1. GEORGIA HOSPITAL ENGAGEMENT NETWORK COHORT 9 COACHING CALL AUGUST 27, 2014 COHORT 2 + COHORT 3 + COHORT 4 = COHORT “9”

2. F RAMING PATIENT STORY HEN UPDATES (Data Submission Document) Videos for Employee Education “Patient’s perspective” Re-Admissions PFE QIO Update LEAPT Spread Worker Safety – Getting Started Getting ready for September spread – Procedural Harm and Failure to Rescue Calendar Review – Upcoming Events HEN Regional Meetings September 16, 2014 GHA September 30, 2014 Macon

3. H EALTH D ISPARITIES A hospital story….

4. C OHORT 2, 3, 4: R EADMISSIONS

6. S ENSE OF U RGENCY What actions will you take to adjust your improvement process based on what you have heard? What can the HEN do to support your efforts? Do Your PART campaign 6

8. http://www.gmcf.org/AlliantWeb/Files/QIOFiles/Members/Important%20Message%20fr om%20Medicare-English.pdf Updated patient letter from new QIO

9. F AILURE TO R ESCUE : S PREAD Bold Aims: PSI-4 – decrease deaths per 1000 patients having developed specified complications of care during hospitalization to 10% by December 2014. Reduce the number of unplanned transfers to a higher level of care by 20% by December 2014. Reduce the number of patients who had a code blue where there was not a Rapid Response Team called first by 20% by December 2014

10. F AILURE TO R ESCUE : S PREAD The Institute for Healthcare Improvement's 5 Million Lives campaign, which is a continuation of its initial 100,000 Lives campaign, calls for the establishment of Rapid Response Systems. i In particular, the goal of RRS implementation is to reduce the number of medical errors by decreasing the number of unmet patient needs prior to cardiac arrest. ii RRSs are established to "respond to a 'spark' before it becomes a 'forest fire,'" thereby preventing failure to rescue. iii

11. F AILURE TO R ESCUE : S PREAD Observable signs of deterioration develop within 6-8 hrs. of a cardiac arrest As many as 17% of cardiac arrests occur in patients being cared for in an inappropriate clinical setting iv Cardiac arrest was potentially avoidable in as many as 95% of these patients iv FTR is potentially avoidable in as many as 60% of patients who were cared for in an appropriate setting. iv

12. F AILURE TO R ESCUE : S PREAD Key Learnings: Position to Spread best practices within our HENs and across the nation starting September 2014  Provide mentor support and monthly coaching calls/webinars Leadership buy-in and Champion to assist with spread throughout organization Formation of Rapid Response Team (RRT) – multidisciplinary team with skill sets to handle emergency care Standardize RRT protocols— (policy/procedure/protocol)

13. F AILURE TO R ESCUE : S PREAD Key Learnings: Education of entire hospital staff AND Patients and Families---when and who can call a RRT call (anyone and everyone); role of each department in RRT is KEY Analyze data and give feedback to entire hospital on regular basis; report card format is preferred Continuous education of staff, patients and families is necessary to increase utilization

14. F AILURE TO R ESCUE : S PREAD Rapid Test of Change: Drills and simulations RRT Call Simulations Code Blue Grand Rounds Rapid Response Teams (RRTs) Implement RRT Policy

15. F AILURE TO R ESCUE : S PREAD Rapid Test of Change: Chart Review: Reconcile Patients with RRT calls with complications / mortality / unplanned transfers Educate staff to reinforce RRT activation criteria Post RRT- call huddles Hospitals are reviewing Rapid Response Team (RRT) activations and comparing to the Modified Early Warning System* (MEWS) scoring to determine feasibility of using the MEWS to identify patients who need an early intervention from a RRT or early response nurse.

16. “CAREGIVER SAFETY” W HERE TO S TART ? 1. Establish - a Team of “stakeholders” Suggest representatives from Occupational / Employee Health, Human Resources, Risk Management, Nursing, Quality, …. 2.Complete - OSHA’s Self –Assessment Tool: “How Safe is my Hospital?” 3.Evaluate - Employee Turnover, and Culture of Safety Survey Results 4. First Step Suggestions - Hospital Governing Board review of Worker Injury data Safe Patient Handling / Use of Low Tech Devices 16

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19. “HOW SAFE IS MY HOSPITAL FOR WORKERS?” 19

20. “HOW SAFE IS MY HOSPITAL FOR WORKERS?” 20

21. “HOW SAFE IS MY HOSPITAL FOR WORKERS?” 21

22. “HOW SAFE IS MY HOSPITAL FOR WORKERS?” 22

23. C ALENDAR OF U PCOMING E VENTS Next Cohort Coaching Call: October 22, 2014 HEN Fall Regional Meetings: September 16 (GHA) September 30 (MACON) Data Submissions: July Data Due September 15: ADE’s including INR, BG, and Opioids Falls with injury VTE-6 (due once a quarter) HAI (if not submitting via NHSN) EED if applicable Workers Safety if applicable

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