The document summarizes a webinar presented by The Leapfrog Group on hospital safety. The webinar discusses Leapfrog's role in publicly reporting hospital safety scores and ensuring a prepared nursing workforce. Leapfrog develops the Hospital Safety Score - a letter grade reflecting how well hospitals prevent errors and harm - using national data. Experts provide guidance on calculating the scores. The scores aim to show hospital performance variation, be relevant to consumers, and report data independently. Magnet status recognition considers nursing factors important to safety.
Patient safety is the absence of preventable harm to a patient during the process of health care and reduction of risk of unnecessary harm associated with health.
Joint Commission and Patients for Patient Safety. Laura Botwinick. III International Conference on Patient Safety: "Patients for Patient Safety" (Madrid, Ministry of Health and Consumer Affairs, 2007)
Patients for patient safety. Margaret Murphy. III International Conference on Patient Safety: "Patients for Patient Safety" (Madrid, Ministry of Health and Consumer Affairs, 2007)
5 Ways Healthcare Organizations Can Promote Patient SafetyAKW Medical
Patients and healthcare professionals can work together to improve patient safety to ensure a higher quality of care, reduce medical errors, and refocus on supporting good health and well-being.
Role of infection control in patient safety [compatibility mode]drnahla
Infection Control and Patient Safety
Dr. NAHLA ABDEL KADERوMD, PhD.
INFECTION CONTROL CONSULTANT, MOH
INFECTION CONTROL CBAHI SURVEYOR
Infection Control Director, KKH.
Risk Management and Patient Safety Evolution and Progress. Charles Vincent. Match Safety critical component of quality (Madrid, Ministry of Health and Consumer Affairs, 2005)
Within integrative medicine “adherence” is more than ensuring patients remembering to take their medication. It's about adhering to a new lifestyle, exercise routine, ditching bad habits, incorporating a new nutrition plan (in addition to medication or supplement use). This slide show take a look at the differences between "patient adherence" and "patient compliance", areas of adherence, the consequences of non-adherence and what you can do as their healthcare professional.
Patient safety is the absence of preventable harm to a patient during the process of health care and reduction of risk of unnecessary harm associated with health.
Joint Commission and Patients for Patient Safety. Laura Botwinick. III International Conference on Patient Safety: "Patients for Patient Safety" (Madrid, Ministry of Health and Consumer Affairs, 2007)
Patients for patient safety. Margaret Murphy. III International Conference on Patient Safety: "Patients for Patient Safety" (Madrid, Ministry of Health and Consumer Affairs, 2007)
5 Ways Healthcare Organizations Can Promote Patient SafetyAKW Medical
Patients and healthcare professionals can work together to improve patient safety to ensure a higher quality of care, reduce medical errors, and refocus on supporting good health and well-being.
Role of infection control in patient safety [compatibility mode]drnahla
Infection Control and Patient Safety
Dr. NAHLA ABDEL KADERوMD, PhD.
INFECTION CONTROL CONSULTANT, MOH
INFECTION CONTROL CBAHI SURVEYOR
Infection Control Director, KKH.
Risk Management and Patient Safety Evolution and Progress. Charles Vincent. Match Safety critical component of quality (Madrid, Ministry of Health and Consumer Affairs, 2005)
Within integrative medicine “adherence” is more than ensuring patients remembering to take their medication. It's about adhering to a new lifestyle, exercise routine, ditching bad habits, incorporating a new nutrition plan (in addition to medication or supplement use). This slide show take a look at the differences between "patient adherence" and "patient compliance", areas of adherence, the consequences of non-adherence and what you can do as their healthcare professional.
In the presentation, a summary of initiatives to be taken by hospitals in different areas for patient safety have been described for the knowledge, practices and implementation of patient safety initiative by hospital managers/Administrators.
Aaron Watkins, Senior Director of Internet Strategy and A. Jay Khanna, MD, Professor of Orthopedic Surgery presented this one hour session at the Healthcare Communicators Conference on online physician reputation management in an era of consumer-generated content on sites like Vitals, Healthgrades, Yelp, Google+, and others
Learn about why FIDO standards matter to healthcare services, and how FIDO-enabled products contribute to patient engagement as well as federal health strategic goals.
Patient Engagement is growing in importance as consumer expectations of healthcare providers change and as portals and other technologies improve. Early studies show affects on outcomes for patient engagement technologies
In this edition....Summaries of innovation projects
Resident transfers from aged care facilities to emergency departments: Can they be avoided?
NSW Trauma App
Queensland’s Digital Hospital
Investigating the relationship between emotional intelligence and transformation leadership in Nurse Managers
Embedding Consumer Engagement in Organisational Governance — Moving Consumers on Committees from Tokenistic to Having an Impact
UK Report Alcohol’s Impact on Emergency Services
9 Actionable Healthcare Tweets from HIMSS 2015Buddy Scalera
9 tweets and action items for healthcare marketers and content strategists, as developed by Marilyn Cox @MarilynECox (Oracle) and Buddy Scalera @MarketingBuddy.
Be sure to visit: http://www.slideshare.net/americanregistry
Key Principles and Approaches to Populaiton Health mManagement - HAS Session 21Health Catalyst
Population Health Management is in its early stages of maturity, suffering from inconsistent definitions and understanding, and is overhyped by vendors and ill-defined by the industry. And yet, many systems are moving forward in innovative pioneering ways to address this growing trend. In this session, you will hear from two very different, successful health systems: a physician-led group and a large integrated delivery system. They will share their best practices, learnings, and different approaches to population health management.
The Transition from Paper to Electronic RecordsMatthew Kim
A presentation depicting the history, selection criteria, implementation process and market share among various electronic health record (EHR) vendors.
David Prior: driving improvements in the quality of care across the systemThe King's Fund
David Prior, Chair, Care Quality Commission, explains how clinicians, providers, commissioners and service users all have a role in regulation. He highlights the new responsibilities of the CQC and how they can help to support integrated care in England.
A summary of macro level trends and issues that are driving the need for enhanced digital marketing and service delivery in the Pharma/Healthcare industry. Included are case studies presented at the recent ePharm Summit in NYC.
Preparing for the Future: How one ACO is Using Analytics to Drive Clinical & ...Health Catalyst
Crystal Run Healthcare — a physician-led Accountable Care Organization (ACO) and one of the first ACOs to participate in the Medicare Shared Savings Program — is experiencing the long-anticipated shift toward more value-based reimbursement.
To ensure financial stability as they assume more risk, Crystal Run is implementing a strategy focused on rapid growth and aligning physician reimbursement with favorable patient outcomes. To effectively execute on this strategy they knew they needed to become more data-driven. Webinar attendees will learn how this ACO is using advanced analytics to execute on their population management and growth strategies with a focus on continuous improvement in the following areas:
Ensuring patient care aligns with evidence based practices
Reducing inappropriate clinical variation
Enhancing operational efficiency
Analyzing data from a “single source of truth” integrated from their EMR, billing, costing, patient satisfaction and other operational systems
Making “self-service analytics” available to decision-makers to decrease time to decision
Please join Greg Spencer, MD, Chief Medical & Chief Medical Information Officer and Scott Hines, MD, Chief Quality Officer and Medical Specialties Medical Director, Crystal Run, as they discuss how advanced analytics is helping position the ACO for continued success in an increasingly value-based reimbursement environment.
Case Study "Using Real Time Clinical Data To Support Patient Risk Stratification in The Clinical Care Setting"
HealthInfoNet operates the statewide health information exchange in Maine. The exchange currently manages clinical and patient care encounter information on 97 percent of the residents of the State of Maine. The information is gathered in real time, standardized, and aggregated at a patient specific level to support treatment. For the past three years, HealthInfoNet has worked with HBI Solutions, Inc of Palo Alto, CA to utilize this real time clinical and encounter data to support the development of predictive analytic tools that risk stratify patient populations and individual patients for future incidence of disease, cost, and both inpatient and ambulatory care encounters. These real time predictive models have now been used in clinical care settings for a year. The presentation will cover both lessons learned to date from implementing and optimizing real time predictive analytic tools and the early finding of the impact that the use of these tools is having on patient care management, utilization and outcome.
Devore Culver
Executive Director & CEO
HealthInfoNet
Similar to Hospital Safety as a Priority: An Opportunity for Nurses to Lead Presented by: The Leapfrog Group (20)
Hosting an event can be a great opportunity for your Action Coalition to engage local communities, organizations, funders, and state leaders as well as to increase support to advance the work of the Future of Nursing: Campaign for Action.
We've created an event-planning toolkit to help plan and host a successful event!
In September 2013, the Future of Nursing: Campaign for Action Leadership Learning Collaborative convened a teleconference to discuss “State Leadership Institutes”.
Complete Communications toolkit includes the following:
• Introduction to Traditional Media Outreach
• Creating Effective Media Materials
• How to Use Campaign Messages
• Hosting an Action Coalition Event
• Social Media toolkit
A webinar hosted with the Interdisciplinary Nursing Quality Research Initiative (INQRI) featuring Barbara Safriet, JD, LLM, Associate Dean and Lecturer, Yale Law School, who outlined why removing barriers to APRN practice and care matters to consumers.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Hospital Safety as a Priority: An Opportunity for Nurses to Lead Presented by: The Leapfrog Group
1. Hospital Safety as a Priority: An
Opportunity for Nurses to Lead
Presented by: The Leapfrog Group
October 31, 2012
2. Susan Reinhard, PhD, RN, FAAN
Senior Vice President & Director,
AARP Public Policy Institute;
Chief Strategist, Center to Champion
Nursing in America
2
3. Patricia A. Polansky, RN, MS
Director of Policy and Communications
Center to Champion Nursing in America
www.campaignforaction.org/webinars
3
4. 1. Provide an overview of the work of the Leapfrog Group
and their role in the public reporting of hospital safety
scores.
2. Discuss Magnet status and public reporting of scores
means for hospitals and consumers.
3. Explain Leapfrog’s role in ensuring a prepared nursing
workforce and how that directly influences hospital safety
and the Magnet designation.
4. Motivate you to treat hospital safety as a priority in health
care.
4
9. • More than 180,000 people die every year from hospital
infections, injuries, and errors (Office of Inspector General;
November 2010)
• A Medicare patient has a one-in-four chance of
experiencing injury, harm or death when admitted to a
hospital
• One out of every six of your employees admitted to a
hospital will suffer an adverse event
• Today alone, 493 people will die because of a preventable
hospital error; 20 of them during this presentation
10. • Founded in 2000 by large employers interested in driving a
market for safety and quality in hospitals
• Annual Leapfrog Hospital Survey reports on hospital
performance
11. • Public reporting/engaging consumers
• Benefits design and contracting
• Value based purchasing
• Direct communication between purchasers and hospitals
• Drive a market for nursing priorities
12. Local, Regional, National
• Regions Drive
Survey Data
Collection
• 45 Regional Roll
Outs invite
hospitals to
complete the
survey
• Use various
incentives and
recognition to drive
further
improvements
13. Shows variation: Show how your performance compares
and contrasts to the broadest spectrum of highs and lows
Relevant: Measure what matters to consumers
Unbiased: Report through an independent arbiter. An
advertisement is not an example of transparency.
23. The Hospital Safety Score is
an A, B, C, D, or F letter
grade reflecting how
hospitals perform at keeping
patients safe from harm and
error
24.
25. • Scores assessed for 2,600 general, acute-care
hospitals
• Data was gathered that is publicly reported at the
national level, including measures reported by the
Center for Medicare Services (CMS) and the annual
Leapfrog Hospital Survey
– Specialty hospitals and hospitals not required to report data
to CMS were not included
• Methodology developed by the Blue Ribbon Expert
Panel
26. ROLE: The Panel provided guidance to Leapfrog on calculating one numerical
score for each general hospital. Leapfrog calculated the final scores and set
the letter grades)
• John Birkmeyer (University of Michigan)
• Ashish Jha (Harvard University)
• Lucian Leape (Harvard University)
• Arnold Milstein (Stanford University)
• Peter Pronovost (Johns Hopkins University)
• Patrick Romano (University of California, Davis)
• Sara Singer (Harvard University)
• Tim Vogus (Vanderbilt University)
• Robert Wachter (University of California, San Francisco)
27. • 600+ Press Mentions in first week after release
– Newspaper- 250
– Broadcasting- 190
– Trade publications- 80
– Online news- 75
– Other- 75
– National includes: CNN, ABC News, Kaiser, Modern Healthcare
• 600 hits per minute day one and two (similar to NYT)
• 575,000 Pages Served first 3 days
• 96,000 Web Visits first 3 days
• Overall, it appears consumers do care about patient safety
28. • Use the Hospital Safety Score as one tool in the process of
selecting a hospital to receive care
– Also consult CMS Hospital Compare, Leapfrog Hospital Survey
results, HealthGrades, etc.
• Talk to a doctor or nurse about hospital safety
• Ask hospital administrators what the hospital is doing to
improve their patient safety record
• Become educated on how to stay safe in the hospital
29. • Hospital Safety Scores will be rereleased in November,
2012
• Twice a year updates going forward
• Look for: a new app
• The Expert Panel will continue adapt the methodology
before each release of the score
• Leapfrog and the Expert Panel will search for ways to
evaluate hospitals not scored this round, including specialty
hospitals, military/veterans hospitals, and hospitals in
Maryland, Guam, and Puerto Rico
30. • NURSING WORKFORCE
• A Leapfrog measure: if a hospital does not voluntarily report
to Leapfrog, nursing is not directly accounted for in the
score
• Magnet Status automatically accounts for full credit on
nursing workforce, and is highlighted by Leapfrog as well
31. • Included senior nursing leadership as part of the hospital
senior management team
• Held the Board and senior administrative leadership
accountable for the provision of financial resources for
nursing services
• Collected and analyzed data of actual unit-specific nurse
staffing levels
• Performed a risk assessment and an evaluation of the
frequency and severity of adverse events that can be
related to nurse staffing.
32. • Infection prevention
• Culture of Safety
• Hand Hygiene policies
• Medication reconciliation
• Deaths from preventable surgical complications
• CPOE
• Preventing falls and pressure ulcers
• Leadership structures to promote safe practices
33. • Pressure ulcer—Stage 3 and 4
• Falls and trauma
• Central Line-Associated Bloodstream Infection
• Iatrogenic Pneumothorax
• Postoperative:
– Respiratory failure
– Clots
– Wound Dehiscence
34.
35.
36. Leah Binder, Leapfrog President & CEO
Marsha Manning, Leapfrog Board Member, Co-Chair of the Board Committee on the
Hospital Safety Score &
Manager, Health Care Initiatives and Employee Benefits Public Policy, General Motors
http://blogs.forbes.com/leahbinder/
The Leapfrog Group
1660 L Street NW Ste. 308
Washington, DC 20036
www.leapfroggroup.org
www.hospitalsafetyscore.org
38. Visit us on the Web
http://campaignforaction.org
Follow us on twitter
http://twitter.com/championnursing
Join us on Facebook
http://www.facebook.com/championnursing
38
Editor's Notes
Susan ReinhardThank you for joining us for today’s webinar on Hospital Safety as a Priority: An Opportunity for Nurses to Lead, presented by the Leapfrog Group.I’m Susan Reinhard, Senior Vice President & Director, AARP Public Policy Institute; Chief Strategist, Center to Champion Nursing in America.Before we go further, I wanted to mention that we are recording today’s webinar, so if you miss a section or would like to pass it on to a colleague, you can find the recording by going to .I also want to let you know, in advance, that we intend to leave some time for questions from those on the phone after the presentation. So if you have a question, write it down or hold on to it and you will have an opportunity to ask it after the presentation.
Susan ReinhardOn today’s webinar, our presenters will…Provide an overview of the work of the Leapfrog Group and their role in the public reporting of hospital safety scores.Discuss Magnet status and public reporting of scores means for hospitals and consumers.Explain Leapfrog’s role in ensuring a prepared nursing workforce and how that directly influences hospital safety and the Magnet designation. ….and we hope that what you hear today will motivate you to treat hospital safety as a priority in health care.As a board member of the Leapfrog group, I am proud of the work Leapfrog does and thrilled to have them here today to present this webinar. The Leapfrog Group has also been part of our Nursing Coalition at CCNA since 2010 and have been working with us to actualize the recommendations of the FON report.
Susan Reinhard Leah is President & CEO of The Leapfrog Group, a national organization based in Washington, DC, representing employer purchasers of health care calling for improvements in the safety of the nation’s hospitals. She is an influential voice for major change in healthcare. For each of the past three years she was named on Modern Healthcare’s list of the 100 Most Influential People in Healthcare, and one of 20 people making healthcare better in Health Leaders Magazine. She is a Forbes.com contributor. Ms. Binder sits on numerous national boards and committees, including the Institute of Medicine Collaboration on Patient Engagement, the National Priorities Partnership Board, and the Advisory Board of the Institute for Interactive Patient Care. She is a frequent speaker on hospital safety and quality, and the importance of payment reform and transparency.Before joining Leapfrog in the spring of 2008, Ms. Binder spent 8 years as vice president at an award-winning rural hospital network in Farmington, Maine, Franklin Community Health Network, and before that she was a senior policy advisor for the Office of Mayor Rudolph Giuliani in New York City. She started her career at the National League for Nursing, where she handled policy and communications for over 6 years.
Susan ReinhardOur second presenter is Marsha Manning. Marsha is Manager, Health Care Plans for General Motors. In this capacity, she is responsible strategy, plan design, administration and oversight for medical and prescription drug benefits for approximately 220,000 covered lives throughout the United States. In addition, the health care plans staff supports delivery system efforts that emphasize performance transparency, optimal use of health care information technology, evidence-based medicine, and patient safety. Manning has more than 30 years of varied experience in health care and human resources, including experience in clinical nursing practice, administration, data analytics, public policy, community initiatives and leadership. She is a member of the board of directors of the Greater Detroit Area Health Council (GDAHC) and The Leapfrog Group. She currently serves as a member of the Steering Committee of the SE Michigan e-Prescribing Initiative, is a member of the Executive Board of the Southeast Michigan Beacon Community, and chairs the Automotive Industry Action Group Health Care Value Task Force. In addition, she serves as the Regional Roll Out Lead for Leapfrog in Michigan, encouraging hospitals to publicly report data on hospital quality, safety and efficiency.So, Leah, I will turn this over to you…
Leah BinderWe have a problem in our country with patient safety. We first recognized the problem in the year 2000 when the Institute of Medicine came out with a study called To Err Is Human, which suggested that upwards of 100,000 Americans were dying unnecessarily of injuries, accidents, and infections in American hospitals. Unfortunately 12 years later all of the studies that have been done to see if we made progress suggest little or no improvement in safety.
Leah BinderThis is the Phoenix Stadium. It holds 60,000 people. This is three pictures of it, so you are looking at approximately 180,000 people. That is approximately the number of people who die every year of injuries, accidents, and infections in American hospitals. Some studies say it’s more. Some deaths are more preventable than others. But this is too many people, and this is too little progress.
Leah BinderThe 180,000 figure comes from a study by the Office of the Inspector General, which in 2010 did a physician chart review of over 800 randomly selected Medicare beneficiaries who were admitted to a hospital. This is the gold standard for observing errors. The results were dismal. A Medicare patient has a one in four chance of experiencing injury or harm or death when admitted to a hospital. Would any of you get on an airplane if you thought you had a one in four chance of being harmed in the flight? One in six people admitted to hospital suffer adverse events. In the course of this presentation today 20 people will die of an injury accident or error in a hospital.
Leah BinderThe Leapfrog Group was founded in 2000 by large employers reacting to the shock of that original IOM report. They were interested in using their leverage as purchasers of health benefits to drive real change. They sought giant “leaps” forward in safety and quality in hospitals, hence the name Leapfrog. They wanted to do so by allowing employees to shop for health care and hospital services the way they shopped for the kinds of products and services. It is perhaps not surprising that automakers were among Leapfrog’s most active founders and remain active today. They are accustomed to competing in a highly transparent marketplace and seek the same market for their health benefits. The Leapfrog Hospital Survey was created in 2000 to collect data from hospitals voluntarily on how they're doing an infection, injuries, errors, and accidents. Leapfrog also now looks at mortality rates from common procedures, and important quality indicators like rates of early elective deliveries. So we have now reported the Leapfrog Hospital Survey for over 10 years and we've learned some things about American hospitals.
Leah BinderLeapfrog is used across the country for public reporting by hundreds of employers. Most seek to engage consumers to support them in making decisions about hospitals based on their safety and quality. Leapfrog also serves as a good platform for candid and direct communication between purchasers and hospitals. These conversations can happen within communities and don’t have to be filtered through health plans. This opens up new opportunities for collaboration and change. Finally, the most important way employers can use Leapfrog is to drive markets for safety and quality—and thus drive a market for nursing priorities. Hospital leaders know well that too often when they perform with excellence markets do not necessarily respond. Leapfrog is about creating a market responsive to quality and safety.
Leah BinderTransparency alone won’t drive markets unless it’s real transparency. Here’s Leapfrog’s checklist for the elements of transparency that are required for consumers to actually use information in their decisiomaking. First, public reporting should show variation among competing products or services. Consumers want to know the best possible performance nationally, and how products contrast with each other. The second element is relevancy. Consumers want to know how products and services compare to each other on the elements that matter most to them. You do not publish a comparison of the type of plastic used to construct automobile hoods because consumers don't care. They want to know how safe the car is or its fuel efficiency. Finally, the third element of transparency that drives a market is that the information is presented in an unbiased and independent format. Consumers don’t think ads are transparent. So let's see how to Leapfrog checklist applies in markets outside of healthcare.
Leah BinderHere's a famous example of transparency that drives markets: the JD power.com website. JD Power interviews consumers to ask them what they think of various cars and then rates the cars on measures that consumers care about. Here's a screenshot example. If you are not familiar with this you certainly know some of the other auto comparison guides available like Motor Trend and Consumer Reports. Cars are compared along a variety of measures and it's quick and easy for consumers to instantly navigate and see how cars compare and contrast with each other.
Leah BinderHere's a more modern form of a transparency. This comes from Amazon.com. Leah was searching for Tupperware and found a 50-piece set that looked good. There were hundreds of consumer reviews, and Amazon sorts the reviews into the most helpful favorable review and the most helpful critical review so that favorable reviews. She agreed that the containers look quite sturdy, but she also agrees there aren’t enough large sizes. One reviewer suggested a different set available at Target, so Leah went and bought that one. So Amazon gave a consumer enough information to lose the sale. That is a new level of transparency demanded by the internet. And we have all come to expect it when we shop online.
Leah BinderSo let's think about these two examples from JD Power and Associates and Amazon.com. Applying Leapfrog’s checklist we certainly see lots of variation demonstrated in each example. We also saw that they offered information relevant to consumers. JD Power is designed to be relevant to consumers, or the company would be out of business. In the case of Amazon consumers themselves write the reviews on the product characteristics they find most important, which is as relevant as you get. Finally, are these tools ubiased? In the case of JD Power their business model relies on consumers trusting their independence. In the case of Amazon, they go out of their way to mitigate against their own sales bias by showing consumers enough information to reject the product.
Leah BinderLet’s look at how healthcare does on Leapfrog’s transparency checklist Here’s Hospital Compare, a famous website produced by CMS that does exactly what its name implies by publicly comparing hospitals on various measures. Leapfrog takes some pride in the fact that we help to advocate for the creation of Hospital Compare. However it’s no substitute for Leapfrog reporting and I’ll show you why. Here's a screenshot from Hospital Compare looking at the issue of pneumonia in hospitals. You can only search three hospitals a time--here's what we searched. Let’s look at that first comparison measure: “Pneumonia patients whose initial emergency room blood culture was performed prior to the administration of the first hospital dose of antibiotics.” I don’t know many people, especially outside of healthcare, who would choose a hospital based on how they did on this particular measure. Most consumers do not care. But even if they did, here's the other problem: in the vast majority of cases the hospital does just fine. 97 to 100% of the time in this case. In fact, for most of the process measures like this in Hospital Compare most of the hospitals perform well most of the time. This is not going to help consumers discern among different hospitals.
Leah BinderThere are some measures on Hospital Compare that consumers do in fact care deeply about. Death rates for certain procedures and conditions are a good example, and here’s a screen shot of some of those. But here’s the problem: In almost all cases the hospital is no different than the national rate. So all hospitals are rated average. In fact, almost all hospitals are rated average almost all the time, with more than 90% rated average for these measures. Again, this is not helpful for consumers deciding among hospitals.
Leah BinderSo let's look at our checklist as it relates to Hospital Compare. It does not show the variation among hospitals. A few of the measures are relevant to consumers but most are not. Finally, is Hospital Compare unbiased? It’s hard to imagine how CMS could be unaffected by politics, and politics is why Hospital Compare is not going to be a good tool to drive markets.
Leah BinderSo let's look at what the Leapfrog Group reports from its survey. Here's a screenshot from Leapfrog. It's a good selection of information on issues like whether the hospital is successful in preventing medication errors, safe staffing for intensive care, precautions in place to prevent harm. Leapfrog’s governance is by purchasers outside of the healthcare industry—which means it’s built into the organizational DNA that it will report measures of interest Leapfrog also reports the data as we see it, and we see variation. You can see the variation among hospitals expressed as cellphone bars on the various measures.
Leah BinderSo let's apply the Leapfrog checklist to the Leapfrog public. Yes, Leapfrog shows variation. Leapfrog shows measures relevant to consumers. And Leapfrog is independent and unbiased in its organizational DNA.
Leah BinderAfter 10 years of public reporting to Leapfrog however we have to admit progress is too slow. We haven’t been able to get enough my enough traction, and although 1200 hospitals voluntarily report, thousands of hospital decline to report. So we have not made the progress we need to make. And that’s a lot of people still dying every year. So the Leapfrog Board Made the decision to try something new in transparency to drive markets.So now I will turn this over to Marsha…
Marsha ManningIn my role at GM, I am responsible for the health care benefits for 220K GM employees, retirees and family members. Thinking about the data that Leah just discussed, this translates into one GM covered member dying every other day from a preventable medical error. Put in those terms, it engages and motivates my leadership to support transparency and quality improvement in general and Leapfrog specifically.So what is the next step in addressing this silent crisis?: The Hospital Safety Score. Leah discussed transparency that shows variation, is relevant and is unbiased. The Hospital Safety score meets this criteria and focuses on a very discrete aspect of Hospital Care: How well do hospitals do at keeping patients safe from harm and error? The Hospital Safety Score’s letter grade scoring system allows consumers to quickly assess the safety of their local hospital, and will help them choose the best hospital to seek care. As consumers’ use of the Hospital Safety Score increases, we hope more hospitals will be compelled to participated in meaningful public reporting.
Marsha ManningWhat purchasers want is for their members to be able to easily identify hospitals where they can receive the safest care.The Hospital Safety Score approach was loosely modeled on the approach used to assess the achievement of food safety standards of restaurants in NYC. Some of you may be familiar with the fact that restaurants in NYC must display their sanitation score- A, B, C, in the window of their establishment for all of their potential customers to see. The score is based on inspections of the restaurant that score their attainment of food safety standards. So ask yourself- no matter how appealing the menu is, no matter how lovely the dining room appears- do you want to eat in a restaurant that has a big fat ‘C’ displayed in the window? Not likely.We want consumers to have the same opportunity to assess how likely it is that they may suffer harm in a hospital setting by using the Hospital Safety Score. This is a screen shot from hospitalsafetyscore.org that displays the safety scores of hospitals in the DC area. Where do you want to receive your care???
Marsha ManningScores are developed for 2,600 acute care hospitals using publicly available data from CMS and the annual Leapfrog Hospital Survey. Certain hospitals are excluded from the scoring process, such as specialty hospitals and those who do not report to CMS. The methodology utilized to score the hospitals has been thoughtfully developed by a Blue Ribbon Expert Panel.
Marsha ManningThis Expert Panel is comprised of many of the top experts in the country on the topic of patient safety. They have enthusiastically provided guidance in developing the methodology that creates one numerical score for each hospital. Leapfrog calculates the finals scores and sets the letter grades. I am sure that many of you are familiar with the work of many of these panelists.
Marsha ManningThe first Hospital Safety Scores were published this past June. As you can see, the release of the scores generated significant media attention, as well as traffic to the hospitalsafetyscore.org website. This is a strong indication that consumers do care about patient safety and are willing to consider this data.
Marsha ManningWhat we want is for consumers to use the Safety Score as one tool in the process of selecting a hospital. There are of course other sources of data, and Leah has shared some of the strengths and weaknesses of available data. The promise of introducing this data is that it will initiate a dialogue- we want patients to talk to their physicians and their nurses about safety, to pose the hard questions to hospital administrators to insure they are focused on safety, and to become better educated consumers so they can take steps to help stay safe in the hospital.
Marsha ManningSo what is ahead for the Safety Score? Hospitals have had some time to address some of their gap areas and improve their performance. The scores will be re-released next month, and Leapfrog anticipates twice yearly updates going forward. We hope that you will all see a big media splash for the next release of the Safety Score- there is a significant effort underway to push this information to consumers through major media outlets this fall.An app for smart phone users will be launched with this release so that consumers can easily identify the safest hospitals. Our enthusiastic Expert panel will continue to evolve the methodology and will work with leapfrog to identify ways to include more hospitals that today are not included in the scoring.
Marsha ManningSo now I want to talk about how critical Nursing is to patient safety. This webinar is timely, as earlier this month, The University of Pennsylvania released a study that confirms the following: if you want to assess a hospital’s quality of care, just ask the nurses.The researchers emphasized what all of you already know: nurses tend to have accurate perceptions of quality of care in the hospital where they work because they are on the front lines and are most familiar with the daily experiences of their patients. In recognition of a growing body of studies highlighting the key role nurses’ play in patient safety, Leapfrog began publicly reporting on hospitals that have demonstrated nursing excellence on the annual hospital survey. Hospitals participating in the Leapfrog Hospital Survey that indicate they have current Magnet® status designation, as determined by the American Nurses Credentialing Center (ANCC) will automatically earn full credit for the Nursing Workforce measure. This section of the survey is used to score hospitals on their commitment to staffing their hospitals with highly trained nurses and putting those nurses in leadership positions which allow them to have substantial input into patient safety issues. When Leapfrog announced the inclusion of the Nursing Workforce measure in the annual survey, Susan Reinhard, who is on the phone with us, stated that: “Representing purchasers of healthcare, Leapfrog offers an important business perspective to the importance of strong nursing. High quality health care requires high quality nurse-delivered care.” And I want to assure you that the purchaser members of Leapfrog recognize this strong link.The nursing workforce measure is also included in the Safety score, and it heavily weighted due to the recognition of the impact of the nursing workforce on patient safety.
Marsha ManningThis slide provides some examples of the standards upon which a hospital is assessed as it relates to the Nursing Workforce. Attainment of these standards demonstrates a hospital’s understanding of and commitment to the value of strong nursing leadership and data analysis related to staffing and outcomes.
Marsha ManningIn addition to the Nursing Workforce measure, nursing is key to many of the process measures that are included in the Hospital Safety Score. You can look at this list and recognize the connection with nursing responsibilities. Strong performance on these measures is in part the result of strong nursing leadership and engagement.
Marsha ManningThe same is true for the key outcome measures on the Safety Score. Again- the link between nursing leadership and engagement and these outcomes measures is tangible.
Marsha ManningAreas to highlight:Magnet Status by name of the hospital- this is the only such designation on the public Leapfrog reporting, indicating the importance of this statusSafe practices includes Nursing Workforce
Marsha ManningImproving the safety of hospital care will take the commitment and expertise of not only those who work within the hospital, but also those of us who work outside of the hospital environment. One of the founding principles of Leapfrog is that purchasers of health care can drive the value of the health care delivery system by demanding transparency of performance and then purchasing health care based on this performance. Continuing to drive value purchasing is key to driving change- the expectation needs to be clear that purchasers want their members to get safe care. In my role at GM, I have to think about the 220K members who receive their health care coverage through GM, and also to think about that one GM member who dies every other day in a US hospital due to a preventable error. Large purchasers, particularly those of us in the manufacturing sector, can also share our own experiences in process improvement and culture change to support change in health care. GM has supported hundreds of lean workshops in the health care delivery system over time. We know that process improvement and culture change can have a huge impact. In the area of safety, there was a time when GM had one of the worst plant safety records in the industry. At a certain point, GM leadership decided that safety must become a priority in our manufacturing environment. And the result is that GM now has one of the best plant safety records in the industry. It takes leadership, engagement and true culture change for this to occur. I am a nurse myself and I feel encouraged at the idea that there are thousands of nurses across the country providing care to all of those GM members- working to keep them safe from harm, demanding that their hospitals do better, being part of the solution.Meanwhile, those of us outside the hospital walls work toward the same end by driving transparency and demanding improvement. It is great to have this team in place!
Susan ReinhardThank you Leah and Marsha….I would now like to open the lines for Q&A Prompt the operator.Ask a question While waiting to hear from audience:
Sue Hassmiller Again I want to thank Leah and Marsha for their As I mentioned earlier, you can view and share the recording of this webinar and many others by going to www.championnursing.org/events. That concludes today’s webinar. Check us out on the web, follow us on twitter, or join us on Facebook!