NSQIP Supports Pneumonia Prevention at Vancouver General Hospital Irene Siu Spotlighting Surgical...
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![Page 1: NSQIP Supports Pneumonia Prevention at Vancouver General Hospital Irene Siu Spotlighting Surgical Improvement in BC November 16, 2012.](https://reader035.fdocuments.us/reader035/viewer/2022081519/56649cae5503460f9497122f/html5/thumbnails/1.jpg)
NSQIP Supports Pneumonia Prevention at Vancouver General Hospital
Irene SiuSpotlighting Surgical Improvement in BC
November 16, 2012
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Non-Risk Adjusted Pneumonia Rates May-Dec 2011
VGH SQAN NSQIP
Overall 2.6 1.3 1.3
General Surgery 3.6 1.9 1.4
Vascular 3.0 3.8 2.2
ENT 4.0 0.5 1.0
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July 2012 SAR Risk Adjusted Pneumonia Outcomes
Odds Ratio Decile Status
ALLCASES 1.67 9High Outlier/Needs
Improvement
GEN 1.55 9 As expected
VASC 1.28 9 As expected
ENT n/a n/a n/a
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Pneumonia Working Group
• Engage manager of General Surgery, Vascular, ENT - units T8/9
• Audit of current practice• Improvement Charter/SBAR• Gather the team
What to do?
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*Rosenkranz et al. (July 24 2011). “ICOUGH”: The Development of a Multidisciplinary Program to Address Postoperative Pulmonary Complications. Powerpoint lecture presented at ACS NSQIP National Conference in Westin Copley Place, Boston MA.
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PDSA, Improvement Charter…
• Goal: Incentive
SpirometerDB+C Oral Care Understand/
EducationGet out of
bed/MobilityHOB 30˚
Pain Control
% Patients 17% 52% 60% 21%17% chair
76% walking 48% 86%
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Goal
50% reduction in post-op pneumonia rates in General Surgery, Vascular and Otolaryngology by June 2013
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Challenges
• Engagement, Buy-In, Ownership
• Details, details, details!– Care plans, education materials, staff education
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Overcoming Challenges
• Enlist people with expertise and influence• TRIZ/TIPS• Don’t re-invent the wheel!• Best practice guidelines• Utilize PDSA, Improvement Charter, SBAR• Don’t give up!
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Going forward…
• Prep T8/9 units December 2012: In-services, educational materials, care plan
• GOLIVE January 2013• Ongoing PR• Schedule ongoing audits• PDSA ongoing• Hospital-wide?
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Thank you!