1. AHRQ Safety Program for Long-term Care: HAIs/CAUTI Cohort 4 May 6, 2015 Health Research & Educational Trust Project Team Members Organizational Lead Informational Webinar

2. DEB BOHR 2

3. Learning Objectives Recognize project goals, project vitals and importance of the project in the long-term care environment Identify the approach to education, coaching and measuring progress Summarize the organizational lead responsibilities expectations in regards to recruitment Describe how HRET and the national project team will support lead organizations Recall upcoming key dates 3

4. Agenda TopicPresenter Project OverviewDeb Bohr Program Interventions & Instructional StrategiesLouella Hung Measuring Progress & Data Collection ScheduleAJ Rolle HRET Support, Timeline & Key DatesHelen Plass Organizational Lead Expectations, Recruitment & EnrollmentLindsay Kolczynski Who to Contact, Q & ALindsay Kolczynski 4

5. Project Goals Primary Goals—reduce CAUTI and improve Safety Culture Develop/adapt evidence-based CAUTI elimination and safety practices and resources for LTCFs Reduce CAUTIs Improve safety culture Secondary Goals—support expanded infection prevention efforts for C. diff, UTI, MDROs by providing education to: Improve hygiene practices (hand, environmental) Promote antibiotic stewardship Promote catheter stewardship Reduce re-hospitalizations 5

6. Project Vitals Lead Organization – Participation Period: May 2015 – August 2016 – Activities include: Recruitment Engagement Monitoring Coaching/Support Project Period for Cohort 4 – Participation Period: July 2015 – August 2016 – Activities include: 2 months of kickoff and facility onboarding 11 months of data collection, educational activities and coaching 6

7. Why This Project Matters 1-3 million serious infections annually in LTC facilities Approximately 380,000 residents die of these infections Urinary Tract Infection is one of the most common HAls in LTC facilities Infections are among the most frequent causes of transfer & readmissions from LTC facilities to acute care hospitals High prevalence of urinary catheters in hospital patients transferred to LTC facilities Improving safety and quality of life for residents and their families is our overall aim! 7

8. How will LTC Facilities Benefit from Participation Potential to: Improve performance on Nursing Home Compare Quality Measures Enhance data collection skills and prepare for mandatory reporting of infection data (NHSN) Benchmark against other LTC facilities (project-level and nationally) Improve communication and relationships with referring hospitals Improve compliance with survey requirement related to quality of care, infection control, etc. 8

9. Project Partners National Program Team (NPT) Abt Associates Association of Professionals in Infection Control & Epidemiology (APIC) Baylor College of Medicine Qualidigm Society of Hospital Medicine (SHM) University of Michigan Partner Agency Centers for Disease Control and Prevention (CDC) 9

10. State, Regional or System-wide Lead Organizations Lead Organizations are key partners who are trusted by Long-term Care Facilities to lead them through a year of improvement Lead Organizations are subcontractors to HRET who coordinate the program in their state/region/constituents and serve as liaisons between NPT and their recruited facilities Examples of current Lead Organizations include: State and regional health care associations Multi-facility operators/long-term care communities Patient safety organizations Health systems QIN-QIOs 10

11. PROGRAM INTERVENTIONS & INSTRUCTIONAL STRATEGIES Louella Hung 11

12. How Will These Goals Be Achieved? Clinical interventions Evidence-based infection prevention practices Indwelling catheter, UA/culture and antibiotic stewardship Strategies to avoid re-hospitalizations, catheter alternatives Cultural interventions Learning from defects to understand and prevent adverse events Senior leadership engagement Front-line staff empowerment Teamwork and communication Regular team meetings 12

13. Educational Sessions In-person or virtual learning sessions: kickoff, mid-course and final Slides, expert faculty, interactive activities, handouts, resources Educational webinar/video series 13 Name of series # of Topics FrequencyWhat Format for Facility Team Lead Format for Front-line Staff Onboarding4Weekly Project orientation WebinarTrained by Facility Team Lead Training Modules4 Once every two weeks Infection prevention Videos Videos, and trained by Facility Team Lead Safety Culture Survey Results Forum 1OnceSafety cultureWebinarN/A Content9Monthly Clinical and cultural interventions WebinarTrained by Facility Team Lead

14. Education Series Schedule Onboarding Webinar SeriesDateTime 1. Building a Culture of Safety TeamThursday, August 61:00 – 1:45 p.m. CT 2. CAUTI DefinitionsThursday, August 131:00 – 1:45 p.m. CT 3. CAUTI SurveillanceThursday, August 201:00 – 1:45 p.m. CT 4. Data Collection TrainingThursday, August 271:00 – 1:45 p.m. CT Training Module SeriesRelease Date 1. Hand HygieneWeek of Aug 31N/A 2. Environment & EquipmentWeek of Sep 14N/A 3. Isolation PrecautionsWeek of Sep 28N/A 4. Antibiotic StewardshipWeek of Oct 12N/A Monthly Webinar SeriesDateTime National Content 3 rd Thursday of each month, beginning in November 11:15 a.m. – 12:00 p.m. CT 14

15. Coaching Calls 15 Ashley Hofmann, MSW Katie Johnson, MHS Anna Wojcik, MPH What :State-/Region-/System-specific coaching call When :Monthly, beginning in September Who : Facilitated and run by the organizational lead All facility team leads Faculty Coach provides clinical and cultural expertise HRET Advisor provides project management support and technical assistance Why : Review data and track project progress Discuss educational webinars and project interventions Share successes, challenges and best practices with other facilities Ask Faculty Coach and facility teams to engage in use of project tools, resources

16. MEASURING PROGRESS & DATA COLLECTION SCHEDULE AJ Rolle 16

17. Purpose of Measurement Measures are developed to support hard-wiring of resident safety processes with attention to the needs of the LTC environment. Improving safety and quality of life for residents and their families is our overall aim! 17

18. Why is Data Collection Crucial? Assesses the impact of the project’s clinical and cultural interventions on the program goals to: Reduce urinary catheter use and CAUTIs Improve patient safety culture Guides quality improvement efforts by: Highlighting areas of success Identifying opportunities for improvement 18

19. Required Data Metrics and Schedule Data CollectedFrequencyTime to Complete Background/Cultural Measures Registration 1x to enroll10 minutes Facility Demographics Baseline15 minutes Safety Culture Survey Baseline and follow-up10 minutes Process Measures Team Communication Guide Quarterly10 minutes Skills Questionnaire Baseline, mid-point, final15 minutes Outcome Measures Catheter Utilization CAUTI rates Urine culture order rates Monthly 19

20. Measurement Support Checklist tools to support awareness and adherence to evidence-based recommendations NHSN CAUTI definition assessment worksheet NHSN CAUTI definition pocket cards Support for survey and certification regulation compliance with: F-tag 315 (catheter with undocumented necessity) F-tag 441 (infection prevention/control failure) 20

21. HRET SUPPORT, TIMELINE & KEY DATES Helen Plass 21

22. How We Will Support You Facility Recruitment & Enrollment Support Flyer for you to customize Facility informational webinars Weekly Updates Reminders, schedules, tips for success Organizational Lead Training Pre-training Webinar Chicago in-person training Organizational Lead Operations Manual Program Website www.ltcsafety.org www.ltcsafety.org Other: facility registration support; facility implementation manual; HRET advisor; subject matter experts; data support 22

23. Cohort 4 Timeline 23

24. Important Dates for Cohort 4 24 ActivityDate/Time Org Lead Pre-Training WebinarThursday, May 28 at 12:00-1:30 p.m. CT Org Lead TrainingMonday, June 22 in Chicago Facility Informational WebinarsWednesday, June 3 or Thursday, June 23 at 11:00 a.m. CT Learning Session #1July 1-24 RegistrationOpens Today, Due July 24 Facility Demographics QuestionnaireOpens July 1, Due July 31 Skills QuestionnaireOpens July 1, Due July 31 Org Lead SubcontractJune 19 Onboarding Educational Series3 rd Thursday of the Month from 1:00-1:45 p.m. CT beginning in August Patient Safety Culture SurveyWeek of August 24, Due Sept 30

25. ORGANIZATIONAL LEAD EXPECTATIONS RECRUITMENT & ENROLLMENT Lindsay Kolczynski 25

26. Organizational Lead Expectations 25-30% FTE over a 14-15 month period Recruit ≥ 15 LTCFs Coach Facility Team Lead Communicate with LTCFs weekly by sharing HRET-prepared weekly updates Monitor LTCF engagement Educational activity participation Data submission Safety culture participation Monitor LTCF progress toward program goals Follow-up with struggling LTCFs Share successful strategies of exemplary LTCFs with HRET and national team Attend monthly calls with HRET/NPT and other org leads 26

27. LTC Facility Team Lead Expectations 100-105 hours over a 13-14 month period (~4.5% FTE) Form the facility team Attend all educational activities Train staff via the train-the-trainer module on each educational module Ensure data collection requirements are met Monitor progress toward goals Utilize expertise of the project team and your faculty coach Utilize project tools and resources Celebrate successes with facility team 27

28. Recruitment & Registration Recruitment Support Template emails and program materials to customize and send to facilities Informational slide deck; HRET team available to present HRET-sponsored Facility Informational Webinars Registration Support Enrollment Packet  Facility Commitment Letter  Data Use Explanation  Team Roster Online Facility Registration 28 Contact information for tips for facility recruitment strategies: David Schulke dschulke@aha.org Deb Bohr dabohr52@gmail.com 646-678-4280

29. Next Steps 1.Confirm participation in AHRQ Safety Program for Long-term Care: HAIs/CAUTI by contacting either Deb Bohrdabohr52@gmail.com646-678-4280dabohr52@gmail.com David Schulkedschulke@aha.orgdschulke@aha.org 2.RSVP to Ashley Hofmann (ahofmann@aha.org) to participate in Org Lead Training on Monday, June 22 in Chicago by May 22ahofmann@aha.org 3.Email signed subcontract to Jeanette Lyons (jlyons@aha.org) by June 19jlyons@aha.org 4.Ask all interested LTCFs to save-the-date for the Facility Informational Webinar on June 3 or June 23 at 11:00 a.m. CT 5.Recruit LTCFs and ensure they register by July 24 6.Identify a date and location for Learning Session #1 between July 1-24 29

30. QUESTIONS? 30 Questions