1. Patient/Family Centered Safe Care Putting Patients First 40/20 by ‘13 What Leaders Need to Know About Patient/ Family Centered Safe Care

2. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 2 Partnership for Patients (PfP) The Partnership for Patients has set an ambitious goal for all U.S. hospitals: reduce preventable all- cause harm rates by 40% and readmissions by 20% in our organization by the end of 2013. 2

3. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 3 Partnership for Patients: A Movement Our hospital is part of a national movement for the triple aim to Put Patients First and make patient care: safer more reliable less costly 3

4. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 4 As part of PfP Our Hospital Pledges To: Make achieving the goals of Putting Patients First, harm reduction and improved care transitions to reduce readmissions a priority for our Board of Directors, senior leaders, clinicians, and staff; Support clinicians and staff working for and with us and engage patients and families in order to make care safer, improve communication, and increase coordination by implementing proven systems and processes; and Learn from and share with others our experiences with Putting Patients First, making care safer and more coordinated. 4

5. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 5 Aim: To Reduce All Cause Harm All preventable harm must be addressed to reach the goal but these are the areas of focus to begin: (Hospital can star their priorities) Adverse Drug Events (ADE) (includes Medication Reconciliation) Catheter-Associated Urinary Tract Infections (CAUTI) Central Line Associated Blood Stream Infections (CLABSI) Injuries from Falls and Immobility Obstetrical Adverse Events (First: Early Elective Deliveries) Pressure Ulcers Surgical Site Infections Venous Thromboembolism (VTE) Ventilator-Associated Pneumonia (VAP) 5

6. Learn. Act. Improve. Spread. Keep the Drum Beat Going. Georgia Hospital Engagement Network Putting Patients First: 40/20 by ‘13 Goals: ­ Change culture to be Patient Focused, Staff Driven ­ Reduce hospital acquired conditions by 40% ­ Reduce readmissions by 20% ­ Increase patient/family engagement ­ Reduce all cause harm

7. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 7 Safe Care Not Only Important to Our Patients…. but also to Hospital Success Payment for care is now based on quality not volume Value Based Purchasing – Medicare payment incentives/penalties to promote: Achievement and improvement of high quality care Annual Market update increased or reduced up to 2% by 2017 – Payment based on quality measures and Patient satisfaction (HCAPHS) – Better scores higher payments, low scores lower payments Nonpayment for Hospital Acquired Conditions – Higher payment withheld if condition not present on admission Payment penalties for excessive readmissions 7

8. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 8 The Hospital's Reputation is Transparent Public Reporting of Quality and Patient Satisfaction Scores Patients/families using Social Media to discuss care 8

9. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 9 Where We Are Today Show Hospital's Quality Data (You can obtain hospital data from the PHA web site. Contact your Quality Director for instructions and password or contact Faizah Muheb at fmuheb@gha.org) 9

10. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 10 Our Hospital's Goals (Consult with your Quality staff for goals. Quality director can consult with PHA staff for assistance in developing your goals). 10

11. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 11 The Costs If We Do Not Meet Our Goals Patients Will Be Harmed Provide VBP Report on hospital’s projected payment Provide data on HAC cost (You can obtain hospital data from PHA web site. Contact your Quality Director for instructions and password or contact Faizah Muheb at fmuheb@gha.org. )fmuheb@gha.org 11

12. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 12 In Order to Provide Patient/Family Centered Safe Care Everyone Must: Work Together to Promote: ­ Patient/Family focus and engagement ­ Boundarilessness, seamless care ­ Unconditional team work ­ Speed and agility of change ­ Decreased cycle time to improvement ­ Repetition, testing, and evolving in real time ­ Reliability, standardization and spreading what works If you’re not working together, you’re not doing your job!

13. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 13 Leaders Must Create A Patients First Culture Align Goals Align Behavior Align Processes Hold everyone accountable and spread a culture of accountability throughout the organization 13

14. Learn. Act. Improve. Spread. Keep the Drum Beat Going. Leadership - Execution Framework Evidence-Based Leadership SM StandardizationAccelerators Must Haves ® Performance Gap Objective Evaluation System Leader Development Foundation STUDER GROUP ® : Agreed upon tactics and behaviors to achieve goals Re-recruit high and Middle/solid performers Move low performers up or out Processes that are consistent and standardized Process Improvement PDSA Lean Six Sigma Baldrige Framework Software Aligned GoalsAligned BehaviorAligned Process Create process to assist leaders in developing skills and leadership competencies necessary to attain desired results Implement an organization- wide staff/leadership evaluation system to hardwire objective accountability (Must Haves ® ) Rev 4.8.11 Breakthrough

15. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 15 Two Step Process The Why: – When everyone sees their role and their importance in being accountable for Safe Patient Care they become truly engaged The How: – Evidence shows that partnering with and supporting staff with tools and resources, especially RNs, leads to better patient outcomes and higher patient satisfaction – Let us know what tools and resources are needed to meet the goals – Hold everyone accountable for outcomes 15

16. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 16 Aligning to Put Patients First Align Goals – Clearly and frequently voicing the goals – Executive Rounding (assessing how things are going, what is working and resources needed) Align Behavior – Manager Rounding – Performance Evaluation 16

17. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 17 Align Processes to Put Patients First (Include QI approach tools your hospital uses) PDSA Reliable Systems Design Comprehensive Unit-Based Safety Program (CUSP) Daily Patient Goals Learning from Defects TeamSTEPPS Huddles Briefs/Debriefs SBAR CUS (Speaking Up) Lean/Six Sigma Other Quality Processes – Hourly Patient Rounding – Bedside Report 17

18. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 18 Leader Actions Are Key to Success We already have successes to celebrate! Our Vision and goals include ( add statements related to quality care) Our Expectations are communicated to employees Accountability is reinforced through rounding and listening We provide support for the work – time and resources Assess progress and measures through regular review at key meetings Feedback to staff, highlight, celebrate and spread success

19. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 19 Leading the Way to Patient/Family Safe Care What is your perception of Board and leadership commitment- how can it be strengthened? What more can we do to create energy and urgency by defining success and identifying clear goals and timelines How can the WILL to execute be demonstrated more? 19

20. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 20 Your Partnership Is Key to Leading the Effort Our expectations are for a fast-moving, iterative work environment- how can you help with that? Let me know of potential staff champions, physician and community champions Improvement teams will be used and supported by leaders to address focus areas of harm – give me ideas for team leaders We are tasking our quality teams to measure results quickly and report them back to hospital staff and partners Communicate to executive leaders needs related to the performance improvement skills and knowledge of staff 20

21. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 21 Your Work in Putting Patients First Lead the Patients First movement in our hospital Become a partner with all senior leaders, physicians, other leaders/managers, staff and patients to be relentless about putting patients first Look for good candidates to involve as patient advocates Include our patients and their families in all of our interactions regarding their care-rounding is mandatory if you work here

22. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 22 You Create the Environment to Put Patients First Evaluate and let the executive team know what additional support and resources are needed for teams to improve care and increase efficiency Create a Just Culture where errors and near misses are freely reported, analyzed and learned from to prevent harm Hold all in the organization accountable for safe patient care Support an environment where everyone can speak up for Safe Patient Care 22

23. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 23 All Hands on Deck Focusing on Our North Star – the Patient 23

24. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 24 Renew Your Sense of Purpose When we do what’s right for the patient the numbers will follow…..

25. Learn. Act. Improve. Spread. Keep the Drum Beat Going. 25 Hospital Executive Team Takes the Putting Patients First Pledge We pledge to: Make achieving the goals of Putting Patients First, harm reduction and improved care transitions to reduce readmissions priority of our Board of Directors, senior leaders, clinicians, and staff; Support and working each other in engaging patients and families in order to make care safer, improve communication, and increase coordination by implementing proven systems and processes; and Learn from and share with others our experiences with Putting Patients First, making care safer and more coordinated. 25