1. ICU Safe Care Initiative/CUSP October 5, 2009 9:00 am – 3:30 pm

2. ICU Safe Care Initiative/CUSP Pat Noga Richard de Filippi Paula Griswold John Combes

3. Objectives for the Day Review the purpose and vision of the ICU Safe Care Initiative/Comprehensive Unit-Based Safety Program (CUSP). Understand how your ICU and your hospital will benefit from participation. Build the skills of physicians, nurses, and other care team members in identifying and eliminating system defects that can result in patient harm, and in improving teamwork and building a safety culture. Engage in discussion with national experts on research and best practices in reducing infections, preventing central line infections, and going beyond the bundle. Discuss how to apply in your hospital including the impact of reducing central line infections on costs and patient days. Discuss steps and timeline in implementation of the initiative.

4. Using Collaboratives to Reduce Central Line-Associated Bloodstream Infections (CLABSI): A National Implementation Program Peter Pronovost, MD John R. Combes, MD

5. National Context and Leadership

6. HHS Steering Committee for the Prevention of HAI Charge: Develop an Action Plan to reduce, prevent, and ultimately eliminate HAIs Plan will: –Establish national goals for reducing HAIs –Include short- and long-term benchmarks –Outline opportunities for collaboration with external stakeholders –Coordinate and leverage HHS resources to accelerate and maximize impact

7. AHA’s Hospitals in Pursuit of Excellence Reduce Surgical Infections and Complications Reduce Central Line- associated Blood Stream Infections (CLABSI) Reduce methicillin-resistant Staphylococcus aureus (MRSA) Reduce clostridium difficile infections (c diff) Reduce ventilator-associated pneumonia (VAP) Reduce catheter-associated urinary tract infections Reduce adverse drug events from high-hazard medications (e.g., anticoagulants, narcotics, opiates, insulin, sedatives) Reduce pressure ulcers

8. State Consortia

10. 8 State Consortia Members State hospital associations State patient safety coalitions Quality improvement organizations (QIOs) State health departments May include others: –Payers –Patient Safety Organizations –Government officials –Business

11. State Consortia & Sustainability State consortia key to sustainability: –Train-the-trainer education to build capacity for future patient safety innovations, e.g., On the CUSP: Decubiti –Evaluation component to identify lessons, including critical success factors and barriers

12. HAI Elimination Collaboration Policy Leadership AHRQ CDC CMS AHA Field Leadership JHU Keystone HRET NW Implementation Leadership State Hospital Associations Patient Safety Coalitions Department of Health Quality Improvement Organizations

13. Keys to National Improvement National Commitment Strong Collaboration –Federal Agencies –Provider Organizations –State Stakeholders Local Consortia Sustainability –Unit Based Culturally Driven Improvements

14. Workshop Objectives Describe the purpose and vision of the ICU Safe Care Initiative/Comprehensive Unit-Based Safety Program. Describe the process used to identify and eliminate system defects. List three tools or strategies used to improve teamwork and build a safety culture. State research and best practices in reducing infections, preventing central line infections, and going beyond the bundle.