Marlyn Conti - Intermountain, Patient Safety Coordinator
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Intermountain-led CMS Hospital Engagement Network Preventing Pressure Ulcers October 22, 2013 Affinity Call • Marlyn Conti - Intermountain, Patient Safety Coordinator • Gina Honermann-Garinger—Baylor Scott & White Health, Center for Clinical Innovation
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Intermountain-led CMS Hospital Engagement Network Preventing Pressure Ulcers October 22, 2013 Affinity Call. Marlyn Conti - Intermountain, Patient Safety Coordinator Gina Honermann-Garinger — Baylor Scott & White Health, Center for Clinical Innovation. Outline for Discussion. - PowerPoint PPT Presentation
Transcript of Marlyn Conti - Intermountain, Patient Safety Coordinator
Intermountain-led CMS Hospital Engagement Network
Preventing Pressure UlcersOctober 22, 2013 Affinity Call
• Marlyn Conti - Intermountain, Patient Safety Coordinator• Gina Honermann-Garinger—Baylor Scott & White Health,
Center for Clinical Innovation
Outline for Discussion
• HEN Pressure ulcer data• What have you implemented this past year?• What are your challenges? • What’s next for your facility/system?
Intermountain HEN 2012-13 submitting Hospitals
Braden Risk AssessmentIntermountain HEN
Rate going up. Braden & Skin Assessment required within 24 Hours of admit
Ulcers below national best practice benchmark and trending down
Is this coding artifact? Are we charting better?
Intermountain HEN PrU =>3
HEN Pressure Ulcer Measures
• Metric specification resource manual http://www.henlearner.org/wp-content/uploads/2012/03/HEN_measure_Feb5.pdf
• Submission schedule: – November 20, 2013: for data through September 2013
Intermountain PrU Prevalence Trends
All stages per quarterly prevalence survey, 22 hospitals
2004
.1 Q3
2005
.1 Q3
2006
.1 Q3
2007
.1 Q3
2008
.1 Q3
2009
.1 Q3
2012
Q1 Q3
2011
Q1 Q3
2012
Q1 Q3
2013
Q1 Q30
2
4
6
8
10
12
14
12.8
8.38.8
9.8
7.8
10.3
7.97.4
10.3
6.7 6.8
4.5
6.8
4.6
1.6
3.5 3.64.0
3.23.9
3.43.1
2.32.7 2.6 2.5
2.9
2.02.4 2.4
1.82.4
2.72.0 2.1 2.2 2.4
1.5 1.5
Intermountain Pressure Ulcer Prevalence Rate per 100 Pa-tients Surveyed 2004-2013
Hospital AcquiredLinear (Hospital Acquired)
Mattress purchase
Mattress Inspec-tions
Ulcer Teams
Required education
Intermountain Hospitals
Intermountain Hospitals
Intermountain Hospitals
Call drill down to the patient and do cause analysis
Intermountain HospitalsPressure Ulcer Prevention Tools
• Care plan for kardex• Bed & surface
algorithm• Skin care product
posters• Patient fact sheets
Working Harder
Baylor All Saints Hospital Acquired Pressure Ulcers
PUT new data here pleaseJanuary
2013February
2013March 2013
4 0 0155 162 0
0.0258065 0 0
Baylor All SaintsPressure Ulcers > Stage 3
2013 Q1 & June Comparison Run ChartJanuary 2012 February
2013March 2013
1 0 0155 162 0
0.0064516 0 0
Baylor All SaintsAHRQ PSI #3
2013 Q1 & June Comparison Run ChartJanuary
2013February
2013March 2013
0 0 0365 288 298
0 0 0
Participant Poll
What to dofor:
Getting Started
Working Harder
Ahead of the Curve
Pressure Injuries
Identify areas needing most attention & appoint a leadership supported “lead” to drive improvement & education SWAT (or champion) teams that includes unit nurse/
Adopt decision algorithms for RNs to select appropriate surfaces make decisions independently of surface decisions.
Establish monthly prevalence studies or incidence rates from electronic medical records then feed that data back to the SWAT teams.
System
What have you implemented
What are your challenges
What’s next
Intermountain
Pressure ulcer bundlesHard coding interventions in computer charting based on Braden scores
‘Getting to Zero’ComplacencyKnown complicationCompeting priorities
Bundle compliance tracking
Baylor
Policy & procedures to back-up protocolBedside reporting
Present on admission reporting is improving
EHR support for risk assessment Documentation of present on admission
Participants
Trial of iPad app for picture documentation in EHR
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Pressure Ulcer Elimination“Bundle” = SKIN (Ascension Health)
Tissue injury can be more than skin deep…
SKIN Manage Nutrition and
Hydration
Manage Incontinence
Keep Patients Moving
Selection of Appropriate Support Surfaces
Getting StartedAccess Available Tool Kits
• Preventing Pressure Ulcers in
Hospitals: A Toolkit for Improving Quality of Care http://www.ahrq.gov/research/ltc/pressureulcertoolkit/
• National Pressure Ulcer Advisory Panel http://www.npuap.org/
• http://www.Henlearner.org
• AHRQ PSNet http://www.psnet.ahrq.gov/
• AHRQ Web M&M http://www.webmm.ahrq.gov/
• AHRQ Health Care Innovations Exchange http://www.innovations.ahrq.gov/
Getting Started
Next Affinity Call Pending
• What questions or topics would you like addressed?
• Send questions to [email protected]• Access HEN webinars and resources at
http://www.henlearner.org/
