Call for Storyboards!

The 2014 Quality & Patient Safety Roadmap will feature keynote speakers, panelists and storyboard sessions focused on engaging patients and families in eliminating harm across the board.

Submit your harm across the board storyboard to share your organization’s experience in eliminating harm and be featured during the storyboard sessions at Roadmap! Details on how to complete the storyboard template and submission details are included in this slide deck.

Please contact slhq@aha.org with any questions.

Eliminating Harm Across the Board (HAB) Template

Objectives

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• Understand what the Eliminating HAB report is and how it is a helpful tool in improving care.

• Understand how to complete your Eliminating HAB report.

• Understand how to submit your Eliminating HAB report.

• Know who to contact if you have questions.

How is Eliminating HAB applicable to SLHQ?

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The Patient

Your W(hat’s) I(n) I(t) F(or) M(e): WIIFM

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• The Eliminating HAB report will: • Help shift your organizational culture; • Put a face on harm; • Tell a compelling story to support

change; • Promote transparency;• Engage patients and their families

and/or Patient and Family Advisory Council (PFAC) members; and

• Help you track your overall harm per discharge and identify the greatest opportunities for eliminating harm.

Eliminating HAB Storyboard Example

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Sharing Your Eliminating HAB Storyboard at Roadmap

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In 2013, Roadmap participants shared their

HAB storyboards with colleagues. In 2014, the

Roadmap HAB storyboards will focus on engaging patients and families in

eliminating harm.

The Eliminating HAB Template:

Eight key slides and tips for how to complete them.

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Insert Hospital Name HereInsert Your Motto Here, e.g. “Our Bottom-line Line is Patient

Safety”Slide 1

Customize the motto

Insert a photo of your hospital and

logo here.

Insert a photo of your Safety Team,

including your CEO and PFA(s) here.

Insert a caption here, including the names of

your Safety Team, CEO and PFAs.

Insert a caption here, including the name of your hospital and the city and

state where you are located.

Customize the team info.

0.00000.01000.02000.03000.04000.05000.06000.07000.08000.09000.1000

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Baseline 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09

Hospital 0.06 0.07 0.04 0.08 0.02 0.03 0.02 0.04 0.03 0.01 0.01 0.02 0.01 0.01 0.02 0.00 0.01 0.00 0.01 0.00 0.01 0.00

Goal 0.04 0.04 0.04 0.04 0.04 0.04 0.04 0.04 0.04 0.04 0.04 0.04 0.04 0.04 0.04 0.04 0.04 0.04 0.04 0.04 0.04 0.04 0.04 0.04

Total Harm per Discharge

Insert a title for your “Total Harms per Discharge” run chart here

e.g., “Cut Harm Across the Board in ½”Customize the heading

Insert your total harm run chart

Slide 2

Insert a title for your “topic-specific” run chart here e.g., “2014 Breakthrough in

Reducing CAUTI: Journey to Zero”Customize the heading and slide based on which specific measure you want to highlight. Insert a

topic-specific run chart

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Baseline 100. 100. 100. 100. 100. 100. 100. 100. 100. 100. 100. 100. 100. 100. 100. 100. 100. 100. 100. 100. 100. 100. 100. 100.

Hospital 105. 66.6 33.3 100. 83.3 45.4 0.00 0.00 52.6 0.00 0.00 52.6 0.00 0.00 52.6 0.00 52.6 0.00 0.00 0.00 0.00 0.00

Goal 60.0 60.0 60.0 60.0 60.0 60.0 60.0 60.0 60.0 60.0 60.0 60.0 60.0 60.0 60.0 60.0 60.0 60.0 60.0 60.0 60.0 60.0 60.0 60.0

Catheter Associated Urinary Tract Infections

Slide 3

AEAs Estimated annual number of patients at risk in each area Number of Opportunities

ADE # of discharges:

CAUTI # pts in IP units with catheter in place:

CLABSI # pts in IP units with central lines:

Falls # of discharges:

EED # of women with elective deliveries

OB # of women with deliveries:

HAPU # of discharges:

SSI # of inpatient surgeries:

VAE # of patients on a ventilator:

VTE # of discharges:

TOTAL Risk opportunities for harm across the board

Readmit. # of inpatients at risk of readmit:

Risk Profile: Areas of Risk We Are Committed To ControllingAnnual discharges: __________ AEA risk

opportunities/discharge: _______Customize the risk opportunities/discharge

Customize the annual discharges

Slide 4

Note: “AEA”

= Adverse

Event Areas

Improving Harm Rates (/ Discharge)

AEAs Baseline Rate[time period]

Target Rate

Current Rate[time period – last 3 months]

Improvement Status (scale)

ADE

CAUTI

CLABSI

Falls

EED

OB

HAPU

SSI

VAE

VTE

Total

         

Readmit.        

Insert a your harm rates per discharge here, using the following table. For non-applicable

topics – please insert “Z”.

Customize the baseline, target and current rates and improvement scale

Slide 5

Hospital Risk Score Card

Our Safety Mandate

Annual Volume (Discharges)

Total risk: annual harm opportunities

Risks per patients (Total Opportunities)/Discharges)

Number of Risk Areas

Number of Risk Areas Applicable (0 – 11)

Number of Risk Areas Applicable & Adopted

Our Progress

Number of Areas with Major Improvement Opportunity

Number of Areas at Improvement Target

Number of Areas at IDEAL

Insert your risk score card here, using the following table:

Customize your score card

Slide 6

How We Engage Patient/Family Advisors in Eliminating HAB

Engaging Patient/Family Advisors

Customize the Model for Improvement, answering the questions to best describe your hospital’s eliminating HAB journey

Slide 7

Our Results and Pearls

Results: A concise description of what you achieved, as it relates to eliminating HAB and engaging PFAs.

Customize your responses

Slide 8

PFA Quote: Insert a PFA quote here about eliminating HAB.

Pearls: Bullet your biggest insights about what worked and how.

- Include what you tested and learned.- Include how you will advance this

topic over the next month (and beyond). - List the most important drivers of

safety that produced these results. Make this list succinct, high-level and clear.

- Include the PFA insights, thoughts and feedback

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Eliminating HAB Template: Examples and

Tips

How we Incorporated a Patient/Family Advisor (PFA) into our Journey to

Eliminate HAB

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Patient/Family Advisors Suggestions for reducing ADE

Slide 7 (EXAMPLE)

Reduce the incidence of preventable adverse drug

events14 ADEs/month to 8 ADEs/month

Have pictures of medications taken at the bedside for patients and

families

Our Results and Pearls

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Results: Reduced ADE by 25% over 6 months. Slide 8 EXAMPLE

“ I always taped a pill on to the medication list for my father so he knew what he was taking. It was so meaningful to share this idea and to

see it help other patients”

Pearls: •Two patient/family advisors were on the ADE committee•They shared the various ways that they organized medications at home and suggested that providing patients with pictures of the pills they were taking in the hospital (since some looked different than what they were taking at home) would help patients and families to know what they were being given and why•At discharge patients received up to date medication lists that included pictures

Run Chart Tips

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• Cut and paste graphs from the improvement calculator:o www.aha-slhq.org / Resources / Using Data

for Improvement

• Customize the heading of each slide

• Utilize labels or a subheader to tell the story

The Improvement Calculator

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Tip: Access the Improvement Calculator here!

Risk Profile Tips

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• These calculations only need to be completed once

• Use one year of data – using baseline

• For Patient Counts for CLABSI, CAUTI, VAEo Use charge master for # of

catheter trays ordered, or # of patients with ventilator charges, or divide your device days by average length of stay

Improvement Scale Tips

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IDEAL: level represents what we see as best possible or ZERO harms At Target: level represents meeting improvement target Progress: level not yet at target Opportunity: level represents an improvement opportunity

Hospital Risk Score Card Tips

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• Our Safety Mandate: use #’s from Risk Profile

• Number of Risk Areas Applicable - includes Readmissions (the max. = 11)

• Our Progress: use Improvement Scale definitions from Improving AEAs per Discharge Slide

• Total Risks per patient: is calculated from total harm opportunities divided by total discharges per applicable risk areas, e.g. - if no vents. or births: 8

Pearl Tips

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• Provide enough detail about the strategy or tactic so others can easily replicate

• Provide examples of key cultural change strategies. For example:o Transparency of datao Front line staff engagemento Senior management supporto Seamless transitionso Recognitiono Promoting a Culture of Safety

• Share learnings and ideas tested• Highlight how strategies be expanded and

spread

Submission Process

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• We encourage you to submit your Eliminating HAB Report for the upcoming Quality & Safety Roadmap Meeting, as well as on our SLHQ Members LISTSERV®: AHA-SLHQ@ahals.aha.org

• For more details - please contact us! See the following slide for contact information.

Questions? Contact Us!

Website: www.aha-slhq.org Email: slhq@aha.org

LISTSERV®: AHA-SLHQ@ahals.aha.orgPhone: (773) 270-3127

Office: 155 N. Wacker Dr., Ste. 400Chicago, IL 60606

Dr. Maulik Joshi: Senior Vice President, AHA and President, HRET (mjoshi@aha.org)

Charisse Coulombe, Vice President, HRET (ccoulombe@aha.org)Jessica Blake, Senior Program Manager, HRET (jblake@aha.org)

Natalie Erb, Administrative Fellow, HRET (nerb@aha.org)

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