KeystoneICUProjectMeasurement.pptVIP

Improving ICU Care Through Teamwork Chris Goeschel RN MPA MPS cgoesch1@ Central Mandate Can One Institution Get to Zero? Can A State ? Project funded by the Agency for Healthcare Research and Quality Context Have we created a culture of safety? The Teams Research Team from Hopkins provides evidence and interventions, data analysis and face to face time with teams Keystone Team from MHA coordinates project (enrollment, data collection and management, conference calls and meetings) Teams from each ICU Implement Interventions and report data. Senior leaders serve as members of each ICU team Goals Work to eliminate CLABSI Ensure 90% of ventilated patients receive evidence-based interventions Learn from 2 defects a quarter One local one central Improve culture by 50% Improve quality improvement Comprehensive Unit-based Safety Program (CUSP) Evaluate culture of safety Educate staff on science of safety /ctlt/training/patient_safety.html Identify defects Executive partnership/ adopt a unit Learn from one defect per month; implement teamwork and clinical improvement tools; Re-Evaluate culture Science of Safety Understand System determines performance Use strategies to improve system performance Standardize Create Independent checks for key process Learn from Mistakes Apply strategies to both technical work and adaptivework. Learning from Mistakes What happened? Why did it happen (system lenses) What could you do to reduce risk How to you know risk was reduced Create policy/process/procedure Ensure staff know policy Evaluate if policy is used correctly Interventions to prevent Blood Stream Infections: 5 Key “Best Practices” Remove Unnecessary Lines Wash Hands Prior to Procedure Use Maximal Barrier Precautions Clean Skin with Chlorhexidine Avoid Femoral Lines Teamwork Tools Team Checkup Tool Daily Goals AM briefing Shadowing Culture check up tool Executive briefings Safety Scorecard Ideas for ensuring patients receive the interventions Engage: stories, show