it takes a village contra costa regional medical center stuart forman, md kathryn moore, otr/l...
TRANSCRIPT
It Takes a Village
Contra Costa Regional Medical Center
Stuart Forman, MDKathryn Moore, OTR/L
Ronald Marquez, PTAngela Bennett, RN
Trent Tate, RCP
Where we were
VAP Rate/ 1000 ventilator days
Where we are now
Last VAP January 2011
How did we get there?
Step 1: Examine the evidence
Step 2: Find a Champion
Step 3: Engage a team
Step 4: Small tests of change
Step 5: Rapid Cycle Improvement
Step 6: Build on Success
ABCDE Building Blocks
• Wake up and breath protocols• Ventilator bundles• CAM-ICU • Daily ventilator rounds• ICU OT/PT staffing
What Were Our Barriers?• Inertia• Staffing• Skeptical doctors• Antiquated chart system• Data gathering
How Did We Overcome These Barriers?
• EBM• Use people’s normal work flow• Invite participation from all team members• Showcase results• Engage quality and infection control managers
What Did We Learn From This Improvement Effort?
• Don’t try everything at once• Culture beats strategy • Engaged leaders • Put front line workers in charge• Data collection is not easy
What Can We Teach From Our Journey?
• Step 1: Find the evidence of efficacy• Step 2: Find a champion• Step 3: Engage the team• Step 4: Small tests of change• Step 5: Rapid cycle improvement—don’t
expect perfection• Step 6: Share and build on your successes• Step 7: Lather, rinse repeat
Feel Free to Contact Us:
Stuart Forman, MD, FAAFPMedical Director, Critical Care Services2500 Alhambra Ave.Martinez, CA 94553