The Development and Implementation of an ESRD LAN The Early Experience December 12, :00 -3:00 PM Presenter: Beverly Hoek RN, Quality Improvement Director Network 3 QualityNet 2012 | Baltimore Marriott Waterfront Hotel December 11-13, 2012

HOW IS IT DIFFERENT FROM A COALITION? What is a LAN? 2

NOT BUSINESS AS USUAL! We Need to Change 3

HOW IS IT DIFFERENT FROM A COALITION? What is a LAN? 4

Definition of Coalition An alliance or union between groups, factions, or parties, especially for some temporary and specific reasons A coalition is a pact or treaty among individuals or groups, during which they cooperate in joint action A coalition is a group that forms for a specific purpose or cause. (noun). An example of a coalition is a task force working on….Fistula First 5

Coalition 6 Project Members

What is a LAN? A Learning and Action Network (LAN) is an improvement initiative that brings together healthcare professionals, patients and other stakeholders around an evidence-based agenda to achieve rapid, wide-scale improvement. The LAN model includes collaborative projects, online interactions, and peer-to-peer education to facilitate shared commitment, energy, and knowledge that allows participants to learn from each other as well as from the Network. 7

HAI LAN 8 NW3 HAI LAN PatientQIPROICPPRHA Society of Nephrology AtlantisFMCANNA Consejo Renal PR Kidney Foundation Auxilio Mutuo NW3 HAI LAN Patient Hospitals QIPRO ICP Hospitals PRHA Society of Nephrology Atlantis FMC ANNA Members ANNA CKD Pts Consejo Renal ESRD Pts PR Kidney Foundation Auxilio Mutuo Hosp. NW3 HAI ANNA PR Kidney Foundation Society of Nephrology Consejo Renal

Benefits of a LAN Connect with organizations and individuals that have similar Quality Improvement (QI) goals and challenges and have the opportunity for in-depth learning and problem solving Learn from others in an "all teach, all learn" environment Be mentored by a high-performing provider Benefit from others' best practices as quickly as they are identified Receive and share free information and tools that support improvement 9

Who will be part of your LAN? 10

11 In the Beginning Participating in Healthcare Quality Strategies, Inc. Learning and Action Network

HQSI’s HAI Advisory Committee Began in August 2011 Members included –NJDOH –APIC –NJ Hospitals –Pharmacists –NJHA Met approximately every 2 months In person or by conference call 12

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Developed Subcommittees Added specialized sub-committees –CLABSI –CAUTI –SSI –MDRO/CDIFF These groups met individually and then reported back to the Advisory Committee 14

HQSI LAN Benefits Opened the silo doors and began the “All Teach - All Learn” Became the framework for QIRN3’s LAN in PR September 13, 2012, Educational Program with the NJ North and South Chapters of APIC purpose was to enhance communication between the dialysis community and the ICP to improve NHSN reporting 15

HQSI LAN Benefits September 20, 2012, CUSP training for NW staff and several dialysis units in Chicago sponsored by the NJHA and HRET December 4, 2012, On the CUSP: Stop BSI- Sustainability for ESRD Patients. 1 st Cohort conference call to Roll Out CUSP Training for NJ dialysis units January 15, 2013, 1 st Cohorts CUSP training program July 2013, 2 nd Cohort of dialysis facilities will be trained in CUSP 16

DO the WAVE Campaign Included Dialysis Units 17

WINNERS 18

Puerto Rico Infection Control Initiative Developing a LAN in Puerto Rico 19

Puerto Rico Infection Control Initiative July 2011, USRDS data on vascular access infections August 2011, joined HQSI’s LAN LANs were mentioned in the Network’s next SOW It was the right thing to do and the timing was perfect. We were going to Puerto Rico in February Why start a LAN when it is not in the current contract ?

HAI LAN 21 NW3 HAI LAN PatientQIPROICPPRHA Society of Nephrology AtlantisFMCANNA Consejo Renal PR Kidney Foundation Auxilio Mutuo NW3 HAI LAN Patient Hospitals QIPRO ICP Hospitals PRHA Society of Nephrology Atlantis FMC ANNA Members ANNA CKD Pts Consejo Renal ESRD Pts PR Kidney Foundation Auxilio Mutuo Hosp. NW3 HAI ANNA PR Kidney Foundation Society of Nephrology Consejo Renal

PR HAI LAN First Face-to-Face Meeting February 2012 Held monthly conference calls –Agenda –Same time and day of the month –Limited to 1 hour Developed a logo Developed a Mission Statement 2 nd Face-to-Face Meeting November

LAN Accomplishments PR Kidney Foundation/ ANNA Caribbean Chapter Society of Nephrology November 10, 2012 Physician Meeting Speakers included –CDC –NW3 –Vascular/Transplant Surgeon –Auxilio Mutuo Administrator 23 May 2012, Patient Education Meeting >500 attendees November 11, 2012 ANNA Educational Program on Infection Control

LAN Accomplishments November 12, 2012, Met with CEO and other leadership staff from HIMA Hospital to discuss collaboration Facilities are reporting to QIRN3, patients that have been identified as developing an infection while hospitalized, this will be reported to the hospital ICP. 24

Do the WAVE campaign translated into Spanish Iza la VELA: ¡Puerto Rico Navega! –V ácunate – protégete de la influenza y la pulmonía. –E dúcate – pregunta cuando tengas dudas para mejorar la calidad de tu cuidado. Aprende sobre el uso correcto del equipo médico. –L impia: lávate las manos antes y después del tratamiento lava tu fístula o “graft” antes del tratamiento usa mascarilla durante la limpieza del catéter y también durante la conexión y desconexión - recuérdale al personal de enfermería que use su equipo protector si no lo tiene. –A ctúa – asegúrate de que el material y equipo médico están limpios y se utilizan correctamente. 25

Iza la VELA: ¡Puerto Rico Navega! Contest initiated November 19, 2012 Deadline for Submission December 31, 2012 Winners will be announced at Network Annual Meeting in PR in March

What Else is the LAN Working On? ICP meeting in PR with the Dialysis Administrators PRHA developing a CUSP training program for dialysis facilities LAN to develop patient education tools to distribute to physician’s office Work with QIPRO and PRHA to include additional hospitals Identify additional key stakeholders 27

Questions? Who will you invite to be on your LAN? Can you think of other organizations that should be on the Puerto Rico LAN? How can this experience be translated into a Beneficiary LAN? 28

Thank You Questions? 29