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OB Hemorrhage: A Collaborative Approach to Standardization Presented by: Kristi McClure, RN, MSN, C-EFM Clinical Educator, MCW June 26, 2014
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Mount Carmel Health System *
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MCHS OB Collaborative
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The Collaborative Approach Who –Multidisciplinary team –Physician champions
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The Standardization Process What –The equipment –The process –The team –The documentation
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The Standardization Process Where –Hospital –Health System –Region/State –Nation
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But WHY? Aviation ACOG AWHONN
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How do We Start? (Project Planning) Regular monthly meetings Leadership buy-in Budget planning Timeline/scheduling Physician Engagement
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Project Components Education Program OB Hemorrhage policy Rapid Response Team Massive Transfusion Protocol Written review process (Peer Review) Written process for weighing blood soaked items when hemorrhage identified
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Accomplishments
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Equipment - OB Hemorrhage Cart
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Policy Development Policy written to include: –Risk assessment of all patients –Weighing all materials for accurate EBL –Staging of hemorrhage based on EBL –Reference to Massive Transfusion Policy*
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OB Alert
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Trinity OB Hemorrhage Education Plan Education RequirementsResponsible PersonsTime Requirement per Participant Approx. Number of MCSA Participants HealthStream Online Pre-Test (Nov 1, 2013 – Mar 31, 2014) Required: Nurses (L&D, MIU, RRT) Physicians (Residents, Employed, Independent) CNMs Encouraged: Anesthesia Providers 30 minutes Nurses = 190 Physicians = 113 CNMs = 15 Anesthesia = 21 Recommended Readings & HealthStream Online Didactic Lecture (Nov 1, 2013 – Mar 31, 2014) Required: Nurses (L&D, MIU, RRT) Physicians (Residents, Employed, Independent) CNMs Encouraged: Anesthesia Providers 90 minutes Nurses = 190 Physicians = 113 CNMs = 15 Anesthesia = 21 OB Hemorrhage Skill Stations (Apr 30, 2014 – Sept 30, 2015) Required: Nurses (L&D, MIU, RRT) Physicians (Residents, Employed, Independent) CNMs OBT, MST, PCA Encouraged: Anesthesia Providers 30 minutes Nurses = 190 Physicians = 113 CNMs = 15 Anesthesia = 21 OBT, MST, PCA = 38 HealthStream Online TeamSTEPPS Lesson (Apr 30, 2014 - Sept 30, 2015) (Must be completed before simulation) Required: Nurses (L&D, MIU, RRT) Physicians (Residents, Employed, Independent) CNMs OBT, MST, PCA Unit Coordinators Encouraged: Anesthesia Providers 30 minutes Nurses = 190 Physicians = 113 CNMs = 15 Anesthesia = 21 OBT, MST, PCA = 38 Unit Coordinators = 17 Simulation & Debriefing (Apr 30, 2014 – Sept 30, 2015) Required: Nurses (L&D, MIU, RRT) Physicians (Residents, Employed, Independent) CNMs OBT, MST, PCA Unit Coordinators Encouraged: Anesthesia Providers 90 minutes Nurses = 190 Physicians = 113 CNMs = 15 Anesthesia = 21 OBT, MST, PCA = 38 Unit Coordinators = 17 HealthStream Online Post-test (complete 3-6 month after simulation/debriefing– no later than Mar 31, 2016) – Must achieve a score of 80% Required: Nurses (L&D, MIU, RRT) Physicians (Residents, Employed, Independent) CNMs Encouraged: Anesthesia Providers 30 minutes Nurses = 190 Physicians = 113 CNMs = 15 Anesthesia = 21 TOTALS5 hrs over 2 ½ years Total Time: 1,824 hrs over 2 ½ years 339 377 394 339
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Skills Stations
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Simulation
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Documentation
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Ultimate Goal
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