Patient Care Quality Outcomes

Patient Care and Quality OutcomesDeborah Bulger, CPHQPaul GartmanVice President, Product ManagementVice President, Product ManagementPerformance ManagementEnterprise VisibilityLearning ObjectivesDetermine how IT can support an organization’s quality performance goals Understand the difference between departmental capacity management and patient flow issues that affect the entire organization Learn how advanced care planning tools can help address an initiative of the IHI: Transforming Care at the Bedside2“Evidence bridge: pathways that derive estimates of clinical outcomes from changes in process measures.”Kendrick, et. al., “Crossing the Evidence Chasm: Building Evidence Bridges from Process Changes to Clinical Outcomes.” JAMIA, May/June 20073Crossing the Evidence BridgeStrategic direction Tactical implementation Effective care Safety planningtechnology and cultureConstituent Visible based analysis communication to all stakeholders4Perfect Care Assessment Identifying the Opportunity% of “No” ResponsesThe higher the bar, the greater the opportunityThe higher the bar…the greater the opportunity!63%64%55%41%December 2007IHI National Forum92 responsesMD, RN, QA, BoardMistake ProofOptimizeAdopt WholeTransformYourPatient FlowSystemCare at theProcessesMeasuresBedside5Perfect Care Assessment Identifying the Opportunity% of “No” ResponsesThe higher the bar, the greater the opportunity63%64%55%“No single tool can solve every 41%problem; often, the answer will lie in the discovery, implementation, and execution of several tools.”Grout J. Mistake-proofing the design of health care processes. AHRQ Publication No. 07-0020. May 2007.Mistake ProofOptimizeAdopt WholeTransformYourPatient FlowSystemCare at theProcessesMeasuresBedside6Mistake Proofing Your Processes Recognition and Prevention of Failure Points% of “No” ResponsesThe higher the bar, the greater the opportunityOnline allergies and med history Automated med74%for each patient reconciliationRapid reporting of critical lab Visiblility to54%valueschanges in ptstatus“Five rights” barcodingPatient safety51%attributesBarcode73%scanning7Removing a Failure PointBarcode Scanning TechnologyBedside barcode scanning of meds Quantifiable results─ 99.7% compliance with bar-code scanning─ 39% increase in reporting of medication errors and near misses─ 33% decrease in percentage of errors causing harm─ 48% decrease in missed doses ─ 73% decrease in extra dosesRapid adoption of technology ─ 63% decrease in wrong doses─ Enhanced charge capture─ Increased clinician satisfaction and retention─ Increased productivity and efficiency─ $300,000 savings in transcription fees─ And on… and on…8“Dockside to Bedside”100% Barcoded Medication Management9Perfect Care Assessment Identifying the Opportunity% of “No” ResponsesThe higher the bar, the greater the opportunity63%64%55%“A hospital is a great example of a complex adaptive 41%system. You have a number of people who are making day-to-day, even minute-to-minute, decisions in their own microsystem … that impact hospital-wide patient flow, and they are making these decisions without access to information about the macro view, or what is going on in the rest of the hospital.”Kirk Jensen, MD, MBA, FACEP, IHI faculty member and co-author, Leadership for Smooth Patient Flow: Improved Outcomes, Improved Service, Improved Bottom LineMistake ProofOptimizeAdopt WholeTransformYourPatient FlowSystemCare at theProcessesMeasuresBedside10