Facilitatingoptimaldischargeplansforhighriskpatients促进高风险患者的最佳治疗方案.pptxVIP

Facilitatingoptimaldischargeplansforhighriskpatients促进高风险患者的最佳治疗方案第1页/共37页 2008 NPSG (selected) 1 - Improve accuracy of patient identification2 - Improve the effectiveness of communication among caregivers3 - Improve safety of using medicationsRequirement 3E: Reduce the likelihood of patient harm associated with the use of anticoagulation therapyNew/第2页/共37页 2008 NPSG (selected)8 - Accurately and completely reconcile medications across the continuum of care9 - Reduce the risk of patient harm resulting from falls13 - Encourage patients’ active involvement in their own care as a patient safety strategy15 - The organization identifies safety risks inherent in its patient population第3页/共37页 NQF Safety Standards Safe Practice 17: Evaluate each patient upon admission, and regularly thereafter, for the risk of developing DVT/VTE. Utilize clinically appropriate methods to prevent DVT/VTE.Safe Practice 18: Utilize dedicated anti-thrombotic (anticoagulation) services that facilitate coordinated care management./第4页/共37页 Goal is to reduce incidence of surgical complications nationwide by 25% by 2010SCIP VTE1 – Surgery patients with recommended VTE prophylaxis orderedSCIP VTE2 – Surgery patients who received VTE prophylaxis within 24 hours after , see Other Resource: About the Project第5页/共37页 OSG Call to Action – Sept 15, 2008/第6页/共37页 The Joint Commission Sentinel Alert – Sept 24, 2008/SentinelEvents/SentinelEventAlert/第7页/共37页 第8页/共37页 Clinic overviewPatients = 4100+Mean age = 69 yrs, SD 13.65, range 20 - 100Common indications for treatment:AF ? 57%VTE ? 15%Heart Valves ? 9%INR intensity ranges2 – 3 ? 87%2.5 – 3.5 ? 9%By request, selected othersAdmissions:~75/month+ Reactivated patients~ 60% new referrals from inpatient (POE Consult referral)Discharges:~ 90/month第9页/共37页 Time in Therapeutic RangeTTR calculated using Rosendaal methodStrict range limits, eg. 2 – 3 and 2.5 – 3.5Using ALL INR data (induction, interruptions, etc)第10页/共37