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OHA Hospital Improvement Innovation Network

Improving Health Care Quality in Ohio

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In 2016, the Centers for Medicaid and Medicare announced its plans to move forward with the next phase of the Partnership for Patients (PfP) initiative to reduce harm and readmissions.

 
The Ohio Hospital Association is one of 16 national, regional or state hospital associations, Quality Improvement Organizations, and health system organizations to continue efforts in reducing preventable hospital-acquired conditions and readmissions. By collaborating with multiple partners to ensure sharing of best practices and education, OHA provides participating hospitals a unique experience for improving care. The Hospital Improvement Innovation Network (HIIN) contract awarded build upon the collective momentum of the Hospital Engagement Networks and Quality Improvement Organizations to reduce patient harm and readmissions. This announcement is part of a broader effort to transform the health care system into one that works better for the American people and for the Medicare program. Additionally, OHA has partnered with Battelle to include WayFinder, a predictive analytics software tool into the HIIN contract. This would allow for all of the OHA HIIN hospitals to access and use the software at minimal or no cost, as well as utilize additional data analytic opportunities that are currently being designed specifically for the PfP initiative.

Through 2019, these Networks will work to achieve a 20 percent decrease in overall hospital-acquired conditions and a 12 percent reduction in 30-day hospital readmissions as a population-based measure (readmissions per 1,000 people) from the 2014 baseline. Efforts to address health equity for Medicare beneficiaries will be central to the Hospital Improvement Innovation Networks efforts. CMS will monitor and evaluate the activities of the Hospital Improvement Innovation Networks to ensure that they are generating results and improving patient safety.


Cross-topic Resources

Core Focus Topics
Adverse Drug Events (ADE)
Adverse drug events (ADEs) are injuries resulting from drug-related medical interventions. ADEs can occur in any health care setting.


RESOURCES

Toolkits
Links
Recorded Webinars
  • Preventing Opioid ADEs...The past, present and future - February 18, 2016
    • Slides: Kelly Besco, Pharm.D., FISMP, CPPS - Medication Safety Officer - OhioHealth Pharmacy Services
  • Glycemic Control: Hitting the Sweet Spot During Inpatient Care - July 1, 2016
    • Slides: Tim Brown, PharmD, BCACP, FASHP - Director of Clinical Pharmacotherapy, Family Medicine, Cleveland Clinic Akron General, Professor, Northeast Ohio Medical University

Clostridium Difficile (C. diff), including antibiotic stewardship

Clostridium difficile (C. difficile) is an important cause of infectious disease death in the United States. C. difficile was estimated to cause almost half a million infections in the United States in 2011. Approximately 83,000 of the patients who developed C. difficile experienced at least one recurrence and 29,000 died within 30 days of the initial diagnosis.

Poor prescribing practices put patients at risk for C. difficileinfections. More than half of all hospitalized patients will get an antibiotic at some point during their hospital stay, but studies have shown that 30-50% of antibiotics prescribed in hospitals are unnecessary or incorrect.

C. difficile infections can be prevented by using infection control recommendations and more careful antibiotic use.

RESOURCES

Literature Toolkits Links Best Practices Webinars
Catheter-Associated Urinary Tract Infections (CAUTI)
A urinary tract infection (UTI) is an infection involving any part of the urinary system, including urethra, bladder, ureters, and kidney. 

RESOURCES

Toolkits
Links
Recorded Webinars
Central Line-Associated Blood Stream Infections (CLABSI)
CLABSI is a primary bloodstream infection that develops in a patient with a central line in place within the 48-hour period before onset of the bloodstream infection that is not related to infection at another site.

RESOURCES

Toolkits Links
Surgical Site Infections (SSI)
A surgical site infection is an infection that occurs after surgery in the part of the body where the surgery took place. 

RESOURCES

Toolkits Links Recorded Webinars
Ventilator-Associated Events (VAE)
Ventilator-associated events are comprised of ventilator-associated conditions (VAC), infection-related ventilator-associated complications (IVAC), and ventilator-associated pneumonia (VAP).

RESOURCES

Literature Toolkits Links Recorded Webinars
  • "How to Keep Your VAP Rate from Defining You: New VAP Definitions 2015" - January 25, 2017
    • Slides - Matthew Exline, MD, MPH, Director MICU, Associate Professor, Division of Pulmonary, Critical Care and Sleep Medicine, The Ohio State University Wexner Medical Center
    • Learning Objectives: Understanding new diagnositc criteria for a ventilator-associated pnuemonia, understanding the treatment options for ventilator-associated pneumonia, and discussing the role of "VAP-bundles" in preventing ventilator-associated infections.
Injuries from falls and immobility
Patient falls are unplanned descents to the floor with or without injury to the patient.

RESOURCES

Literature Toolkits Links Webinars
Pressure Ulcers
A pressure ulcer is an area of skin that breaks down when something keeps rubbing or pressing against the skin.


RESOURCES

Toolkits Links
Venous Thromboembolism (VTE)
Venous thromboembolism (VTE) is a disease that includes both deep vein thrombosis (DVT) and pulmonary embolism (PE). It is a common, lethal disorder that affects hospitalized and nonhospitalized patients, recurs frequently, is often overlooked, and results in long-term complications including chronic thromboembolic pulmonary hypertension (CTPH) and the post-thrombotic syndrome (PTS).

RESOURCES

Toolkits Links Articles
Readmissions
Hospitalizations account for nearly one-third of the total $2 trillion spent on health care in the United States. In the majority of cases, hospitalization is necessary and appropriate. However, a substantial fraction of all hospitalizations are patients returning to the hospital soon after their previous stay. These rehospitalizations are costly, potentially harmful, and often avoidable.

RESOURCES

Toolkits Links Best Practice Recorded Webinars
Severe Sepsis and Septic Shock
Sepsis, a deadly blood infection, impacts thousands of Ohioans every year (estimated 34,000 patients). Many of these patients continue to require additional health care services after surviving sepsis due to the complications of the disease. Early recognition and treatment can reduce the morbidity and mortality of sepsis.

RESOURCES

For Resources and Links related to sepsis, please visit the OHA Statewide Sepsis Initiative here.
Additional Topics
Hospital Culture of Safety
The safety culture of an organization is the product of individual and group values, attitudes, perceptions, competencies, and patterns of behavior that determine the commitment to, and the style and proficiency of, an organization’s health and safety management.

RESOURCES

Literature Toolkits Links Best Practices
Iatrogenic Delirium

Delirium may be the single most common acute disorder affecting adults in general hospitals. It affects 10-20 percent of all hospitalized adults, 30-40 percent of elderly hospitalized patients and up to 80 percent of ICU patients. In addition, delirium increases length of hospital stays, contributes to higher cost of care, leads to long-term cognitive impairment and increases mortality rates.

RESOURCES

Calendar of upcoming sessions: click here (Partnership with Minnesota HEN)

Literature Toolkits
Links Recorded Webinars
  • May 25, 2017: ICU Delirium Prevention and Treatment: Medication-Associated Implications
    • John W. Devlin, PharmD, BCCCP, FCCM, FCCP, Professor of Pharmacy, Northeastern University and Member of Scientific Staff in the Division of Pulmonary, Critical Care and Sleep Medicine at Tufts Medical Center, Boston, MA (Slides, Recorded Session)
  • March 23, 2017:  Physical Therapy Intervention in Delirium: Prevention, Identification, and Treatment
    • Amanda LaLonde, PT, DPT, Director of Clinical Education, Assistant Professor, Division of Physical Therapy (Slides, Recorded Session)
  • January 26, 2017: Delirium: How We Can Make A Difference
    • Denis Kresevic, RN, PhD., APN, Clinical Nurse Specialist III, University Hospital Case Medical Center (Slides)
  • December 1, 2016: Road Map to a Delirium Detection, Preention, Management Program
  • July 27, 2016: Non-Pharmacologic Management of Delirium: An ABCDEF Approach - recorded session
    • slides: Michelle Balas PhD, RN, APRN-NP, CCRN-K, FCCM - Discusses research findings to identify clinical education opportunities and clinical practice implementation.
  • June 22, 2016: System Wide Delirium Prevention Program at HealthPartners Facilities in Minnesota and Wisconsin - Engaging Patients and Families - recorded session
    • slides: Jan Dionne, MSN, CNS-BC, CEN; Susan Schumacher, MS, APRN, GCNS
  • April 27, 2016: Iatrogenic Delirium & Dementia/Delirium Related Behaviors - recorded session
    • slides: Heather Carey, PharmD, BCPP - UH Richmond Medical Center
    • slides: Sue Bikkie, DNP, GNP, APRN, BC - Orr & Associates
  • February 24, 2016: Delirium Assessment & ICU Delirium - recorded session
    • slides: Susan Schumacher, MS, APRN-BC - Park Nicollet Methodist Hospital
    • slides: Denise Kresevic, RN, Ph.D, APN - UH Case Medical Center
MRSA
Integration of Worker & Patient Safety
Health care professionals whose focus is on patient safety are very familiar with these alarming and frequently cited statistics from the Institute of Medicine: medical errors result in the death of between 44,000 and 98,000 patients every year. Health care professionals whose focus is on occupational health and safety, however, are likely aware of additional statistics that are less well known: health care workers experience some of the highest rates of nonfatal occupational illness and injury—exceeding even construction and manufacturing industries.

RESOURCES

Literature Toolkits Links Best Practices Webinars/Recordings
  • May 7, 2017:  The Integration of Worker and PatientSafety: We Share 4 Safety Brad Hunt, MBA, RiskControl360; Courtney Ulrich, MHSA, RiskControl360; Kelly Austin, PsyD, KLA Risk Consulting

Crosscutting Topics
Patient and Family Engagement
Engaging patients and families in improving health care safety means creating effective partnerships between those who provide care and those who receive it—at every level, including individual clinical encounters, safety committees, executive suites, boardrooms, research teams, and national policy-setting bodies. Increasing engagement through effective partnerships can yield many benefits, both in the form of improved health and outcomes for individuals and in safer and more productive work environments for health
care professionals.

RECORDINGS

May 11, 2017 - Metric 3: Overside of PFE; Chrissie Blackburn, MHA

April 13, 2017 - 12-1pm - Activating Patient Family Engagement as a Strategy for Improvement

  • Slides: Libby Hoy, Founder/CEO PFCCpartners

March 9, 2017 - 12-1pm - Person & Family Engagement (PFE) as a Strategy to Improve Patient Safety

February 9, 2017 - 12-1pm - Patient & Family Advisory Councils

Presenters: Chrissie BlackburnMHA
 

RESOURCES

Toolkits Best Practices Links
Disparities
Racial and socioeconomic inequity persists in health care quality. To meet the needs of their diverse populations, hospitals and health systems will need to bridge the gap between collecting meaningful patient data and reviewing the data to identify inequities in health care provision and utilization, and to implement simple yet effective interventions to improve care for patients.

RESOURCES

Toolkits Links
Leadership
Leadership is a critical function in promoting high quality, safe health care. In health care organizations, leadership is provided by the governing body, the chief executive and senior managers, and the leaders of the clinical staff. When a sentinel event occurs in a health care organization, inadequate or ineffective leadership is often one of the contributing factors. In fact, inadequate leadership was a contributing factor in 50 percent of the sentinel events reported to The Joint Commission in 2006. Research shows that leadership makes a major difference in the quality and safety of patient care.

RESOURCES

Webinars/Recordings
 

April 26, 2017: Hourly Rounding presented by Katie Galvan and Matthew Frye with Cleveland Clinic Fairview Hospital;  Recorded Session;   Slides

Literature

Toolkits Links

OHA HEN (2012-2014)

During the first campaign (2012-2014) the Ohio Hospital Association served as a leading Hospital Engagement Network within the state of Ohio. OHA had 68 Ohio hospitals who were participating in the PfP initiative.

OHA was also one of only six HENs in the country who participated in the Leading Edge Advanced Practice Topics initiative focusing on additional safety focus areas. The OHA HEN demonstrated a reduction of overall harm by 55%, improved patient and family engagement by 39% and improved leadership by 29% while reducing overall costs by more than $100 million.

In addition the individual hospitals made significant progress in Safety Across the Board in the three years of the campaign.

Click here to view the report.
© 2017 The Ohio Hospital Association. All Rights Reserved.