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Medical College of Central Georgia

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Medical College of Central Georgia

  1. 1. Captive Funded Risk Reduction<br />Medical Center of Central Georgia<br />Staff Injury Prevention Program<br />
  2. 2. Medical Center of Central GA<br />637 Bed Not for Profit Community Hospital<br />Level 1 Trauma<br />Women's Services – 3000+ Births<br />Children’s Hospital <br />314,000 Annual Visits<br />25,000 OR Visits<br />5000 Employees<br />“Bacon Belt” of America!<br />
  3. 3. The Beginning<br /><ul><li>Safety Committee meets monthly
  4. 4. Review of injuries showed frequent patient handling occurrences
  5. 5. The injuries were NOT r/t bariatric patients only
  6. 6. LOTS of discussion about how to reduce injury
  7. 7. Annual training on proper body mechanics?
  8. 8. Staff education about how injuries were happening
  9. 9. Increased utilization of “Lift Team”?</li></li></ul><li>Staff Injury Prevention Initiative<br /> <br /><ul><li>Nurses lift 1.8 tons during shift
  10. 10. Hospital injuries 8.8/100 FTE’s
  11. 11. Nurses who suffer injuries on the job are much more likely to leave nursing and patient care
  12. 12. Initiative to protect staff
  13. 13. Based on evidenced based research
  14. 14. Equipment must be available for staff
  15. 15. Equipment must be used
  16. 16. Administration support</li></li></ul><li>Staff Injury Prevention Initiative<br /><ul><li>JCAHO - 8 standards relate SIP
  17. 17. ANA –Handle with Care
  18. 18. OSHA
  19. 19. Magnet –FOM 4.2 - Safe Environment
  20. 20. 6.6; 6.7; 6.10; 6.21– Safety Initiatives
  21. 21. National legislation in many states</li></li></ul><li>SIP/MLP<br />Review of best practices:<br />Culture change was needed<br />Staff Injury Prevention Program/Minimal Lift<br />Takes focus off Bariatrics – <br />Focus on “Lifting, Moving, Transfer”<br />Equipment makes a difference<br />Expert Partner needed<br />We needed Fund$ to accomplish<br />
  22. 22. Staff Injury Prevention Initiative Prevention Initiative Case<br /><ul><li>Our People – Minimal Lift Program geared toward staff
  23. 23. Service Excellence- Improve Customer Service
  24. 24. Safety – Decrease employee injury
  25. 25. Financial Growth
  26. 26. Average annual spend R/T Back Injury –
  27. 27. $400-500,000
  28. 28. Missed work
  29. 29. Clear Opportunity to save money and make a difference</li></li></ul><li>The CASE for Change<br /><ul><li>Workman comp payouts of </li></ul>$400-500,000/ year <br /><ul><li>Lost Days to Injury
  30. 30. either out of work or “light duty” </li></li></ul><li>Risk Management department was integrated into the Finance Department in 2008- (member of Safety Committee)<br /><ul><li>AVP Finance proposed CAPTIVE as Funding possibility to help
  31. 31. decrease Workman’s Comp Liability </li></ul> by decreasing staff injury<br />
  32. 32. What IS a CAPTIVE?<br />In Simple Terms – a Captive is an INSURANCE COMPANY – <br /> - Insured is the owner of the company<br />We started our CAPTIVE in 1994 – and had very good success in the stock market<br />We had in EXCESS of 30 million shares<br />Possibility – Dividend the funds / vs Grant Program<br />
  33. 33. Captive/ Grant Opportunity<br /> GRANT$ – Could we design a program to fund initiatives that would help with professional indemnity – <br />and reduce $$$$$$$Claims Cost?$$$$<br />
  34. 34. Captive Funded Grant<br /><ul><li>Reducing Claims Cost
  35. 35. Decreases the amount to fund</li></ul>Funding = Paying Premiums<br /><ul><li>First Steps
  36. 36. Track issues to determine how to reduce claims
  37. 37. Safety Committee – already looking at Patient Handling
  38. 38. Identified Patient handling injury as an opportunity</li></li></ul><li>Captive/ Grant Proposal<br /><ul><li>Captive would fund certain initiatives </li></ul>Application process <br /><ul><li>Proposals would have to:</li></ul> Encourage risk management/reduction<br /> Provide staff education<br /> Demonstrate “closed loop” – report back to show return on inve$tment<br />Decision<br /><ul><li>Grant out 10-15% of audited net income
  39. 39. Allocated Income from prior year</li></li></ul><li>The Partnership Begins<br /><ul><li>Diligent Process:
  40. 40. Conference Call
  41. 41. Assignment of Roles
  42. 42. Process Mapping
  43. 43. Education
  44. 44. Org Wide – Administration and Department Heads
  45. 45. Implementation
  46. 46. Nursing and Patient Care education
  47. 47. Critical to success of program
  48. 48. Education and Accountability</li></li></ul><li>Minimal Lift Program<br />Assessment<br />Implementation<br />Evaluation<br />What equipment is needed<br />Where will equipment be located<br />What is staff’s current knowledge<br />How will we educate<br />
  49. 49. The MCCG/Diligent Partnership<br /><ul><li>The Diligent/MCCG partnership began with the contract signing on Oct 22nd, 2008. It included 928 contract hours time, which includes 360 hours during implementation and 400 hours over 36 months for clinical support as well as phone/meeting time. As of July 1st, 2010, MCCG has received 704 hours and has 224 hours left in the contract. Training was completed for 1600 general staff, 150 coaches and 11 rehab coaches. </li></li></ul><li>Assessment<br />Recommendations were provided by Diligent for best locations on each unit<br />All floors had the ability to store their equipment but needed some spring cleaning done.<br />Shelving vs. hooks<br />Outlets for charging<br />Accessibility is KEY<br />
  50. 50. Location – Location - Location<br />
  51. 51. Easy Accessibility<br />
  52. 52. Centrally Located “garage”<br />
  53. 53. Centrally Located “garage”<br />
  54. 54. Plan for Battery Charging<br />
  55. 55. Implementation Safe Patient Handling at MCCG<br /><ul><li>Culture Change
  56. 56. Research – Surveyed staff to assess knowledge
  57. 57. Manager Buy-in
  58. 58. Leadership rounding
  59. 59. Accountability
  60. 60. Staff buy-in
  61. 61. Awareness
  62. 62. Rationale
  63. 63. Education
  64. 64. TMC classes – 8 hours
  65. 65. General Staff classes – 2 hours
  66. 66. Contest to NAME program</li></li></ul><li>Establish PAR Levels<br />
  67. 67. PAR Supplies (near at hand)<br />
  68. 68. Proactive use of Supplies<br />
  69. 69. SPH – Minimal Lift - Liftsaver<br /><ul><li>Nursing units assigned TMC’s – days & nights
  70. 70. EMERGENCY CENTER
  71. 71. Surgical Services
  72. 72. Labor and Delivery
  73. 73. Cath & Vascular Labs
  74. 74. Support Departments have TMC’s
  75. 75. X-RAY
  76. 76. Rehab
  77. 77. Home Health
  78. 78. Morgue!!</li></li></ul><li>Strategic Placement - CT<br />
  79. 79. Liftsaver – Ceiling Lift Placement<br />
  80. 80. Liftsaver – Ceiling Lift Placement<br />
  81. 81. Critical Care Concerns<br />HAPU – r/t loss of air flow<br />“We will never use this stuff”<br />“It will take too long”<br />“I know how to move MY patient”<br />
  82. 82. Repositioning - good use of resources<br />
  83. 83. Repositioning “Benefits” <br />
  84. 84. Changes <br /> Decreased calls to Lift Team<br />Staff can turn, reposition and move patients<br />Equipment changes resources needed from 3 or more – to 1!!<br />Leadership rounding/Unit Surveys<br />Continual assessment of staff knowledge<br />Staff held accountable to policy<br />EVERY injury investigated immediately<br />
  85. 85. SAFETY<br />
  86. 86. Lift from Floor to Chair<br />
  87. 87. Safety<br />
  88. 88. Easy on Patient and Staff<br />
  89. 89. Easy <br />
  90. 90. Easy<br />
  91. 91. Back To Bed<br />
  92. 92. Good-by Rollerboards<br />
  93. 93. Liftsaver Program<br />
  94. 94. Diligent Activity Report (sample)<br /><ul><li> We met with OR and with Critical Care. The computerized assessment profile was reviewed and discussed. Patti has done a great job on this. Specialty training sessions will be scheduled for OR, rehab,PACU, ED, CATH, Radiology and same day surgery. More days may be needed for some units and this will be determined later on. Process Resolution is scheduled for March 24th 8-2, and the meeting with the executive team on March 25th at 11:30 AM.
  95. 95. We look forward to working with all involved at MCCG.</li></li></ul><li>Evaluation/Results<br /><ul><li>The Diligent/MCCG partnership began with the contract signing on Oct 22nd, 2008.
  96. 96. Included 928 contract hours time
  97. 97. 360 hours during implementation
  98. 98. 400 hours over 36 months for clinical support as well as phone/meeting time.
  99. 99. As of July 1st, 2010, MCCG has received 704 hours and has 224 hours left in the contract.
  100. 100. Training was completed for 1600 general staff, 150 coaches and 11 rehab coaches. </li></li></ul><li>Evaluation/Results/Statistics<br /><ul><li> The pre-program baseline number of patient-handling injuries developed was agreed upon as 82 injuries.
  101. 101. The Diligent program “went live” on 7/2/09 on the designated areas agreed upon.
  102. 102. Since 9/2/09 there has been a total of 1 recordable injury and 8 incidents (3 repositioning in bed, 4 other and one from floor). </li></li></ul><li>Evaluation/Results<br />Therefore, the overall decrease in injuries was 98.7%.<br />The recordable injury did not meet the Diligent contract criteria and is exempt from the reimbursement guarantee. <br />
  103. 103. Evaluation/ Results<br />8 Number of Injuries that potentially could have been avoided through the use of ARJO-Huntleigh equipment <br /> If equipment had been used, the injury reduction would have been 100%.<br />
  104. 104. CURRENT STATUS<br />The Diligent/MCCG Lift Saver program has created an overall awareness in the facility and highlighted the importance of staff to effectively plan for patient These results are a very good start and the nursing management and staff should be commended. Our goal is to continue the success for the rest of the contract. <br />
  105. 105. CURRENT STATUS<br /><ul><li>The overall 98.7% decrease in staff injuries from the start of the program in 10 months is indicative of the beginning of a cultural shift towards a safe patient handling environment. MCCG has started using score cards monthly to be accountable for the Lift Saver program. The results have been very promising for March through June, with units scoring above 86% on average. </li></li></ul><li>CURRENT STATUS<br />MCCG has started using score cards monthly to be accountable for the Lift Saver program. The results have been very promising for March through June, with units scoring above 86% on average.<br />

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