADE – Adverse Drug Event
OB – Obstetrical Adverse Event
THA HEN/TCPS
Staff
•
•
•
•
•
•
•
Chris Clarke, Sr. VP, Clinical and Professional Practices
Darlene Swart, VP, Clinical Director
Patrice Mayo, VP, Operations Director
Larissa Lee, Project and Data Manager
Angela O’Neal, Executive Assistant
Mary Ellen Mooney, Clinical Director, PSO
Rebecca Carroll, Executive Assistant and Project
Coordinator, PSO and TSQC
• Lin Keyes, Data Quality Control Assistant
• Jackie Moreland, Clinical Quality Improvement Specialist
Contact Information
Darlene Swart, VP, Clinical Director
Phone: (615) 401-7460
Email: [email protected]
Website: www.TNPatientSafety.com
QUESTION & ANSWER PERIOD