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Engage Front-line Care Team Using Clinical Audit Checklists

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The culture of patient safety, quality, and transparency is central to improving care delivery at the organization and industry level. Implementing a sustainable frontline solution like quality …

The culture of patient safety, quality, and transparency is central to improving care delivery at the organization and industry level. Implementing a sustainable frontline solution like quality checklists will require new leadership, innovative thinking, applications of human factor engineering, and patient voices who demand better. We need to reward staff engagement and quality patient safety efforts which can translate into better patient outcomes. CCG, PSO developed a Clinical Audit Checklist program that can support a culture of transparency and accountability, thereby reducing healthcare costs and delivering positive patient outcomes. Together, we can make continuous daily improvement a standard practice at the hospital and system level. Patients are counting on us to make care delivery safer today for a better patient experience tomorrow.

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  • 1. Engage Frontline Staff using Clinical Audit Checklists to Improve Patient Background and Context of the Problem Standardized Work is: "The current one BEST way to safely complete an activity with the proper outcome, and the highest quality, using the fewest possible resources". Graban M (2012) Lean Hospitals Dr. Atul Gawande, in his recent TED talk, "How do we Heal Medicine", described talk, how the science of medicine, has made great discoveries in the last 60 year The years. future challenge for the healthcare industry is this how do we deliver "new advances in medicine" to the general public, with the right technology, price, quality, and sim simplicity that we can all afford? "Better care" means - engaged patients, providers and organizations that support the quality mission in a learning organization. Overcoming this challenge will require new skills, new technology, and novel ways of care delivery that ca incorporates real time information from routine patient care, disseminates this real-time critical patient data using electronic methods and e tools to help analyze and e-tools trend key metrics to improve care at the micro and macro levels. The continuous pursuit of quality improvement (QI), in many industries, has us proven to lower costs, customizable product offerings, better customer service and improved satisfaction. Succes Successful companies have achieved improved outcomes and lowered costs by engaging their staff, leading by example, being their example transparent in actions, with a priority focus on quality and safety. 1 © Copyright iCareQuality Inc. 2013 www.iCareQuality.org
  • 2. Obstacles to Quality Improvement in Healthcare Patient safety, rising costs, healthcare outcomes, targeted mea measures, and improvement efforts, are often "talked" about and "debated" in government, If we always DO what we’ve academia, and senior leadership circles. Even healthcare workers on the re frontline agree T THEY NEED quality improvement . However, many times these efforts fall short and don't operate as planned due to conflicting needs always DONE, and expectations. Common obstacles to the QI process are often derived by We will GET, the hospital's own Staff and Management - making the QI system almost what we’ve impossible to work properly to improve pa ble patient care. Typical thinking often thinki always GOT. includes.... ~ Adam  Staff can do QI in their spare time Urbanski  It's not my job, it's someone else's s  Lean Six Sigma are good strategies, but take too long  We don't have time. We're too busy with patient care  We have so many metrics, it's hard to track them all What Would Happen if we don’t Invest in QI? Medical errors and unintentional deaths would continue to rise and plague our burdened health system. New patient safety data just released refutes the legendary IOM report (To Err is Human) a that revealed startling news how medical errors caused over 100 thousand patient deaths each year. The new report in the Journal of Patient Safety (Sept 2013), new estimates that medical harm is three hat times higher than previously thought, and estimated are closer to 400 thousand deaths per year. It's han over 10 years now since the regulatory and organizational focus on quality, however, two key e questions remain: Have we made a difference in front front-line care delivery? And, have we improved the ave quality and safety of care for our patients and families? And the unfortunate answer is NO..not enough. Clinical Checklist Solution Our current healthcare system is undergoing unprecedented change. It feels more like a "Super ealthcare Storm Sandy" or massive hurricane on a daily basis Patients, providers and policy leaders are basis. attempting to re-design care delivery, expand services, improve patient safety, and reduce errors. At design the same time, healthcare costs are escala escalating, regulatory mandates are expanding with little improvement in patient safety at the bedside. So, the million dollar question remains.. how DOES a hospital reduce costs, improve quality that produces positive patient outcomes, and saves lives? 2 © Copyright iCareQuality Inc. 2013 www.iCareQuality.org
  • 3. Clinical Audit Checklists can be the answer! It's that simple. Checklists are a quick and easy tool to conduct quality improvement projects on the frontlin Checklists are visual, practical, and concise. ment frontline. Checklists standardized our actions and help us cook a meal or land a plane. According to AHRQ, "a tions checklist is an algorithmic listing of actions to be performed in a given clinical setting, the goal being to ensure that no step will be forgotten. Although a seemingly simple intervention, checklists have a intervention, sound theoretical basis in principles of human factors engineering and have played a major role in some of the most significant successes achieved in patient safety." ficant Best Practice checklists are a simple, cost cost-effective solution that can be used by front-line providers to front measure staff compliance to best practice standards in the industry In other words.. use clinical iance industry. us checklists to MEASURE ONGOING QUALITY IMPROVEMENT EFFORTS. MENT It's great method to implement a quality safety program. But the challenge is... how to sustain it!! Now that's the real challenge! Clinical Audit Checklists are the answer to Continuous Daily Improvement (CDI) where Daily quality and patient centeredness become the norm. CloseCareGap, Patient Safety Organization tient For the past five years, our iCareQuality team has worked on a process improvement and quality patient safety for front-line clinicians. Our goal is to collaborate with our quality partners on key line healthcare initiatives to improve improve patient safety at the regional and national level. CloseCareGap(CCG) is a new Patient Safety Organization (PSO) in Springfield, PA. In 2013, CCG, PSO was officially listed by the U.S. Department of Health and Human Services as a federal designated federally Patient Safety Organization under the Patient Safety and Quality Improvement Act of 2005. CCG,PSO has developed a sustainable, automated Clinical Checklist program based on the 2013 National Quality Strategies. We've adopted the Triple Aim and HRET - Partnership for Patients campaign to help improve quality, safety and affordability of health care. Our ePlatform gives frontline providers automated checklists and smart tools to help measure best practice, standardize care processes, reduce variations, and ultimately improve care delivery and patient outcomes. The ations, basic quality toolkit is FREE and can be used in any healthcare care setting to improve high risk conditions such as Falls, Hand-off, CLABSI, CAUTI, Pressure Ulcers, VAP, Surgical Site Infections, off, and much more. 3 © Copyright iCareQuality Inc. 2013 www.iCareQuality.org
  • 4. Conclusion The culture of patient safety, quality, and transparency is central to improving care delivery at the organization and industry level. Implemen Implementing a sustainable frontline solution like quality checklists will require new leadership, innovative thinking, applications of human factor engineering, and patient voices who demand better. We need to reward staff engagement and quality patient safety efforts which can translate into better patient outcomes. Our PSO, Clinical Audit Checklist program inical C can support a culture of transparency and accountability thereby reducing healthcare costs and ulture accountability, delivering positive patient outcomes. Together, we can make continuous daily improvement a standard practice at the hospital and system level. Patients are counting on us to make care delivery ounting safer today for a better patient experience tomorrow. If you would like to learn more about how your organization can join our team, or becoming a beta , site please contact CloseCareGap, PSO to discuss how we can support your quality improvement program. Visit our website at: http://www.iCareQuality iCareQuality.org/ Kate ONeill, MSN, RN VP of Quality and Safety kate.oneill@iCareQuality.org www.iCareQuality.org 610.732.8500 Sathya Elumalai B. Tech, MS Director of Research and Development Sathya.Elumalai@iCareQuality.org www.iCareQuality.org 610.732.8500 4 © Copyright iCareQuality Inc. 2013 www.iCareQuality.org