Small and Rural Critical Access Hospitals

July 19, 2011

Agenda

• Denise Flook and Lorna Martin• Applying CUSP in the Small and Rural Critical

Access Hospital• Using CUSP Beyond CLABSI and CAUTI

• Critical Access Hospital Team Leaders• Paul Frigoli, Grant Regional Health Center• Illinois Critical Access Hospital Team Leader

• Suggestions for future calls

Denise M. Flook, RN, MPH, CICDirector, Workforce Development & Infection

Prevention

Lorna Martin, RNPatient Safety & Quality Improvement Specialist

Applying CUSP in the Small and Rural Critical Access Hospital

Quality and Safety are Now Key to Hospital Success

• Payers, including the Government and the public, demand more efficient, safer care

• Limited resources will necessitate efficiency

The Challenge

• How do we provide and sustain the highest quality and safest care for every patient, every time in the current environment of diminishing resources?

• It is easy to think that simply implementing a checklist is the path to better outcomes, but Changing culture is the key to sustained safety and improved outcomes for patients

Safety/Quality Improvement is a Two-Part Process

What is CUSP?

• Comprehensive Unit-based Safety Program• An intervention to learn from mistakes and improve

safety culture for sustained improved patient outcomes

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The CUSP Steps

1. Develop a team2. Assign executive to adopt unit3. Educate staff on science of safety4. Identify and prioritize defects5. Implement teamwork tools6. Provide timely feedback7. Learn from defects – Have staff investigate each occurrence

Adapted from Pronovost, Patient Safety, 2005

CUSP is a Continuous Effort

• Add science of safety education to orientation• Learn from one defect per quarter; share or post

lessons • Use quality improvement and teamwork tools that

best meet the hospital/unit’s needs• Feed back timely data; investigate each event

Walking Through the Process

Eliminate Hospital-Acquired Stage 3/4 Pressure Ulcerson the Unit•Develop a team -- Include staff nurses•Gather baseline data•Have first team meeting; educate on science of safety, data, goals•Research the evidence-based practices that eliminate pressure ulcers

The CUSP/Improvement Intervention

It Goes Back to Leadership – On All Levels

• Engage, commit• Communicate • Provide education• Provide resources• Be visible and transparent• Give feedback• Investigate and own outcomes and improvement

Keep the Focus

• There are challenges ahead, but everyone must not lose sight of our North Star – the patient -- who must be kept in the center of all we do

• Your commitment, leadership, and persistence are essential to patient quality and safety

References• Pronovost P, Weast B, Rosenstein B, et al. Implementing and validating a

comprehensive unit-based safety program. J Pat Safety. 2005; 1(1):33-40.

• Pronovost P, Berenholtz S, Dorman T, et al. Improving communication in the ICU using daily goals. J Crit Care. 2003; 18(2):71-75.

• Pronovost PJ, Weast B, Bishop K, et al. Senior executive adopt-a-work unit: A model for safety improvement. Jt Comm J Qual Saf. 2004; 30(2):59-68.

• Thompson DA, Holzmueller CG, Cafeo CL, et al. A morning briefing: Setting the stage for a clinically and operationally good day. Jt Comm J Qual and Saf. 2005; 31(8):476-479.

Denise M. Flook, RN, MPH,CICDirector, Workforce Development/Infection

Prevention770-249-4518dflook@gha.org.

CUSP Resources

• Contact your State Hospital Association quality director for more information about CUSP initiatives

• Visit the On the CUSP: Stop HAI project Web site: www.onthecuspstophai.org

Hearing From Your Peers

Paul FrigoliQuality Director

Grant Regional Health CenterLancaster, WI

Agenda

• Why we joined the CLABSI & CAUTI projects• Barriers and successes • Key lessons

Val Pfoutz, RNICU DirectorKSB Hospital

Dixon, IL

Agenda

• Why we joined the CLABSI & CAUTI projects• Barriers and successes • Key lessons

CUSP Resources

• Contact your State Hospital Association quality director for more information about CUSP initiatives

• Visit the On the CUSP: Stop HAI project Web site: www.onthecuspstophai.org

Hearing From You

• What should future small & rural critical access hospital supplemental calls address?

• What resources can you share with others? • What additional resources would help you

improve patient safety?