QHN Fall Forum 2008 University of Ottawa Heart Institute


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QHN Fall Forum 2008 University of Ottawa Heart Institute

  1. 1. <ul><li>University of Ottawa Heart Institute </li></ul><ul><li>To Clip or Not Clip… </li></ul><ul><li>How to Change an Organizations Practice </li></ul><ul><li>Brainstorming with a Multidisciplinary Team </li></ul>
  2. 2. Who we are <ul><li>University of Ottawa Heart Institute (UOHI) is a 134 bed institution </li></ul><ul><li>Part of The Ottawa Hospital </li></ul><ul><li>Cardiology/Cardiac Surgery Patients </li></ul><ul><li>Cardiac Rehab </li></ul><ul><li>Ambulatory Care </li></ul>
  3. 3. Background <ul><li>Appropriate hair removal on all patients in the University of Ottawa Heart Institute </li></ul><ul><li>To prevent surgical site infections in Coronary Artery Bypass Graft (CABG) patients by implementing the Safer Healthcare Now (SHN) Surgical Site Infection (SSI) bundle components as appropriate at the UOHI </li></ul><ul><li>Brainstorming with a multidisciplinary team was the quality improvement tool used. This tool enabled the SSI committee to generate many proactive ideas and measures in an effort to successfully implement a change in practice in our organization </li></ul>
  4. 4. Team Members <ul><li>Dr. Paul Hendry (CHAIR ), Department of Cardiac Surgery </li></ul><ul><li>Heather Sherrard, Vice President, Clinical Services </li></ul><ul><li>Dr. Kathy Suh, Infection Control </li></ul><ul><li>Dr. Michael Bourke, Department of Anaesthesiology </li></ul><ul><li>Natalie Bruce/Jenn Johnson, Infection Control </li></ul><ul><li>Erika MacPhee, SHN Project Facilitator </li></ul><ul><li>Sharon Ann Kearns, Manager Quality and Performance Measurement </li></ul><ul><li>Karen Charron, Clinical Manager H3 </li></ul><ul><li>Elaine Vandenberg, Clinical Manager CSICU </li></ul><ul><li>Cynthia Holm, Clinical Manager COR/ </li></ul><ul><li>Gloria Prendergast, Team Leader CSICU </li></ul><ul><li>Carol McKissock, Resource Nurse CSICU </li></ul><ul><li>Debbie Hubble, Manager Perfusion </li></ul><ul><li>Bob Boxell, Anaesthesia Tech </li></ul><ul><li>Dave Cecillon, Manager Pharmacy </li></ul>
  5. 5. Responsibilities of SSI Team <ul><li>Identify and address areas for improvement in preventing Surgical Site Infections and to support the transfer of knowledge to improve patient care at The University of Ottawa Heart Institute </li></ul><ul><li>Advocating for policies and systems to be in place to reduce the rate of surgical site infections </li></ul><ul><li>Facilitating the development of a patient safety culture through education and other initiatives </li></ul>
  6. 6. Measures Used <ul><li>Brainstorming with a multidisciplinary team </li></ul><ul><li>Reviewed entire process at UOHI to identify current practice </li></ul><ul><li>Identified practice concerns </li></ul><ul><li>Performed Chart Audits </li></ul><ul><li>Performed Surveys </li></ul>
  7. 7. Intended or Achieved Outcomes <ul><li>Hair removal </li></ul><ul><ul><li>Identified process issue here </li></ul></ul><ul><ul><ul><li>to clip or not to clip…or just do whatever the heck you feel like!!! </li></ul></ul></ul><ul><ul><li>Removal of all razors in building </li></ul></ul><ul><ul><li>More clippers in building </li></ul></ul><ul><ul><li>Re education/ in-services </li></ul></ul><ul><ul><li>Revise pre-op checklist </li></ul></ul><ul><ul><li>Policy and Procedure developed for hair removal at UOHI </li></ul></ul>
  8. 8. Lessons Learned <ul><li>Assembling a team is not as easy as one would think </li></ul><ul><li>Identify a champion or 2 (physician and one other health care team member). </li></ul><ul><li>Persistence with the physicians…face to face contact to get them to commit to meetings </li></ul><ul><li>Assign tasks to your team members and hold them accountable </li></ul><ul><li>Make the meetings formal </li></ul><ul><ul><li>Establish Terms of Reference </li></ul></ul><ul><ul><li>Agendas </li></ul></ul><ul><ul><li>Minutes </li></ul></ul><ul><li>Don’t Take it all on yourself!!!! </li></ul>
  9. 9. Key Success Factors/Enablers <ul><li>Once a physician champion was enlisted, the key to the success of this initiative was the all or none principle </li></ul><ul><li>Every patient who sets foot in our institution is a potential surgical patient, therefore ALL razors were removed from the building </li></ul><ul><li>The clipper rep invited in for a 2 day blitz of in-services on clipper use </li></ul><ul><li>A designated manager ordered all the replacement clipper heads and policy drafted for appropriate hair removal </li></ul>
  10. 10. Potential or Actual Barriers <ul><li>Staff reluctant to change </li></ul><ul><li>Referring centers don’t necessarily have the same practice as the UOHI </li></ul><ul><li>Physician buy in and compliance </li></ul><ul><li>Preconceived notions of who should get what kind of hair removal </li></ul>
  11. 11. Next Steps <ul><li>All referring hospitals were notified by letter about the hair removal policy and this is a standard order on the transfer to UOHI documents </li></ul><ul><li>Ongoing audits to ensure compliance </li></ul><ul><li>Spot checks on units to ensure no razors </li></ul><ul><li>Social work will look after ordering of facial razors for our long term patients </li></ul><ul><li>Share the UOHI Policy and Procedure for Hair Removal with our colleagues at The Ottawa Hospital </li></ul>
  12. 12. Contact Information <ul><li>Erika MacPhee RN, MHScN </li></ul><ul><li>University of Ottawa Heart Institute </li></ul><ul><li>Clinical Nurse Educator/Project Facilitator </li></ul><ul><li>613-798-5555 x15450 </li></ul><ul><li>[email_address] </li></ul><ul><li>Sharon Ann Kearns RN,BScN, CPHQ </li></ul><ul><li>University of Ottawa Heart Institute </li></ul><ul><li>Manager Quality and Performance Measurement </li></ul><ul><li>613-761-4322 </li></ul><ul><li>[email_address] </li></ul>