1. Partners for Patients HEN 2.0 Kick-Off Orientation Courtesy Reminders: During the webinar, you may select *7 on your phone to speak, and use *6 to mute. Please refrain from placing the phone on HOLD during the presentation.

2. In this presentation Overview of the WHA HEN (Partners for Patients) Initiatives planned for HEN 2.0 New Approaches Measures and Reporting requirements Enrollment Process

3. The HEN in Wisconsin 94 Hospitals 

4. What We’ve Achieved Agency for Healthcare Research and Quality (AHRQ) – Wisconsin 2 nd highest in healthcare quality in the nation WI Health System Cost Saving through PfP – $87,094,000 Harm Reduced by: – 9,304 Wisconsin Patients Our relatives, friends and neighbors

5. WHA Partners for Patients All Hospital Aggregate Results 17 % Venous Thromboembolism 15% Pressure Ulcers 0% Falls* 43% Adverse Drug Events 30% Catheter- Associated Urinary Tract Infections 48% Central Line Infections 6% Surgical Site Infections 7% Readmissions * While the rate of falls has remained steady, Wisconsin’s rate is 24% better than the national average.

6. WHA’s Approach to Quality Expand the hospital’s capacity to improve (be agile) Promote the involvement of front-line clinical staff, as essential partners, in safety work and process design. Improve the QI knowledge base of front-line staff. Teach effective “rapid cycle change” methodologies. Incorporate ‘learning by doing’ approaches. Provide a flexible learning environment (on-demand). Influence the role of hospital QI to be less the “doers” and more the “leaders”. The Key: Foundational QI methods executed very well

7. Evolution of Methods – our PDSA’s 9 mos. webinars Teach PDSA To Teams; Followed by best practices 6 mos. Webinars Teach best practices 1st, and tie to PDSA tools Hospitals attend according to their needs 6 mos. Webinars, Improvement Workbook; Hospitals Recruit team leads from clinical areas New HAC initiative for hospital?  WHA Webinar Series Need for ‘hardcoding’ practices?  Implementing a Protocol series Our Plan 2015-2016 2014 2013 2012 Patient-Family Engagement Practices Improving cross- cutting Essential Safety Practices

8. Emphasis is on “How” to improve Updated with new sections!

9. The work is not done yet Readmissions Falls Pressure Ulcers VTE Adverse drug events Surgical site infections OB harm and Early Elective Delivery CLABSI CAUTI Ventilator Associated Events Sepsis C. difficile Patient and Family Engagement Antimicrobial Stewardship

10. About the Initiatives for Partners for Patients

11. What’s the Same Access to latest best practices (HRET and IHI) WHA Quality Center resources Hospital wide engagement – beyond the quality department Access to HRET learning opportunities – Topic webinars – IHI Improvement Fellowship Your friendly Improvement Advisors

12. Improvement Advisors Stephanie Sobczak Tom Kaster Jill Hanson Regular phone consultations Site visits at your request Regions are approximated

13. What’s Different More frequent networking calls (we heard you) More Rapid Cycle approaches Targeted CAUTI Approach, using NHSN TAP reports to identify hospitals needing improvement Collaborative development on Patient-Family Engagement, Anti-microbial Stewardship, ADE

14. Approach Targeted Approach – Focus on opportunities relative to CMS benchmarks – Based on hospital performance – we will work with you to customize your approach Efficiently Implementing Protocols and Bundles - Closing the gaps in practice to get to zero harms Incorporate 7 Essential Safety Practices to address multiple impacts on patient safety QI Improvement Lead Fellowship - Expanding QI capacity and agility for your staff

15. Resources for Partners for Patients Improvement Strategy – Webinars Webinar series (Sepsis, C. diff, Readmissions, Falls, Patient/Family Engagement) Implementing a Protocol – New approach for CAUTI, CLABSI, Falls, PUP, VTE, etc. – a 4 month series HRET QI Fellowship with Institute for Healthcare Improvement Essential Safety Practices – cross cutting strategies – In-person Regional Events – CAUTI, Patient/Family Engagement

16. Your Options There are three approaches you could apply to an initiative: 1.Doing well, no assistance needed 2.Brand new topic & people new to QI 3.Need to close a few gaps

17. Doing Well  Enroll, and sign Statement of Work #12  We will use WHA Information Center data  You may optionally track Falls with Injury, manual entry or track process measures  Utilize WHA resources as needed  You will continue to receive Wednesday Weekly for educational opportunities

18. New Topic or New Team Leads  Enroll, and sign Statement of Work #12  Use WHA-IC data, or Enter more current data  Track process measures as needed  Assign a Team Lead for our topic content  Enroll for the appropriate webinar series  Enroll in the IHI Quality Fellowship through HRET  Consider selecting a few Essential Safety Topics

19. Need to Close a Few Gaps  Enroll, and sign Statement of Work #12  Use WHA-IC data, or Enter more current data  Enroll a Team Facilitator and Team Lead in the Efficiently Implementing a Protocol Series  Consider selecting a few Essential Safety Topics to apply

20. WHA Monthly Webinar Engagement 20 Webinar Part I: Evidence & Best Practice Sharing (30 min) Part II: Improvement Methods (30 min) 30 day Action Items Select from list of options Engage the team & any staff impacted by changes Anytime consultation or Interim Coaching Calls Data Submission Outcome and Process data submitted monthly Progress Reports to leaders View data in real time

21. When webinars make a difference (several of these are true) Clinical areas attend the webinars (not just QI) More than one person attends the webinars More than one shift views the webinars There is accountability in the hospital to move forward with selected action items There is active participation on requests for sharing and best practice write-ups

22. Efficiently Adopting Protocols and Bundles New approach Using a structured change management method – “Fix it in 6” 4 month webinar series Mid-month coaching calls (optional) Applicable to any HAC initiative or other topic Learn more during the October Improvement Forum – Oct 22 nd at Noon

23. Efficiently Implementing Bundles Internal MeetingsPurpose Webinar 1 Engaging Stakeholders Dec 9, 2 pm Optional Coaching call Jan 27, 2pm Pre-work Huddle Identify participants Gather information needed for stakeholders 1 – Stakeholders Meeting Identify gaps in best practices Determine other key stakeholders Webinar 2 Action Planning January 13, 2pm 2 – Action Planning Meeting Discuss priorities Identify low hanging fruit Identify processes to test Webinar 3 Change Planning Feb 10, 2 pm 3 – Change Planning Meeting Involve staff doing the work Plan for just in time trials/tests 4 – Progress Check Meeting Reports on pilots and tests Decision to continue, or adopt the change Webinar 4 Making Progress Mar 9, 2 pm 5 – Implementation Planning Meeting Discuss the implementation checklist Determine next steps Coaching Call on Implementation March 30 2pm 6 – Implementation Follow-up Meeting Monitor progress with implementation Determine accountable staff

24. Essential Safety Practices Topics for Collaborative Learning and Coaching Daily Whole House Safety Huddle January & February Use of Patient White Boards December Bedside Shift Report / Structured Hand-offs Purposeful (Hourly) Rounding Multi-disciplinary Care Huddles Hand Hygiene Compliance Leadership Rounds

25. Patient and Family Engagement Our Aim Pool the existing resources within the state of Wisconsin to develop a strategy and structure for facilitating the spread of Patient and Family Centered Care and Engagement through education, consultation, collaboration, training and dedication.

26. Patient and Family Centered Care Resources Event in 2016 – Patient and Family Advisory Councils Quarterly webinars

27. OB – Early Elective Deliveries Great progress in past 3 years Showing some decline in performance If your hospital has an EED rate over 2%, we will contact you and discuss additional resources that may help.

28. OB Clinical Simulation Training Training for high risk OB situations Scholarships through WHA Foundation One full day or two half days at a SIM lab OB interdisciplinary team of 8-10 Application for limited spots Contact Stephanie Sobczak for an application – ssobczak@wha.orgssobczak@wha.org

29. Targeted Approach We will consult with you on your hospital’s drivers of improvement We will come to your hospital for customized training of your team leads and staff We can help connect you with topic experts

30. HRET Learning Opportunities We will post links in the Wednesday Weekly Tentatively: October 27 CAUTI October 29 Readmissions November 4 – QI Fellowship with IHI launches

31. Measures and Reporting

32. Easy Data Measures – The majority are the same 15 measures from WHA Information Center (via Statement of Work #12) EED transferred from Checkpoint Five optional manual entry measures (Falls (2), ADE (3), Pressure Ulcer (1)) 18 measures from NHSN (if applicable to your hospital)

33. Process Measures You select which process measures will be helpful to drive improvement for a given topic. See the Encyclopedia of Measures document on the Quality Center for details

34. Getting Started

35. Enrollment Packet Next Steps  Participation and WHAQ Agreement  Senior Leader Attestation Form  Contact Information Form

36. Orientation Webinars New Team Lead On-Boarding We are presenting orientation webinars for any new team leaders WHA resources, Quality Center, and data submission Senior Leader Orientation webinar Team Lead Orientation – option 1 WebinarThursday, November 12, Noon Team Lead Orientation – option 2 WebinarFriday, November 13, 2 pm Senior Leader Orientation WebinarTuesday, November 17, Noon Register on the Quality Center Calendar

37. Questions? Please select *7 on your phone keypad to speak