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Patient Safety Initiatives
         in Healthcare:
     Understanding Their
   Importance to the Supplier


Click image
                 Dan Maloy
 for audio    The Maloy Group, LLC
               September 23, 2009
Agenda
•   The issue and landscape
•   Developing the Value Proposition
•   Connecting the Value Proposition
•   Translating the Value Proposition
•   Implementing the Value Proposition
•   Additional resources
28 „Never‟ Events1
   Surgical Events                                             Care Management Events
   •    Surgery on wrong body part                             •   Death/disability associated with medication error
   •    Surgery on wrong patient                               •   Death/disability associated with incompatible blood
   •    Wrong surgery on a patient                             •   Maternal death/disability with low risk delivery
   •    Foreign object left in patient after surgery           •   Death/disability associated with hypoglycemia
   •    Post-operative death in normal health patient          •   Death/disability associated with hyperbilirubinemia in
   •    Implantation of wrong egg                                  neonates
                                                               •   Stage 3 or 4 pressure ulcers after admission
   Product or Device Events                                    •   Death/disability due to spinal manipulative therapy
   •    Death/disability associated with use of contaminated
        drugs                                                  Environment Events
   •    Death/disability associated with use of device other   •   Death/disability associated with electric shock
        than as intended                                       •   Incident due to wrong oxygen or other gas
   •    Death/disability associated with intravascular air     •   Death/disability associated with a burn incurred
        embolism                                                   within facility
                                                               •   Death/disability associated with a fall within facility
   Patient Protection Events                                   •   Death/disability associated with use of restraints
   •    Infant discharged to wrong person                          within facility
   •    Death/disability due to patient elopement
   •    Patient suicide or attempted suicide resulting in      Criminal Events
        disability                                             •   Impersonating a heath care provider (i.e., physician,
                                                                   nurse)
                                                               •   Abduction of a patient
                                                               •   Sexual assault of a patient within or on facility
                                                                   grounds
NQF Serious Reportable                                         •   Death/disability resulting from physical assault within
                                                                   or on facility grounds
Adverse Events
1www.cms.hhs.gov
Hospital CEO Concerns
Patient safety and quality ranks second behind financial challenges2




 2American   College of Healthcare Executives, 2008 survey, www.ache.org
Patient Safety and Quality
               Specific Concerns2
            •    Redesigning care processes                               66%
            •    Redesigning work environment                             66%
            •    Compliance with accred. orgs.                            60%
            •    Medication errors                                        57%
            •    Nosocomial infections                                    47%
            •    Nonpayment for “never events”                            43%
            •    Pay for performance                                      41%
            •    Leapfrog demands                                         40%
            •    Public reporting of outcomes data                        40%
            •    Surgical mistakes                                        24%
            •    Other                                                    7%
2American   College of Healthcare Executives, 2008 survey, www.ache.org
Hospitals are funding
                  patient safety initiatives3




3Quality and Patient Safety: A Sharper Focus; Amerinet Executive Briefing, May 2009;
http://www.amerinet-gpo1.com/anetpub/uploads/2009_Executive_Briefing_QualityDrKaplan.pdf
Where is the money going?3

                                                                                           Documentation


                                                                                           Awareness




3Quality and Patient Safety: A Sharper Focus; Amerinet Executive Briefing, May 2009;
http://www.amerinet-gpo1.com/anetpub/uploads/2009_Executive_Briefing_QualityDrKaplan.pdf
HOW DO YOU GAIN THE
COMPETITIVE ADVANTAGE?

      And your share of the
   patient safety expenditures?
Healthcare Provider Challenges
Patient Safety is a major
 concern for providers;                       Financial
                                              Concerns
 however, it is certainly
 not their only
 challenge.                 Patient Safety
                              Concerns
                                                            Workforce Limitations




How do their challenges                        Product
                                             Expenditures



 impact the adoption of
 your products?
Critical Points in your
          Product Lifecycle




Early Adopters
•Champion
•Budget
•Infrastructure
Moving Up the Value Pyramid
              Patient
               Safety
             Total Cost
               in Use



                Price

              Service

           Product Quality

        Product Requirements
Develop the Value Proposition
• Define what your product accomplishes
  in terms of Patient Safety
  – Our X protects patients by …
  – Our Y prevents infections …
• Target your messaging to the provider,
  and their needs
• Quantify the benefits – address the
  economic factors which point to the
  adoption of your solution
Two Very Different
        Value Propositions
 Our product enhances patient safety by
  reducing the infection rates by X%.

  By reducing infection rates by X%, our
product reduces nosocomial infections and
saves the average hospital $Y annually for
      every 500 surgical procedures.
“Everything has become a
      spreadsheet sale.”
- Field Representative, major healthcare supplier

Your solution must make sense financially
• Budget neutral, or
• Savings in cost of use, or
• Savings based on clinical outcomes
Economic Model
• Inputs should be standard measures
   – Admissions, procedures, APD
   – Infection rates
   – Re-admission rates
• Output should include savings and quality
  improvements
   –   Total savings, Net savings (less cost of product)
   –   Savings per X (procedures, APD)
   –   Reduction of Y%
   –   Elimination of Z days of uncompensated care
• Model should have baseline data from other
  facilities
   – Validation
   – Standard factor
• Model should be user-friendly for all user levels
Connect the Value Proposition
     (seed the market)
• Find the appropriate organizations
    – Clinical (i.e. AORN, APIC, etc.)
    – Providers (i.e. AHA)
    – „Issue based‟ (i.e. EpiNet)
    – Group Purchasing Organizations
•   Connect to their initiatives
•   Support their organization
•   Support their initiatives
•   Connect to their leaders
Translate the Value Proposition
       (engage locally)
• Market your product and solutions to the
  various stakeholders (clinical and
  administrative) at the provider level
  – Raise awareness
  – Generate interest
  – Identify your champions
• Connect to organizations
• Connect to individuals
• Identify thought leaders
Critical Points in your
          Product Lifecycle

                  How is your team
                  prepared to support
                  the next „round‟ of
                  customers?




Early Adopters
•Champion
•Budget
•Infrastructure
Implement the Value Proposition
• Provide tools to support the internal sales efforts of the
  customer champion
   – Economic models
   – Clear outline of implementation support and training
   – Customer success stories, clinical data, etc.
• Develop the tools to facilitate your customers‟
  implementation of your solutions
   – Training tools
      • Pre-packaged implementation kits
      • Online training
   – Reporting tools
   – Monitoring tools
• Align your resources to support the customer
   – Economic „seller‟
   – Clinical support
Are you ready to PARTNER?
Demonstrate how the product satisfies the
 customer‟s patient safety goals
Share economic models to understand the
 impact of the change
Engage in planning dialogue
Provide resources to support implementation

? Share risk with customers
Past Successes
• Silver coated urological catheter
  – UTI reduction guarantee
• BIOPATCH®                    Safety Catheter Adoption
  – Clinical studies           1990-2004 (2000-4 proj.)
                        100%
• Safety IV Catheters    80%
  – Slow adoption        60%

  – Legislation          40%
                         20%
                         0%
Support Tools4




4   http://www.sandelmedical.com/time-out-products.asp
Recognize the Challenge

       • Seatbelt usage has
         grown as awareness
         and penalties have
         grown.

       • Despite this, approx.
         20% of US drivers still
         do not buckle up.


5   http://www.nhtsa.dot.gov/people/injury/airbags/Archive-04/PresBelt/america_seatbelt.html
Additional Resources
• Government:
  – CMS, HHS, etc.
• Organizations:
  – JCAHO, APIC, SHEA, etc.
  – List of organizations:
      http://www.firestone-
      callahan.com/image/Professional_Organization_
      Patient_Safety_Initiatives.pdf

• GPO resources
QUESTIONS?
 dan.maloy@maloygroup.com


     Register for the
Spring 2010 IDN Summit
    www.idnsummit.com
     April 20-22, 2010

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Patient Safety Initiatives Maloy IDN Summit Fall 2009

  • 1. Patient Safety Initiatives in Healthcare: Understanding Their Importance to the Supplier Click image Dan Maloy for audio The Maloy Group, LLC September 23, 2009
  • 2. Agenda • The issue and landscape • Developing the Value Proposition • Connecting the Value Proposition • Translating the Value Proposition • Implementing the Value Proposition • Additional resources
  • 3. 28 „Never‟ Events1 Surgical Events Care Management Events • Surgery on wrong body part • Death/disability associated with medication error • Surgery on wrong patient • Death/disability associated with incompatible blood • Wrong surgery on a patient • Maternal death/disability with low risk delivery • Foreign object left in patient after surgery • Death/disability associated with hypoglycemia • Post-operative death in normal health patient • Death/disability associated with hyperbilirubinemia in • Implantation of wrong egg neonates • Stage 3 or 4 pressure ulcers after admission Product or Device Events • Death/disability due to spinal manipulative therapy • Death/disability associated with use of contaminated drugs Environment Events • Death/disability associated with use of device other • Death/disability associated with electric shock than as intended • Incident due to wrong oxygen or other gas • Death/disability associated with intravascular air • Death/disability associated with a burn incurred embolism within facility • Death/disability associated with a fall within facility Patient Protection Events • Death/disability associated with use of restraints • Infant discharged to wrong person within facility • Death/disability due to patient elopement • Patient suicide or attempted suicide resulting in Criminal Events disability • Impersonating a heath care provider (i.e., physician, nurse) • Abduction of a patient • Sexual assault of a patient within or on facility grounds NQF Serious Reportable • Death/disability resulting from physical assault within or on facility grounds Adverse Events 1www.cms.hhs.gov
  • 4. Hospital CEO Concerns Patient safety and quality ranks second behind financial challenges2 2American College of Healthcare Executives, 2008 survey, www.ache.org
  • 5. Patient Safety and Quality Specific Concerns2 • Redesigning care processes 66% • Redesigning work environment 66% • Compliance with accred. orgs. 60% • Medication errors 57% • Nosocomial infections 47% • Nonpayment for “never events” 43% • Pay for performance 41% • Leapfrog demands 40% • Public reporting of outcomes data 40% • Surgical mistakes 24% • Other 7% 2American College of Healthcare Executives, 2008 survey, www.ache.org
  • 6. Hospitals are funding patient safety initiatives3 3Quality and Patient Safety: A Sharper Focus; Amerinet Executive Briefing, May 2009; http://www.amerinet-gpo1.com/anetpub/uploads/2009_Executive_Briefing_QualityDrKaplan.pdf
  • 7. Where is the money going?3 Documentation Awareness 3Quality and Patient Safety: A Sharper Focus; Amerinet Executive Briefing, May 2009; http://www.amerinet-gpo1.com/anetpub/uploads/2009_Executive_Briefing_QualityDrKaplan.pdf
  • 8. HOW DO YOU GAIN THE COMPETITIVE ADVANTAGE? And your share of the patient safety expenditures?
  • 9. Healthcare Provider Challenges Patient Safety is a major concern for providers; Financial Concerns however, it is certainly not their only challenge. Patient Safety Concerns Workforce Limitations How do their challenges Product Expenditures impact the adoption of your products?
  • 10. Critical Points in your Product Lifecycle Early Adopters •Champion •Budget •Infrastructure
  • 11. Moving Up the Value Pyramid Patient Safety Total Cost in Use Price Service Product Quality Product Requirements
  • 12. Develop the Value Proposition • Define what your product accomplishes in terms of Patient Safety – Our X protects patients by … – Our Y prevents infections … • Target your messaging to the provider, and their needs • Quantify the benefits – address the economic factors which point to the adoption of your solution
  • 13. Two Very Different Value Propositions Our product enhances patient safety by reducing the infection rates by X%. By reducing infection rates by X%, our product reduces nosocomial infections and saves the average hospital $Y annually for every 500 surgical procedures.
  • 14. “Everything has become a spreadsheet sale.” - Field Representative, major healthcare supplier Your solution must make sense financially • Budget neutral, or • Savings in cost of use, or • Savings based on clinical outcomes
  • 15. Economic Model • Inputs should be standard measures – Admissions, procedures, APD – Infection rates – Re-admission rates • Output should include savings and quality improvements – Total savings, Net savings (less cost of product) – Savings per X (procedures, APD) – Reduction of Y% – Elimination of Z days of uncompensated care • Model should have baseline data from other facilities – Validation – Standard factor • Model should be user-friendly for all user levels
  • 16. Connect the Value Proposition (seed the market) • Find the appropriate organizations – Clinical (i.e. AORN, APIC, etc.) – Providers (i.e. AHA) – „Issue based‟ (i.e. EpiNet) – Group Purchasing Organizations • Connect to their initiatives • Support their organization • Support their initiatives • Connect to their leaders
  • 17. Translate the Value Proposition (engage locally) • Market your product and solutions to the various stakeholders (clinical and administrative) at the provider level – Raise awareness – Generate interest – Identify your champions • Connect to organizations • Connect to individuals • Identify thought leaders
  • 18. Critical Points in your Product Lifecycle How is your team prepared to support the next „round‟ of customers? Early Adopters •Champion •Budget •Infrastructure
  • 19. Implement the Value Proposition • Provide tools to support the internal sales efforts of the customer champion – Economic models – Clear outline of implementation support and training – Customer success stories, clinical data, etc. • Develop the tools to facilitate your customers‟ implementation of your solutions – Training tools • Pre-packaged implementation kits • Online training – Reporting tools – Monitoring tools • Align your resources to support the customer – Economic „seller‟ – Clinical support
  • 20. Are you ready to PARTNER? Demonstrate how the product satisfies the customer‟s patient safety goals Share economic models to understand the impact of the change Engage in planning dialogue Provide resources to support implementation ? Share risk with customers
  • 21. Past Successes • Silver coated urological catheter – UTI reduction guarantee • BIOPATCH® Safety Catheter Adoption – Clinical studies 1990-2004 (2000-4 proj.) 100% • Safety IV Catheters 80% – Slow adoption 60% – Legislation 40% 20% 0%
  • 22. Support Tools4 4 http://www.sandelmedical.com/time-out-products.asp
  • 23. Recognize the Challenge • Seatbelt usage has grown as awareness and penalties have grown. • Despite this, approx. 20% of US drivers still do not buckle up. 5 http://www.nhtsa.dot.gov/people/injury/airbags/Archive-04/PresBelt/america_seatbelt.html
  • 24. Additional Resources • Government: – CMS, HHS, etc. • Organizations: – JCAHO, APIC, SHEA, etc. – List of organizations: http://www.firestone- callahan.com/image/Professional_Organization_ Patient_Safety_Initiatives.pdf • GPO resources
  • 25. QUESTIONS? dan.maloy@maloygroup.com Register for the Spring 2010 IDN Summit www.idnsummit.com April 20-22, 2010