Joint Commission Center for Transforming Healthcare
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1 Joint Commission Center for Transforming Healthcare Hand-Off Communications Alex Vandiver Executive Director, MBB Joint Commission Center for Transforming Healthcare
2 Current State of Quality Source: Stelfox HT, Palmisani S, Scurlock C, Orav EJ, Bates DW. The "To Err is Human" report and the patient safety literature. Qual Saf Health Care. 2006;15: We have focused intensely for more than a decade on improving quality and safety Yet, quality problems still surround us Health care associated infections Medication errors that cause harm Failed communication in transitions of care Uncommon, preventable adverse events that are inexplicable to patients and families Wrong site surgery, OR fires 2
3 Introduction to CTH-Vision One Vision All people always experience the safest, highest quality, best-value health care across all settings. 3
4 Introduction to CTH- Mission Leadership The responsibility of leadership to make high reliability the priority Safety Culture The importance of creating a culture of safety within an organization RPI The use of proven quality methods Lean Six Sigma & change management (known together as robust process improvement ) to systematically improve processes and avoid common, crucial failures Our Mission: Transform health care into a high reliability industry and to ensure patients receive the safest, highest quality care they expect and deserve 4
5 Robust Process Improvement (RPI) A New Way in Delivering Results Usual Approaches: One-size-fits-all works well only in very limited circumstances: Process varies little from place to place Causes of failure are few and common New Generation of Best Practices: Complex processes require RPI to produce solutions customized to an organization s most important causes Protocol s Checklist s Toolkits or Many causes of the same problem Key causes different from place to place Each cause requires a different strategy Bundles RPI 5
6 6
7 Develop Solutions with Leading Hospitals Atlantic Health Barnes-Jewish Baylor Cedars-Sinai Cleveland Clinic Exempla Fairview Floyd Medical Center Froedtert Intermountain Johns Hopkins Kaiser-Permanente Mayo Clinic Memorial Hermann NY-Presbyterian North Shore-LIJ Northwestern OSF Partners HealthCare Sharp Healthcare Stanford Hospital Texas Health Resources Trinity Health VA Palo Alto HCS Virtua Wake Forest Baptist Wentworth-Douglass 7
8 Center Operating Model Project Selection Determine Topic Create Solutions, Pilot Test, Build RPI Expertise Solve with Participating Organizations Spread No RPI Expertise Pilot Test 1 Pilot Test 2: Integrate Solutions into TST (Beta-Testing) Launch TST 8
9 Confidential Easy to Use No Extra Cost Separate from Accreditation Educational, no jargon, no special training and no knowledge of RPI methodology needed Guides users to customized solutions. Data analysis conducted by the tool, not the user. Tool walks user through process of: Measuring current state Determining root causes Selecting targeted solutions Control of process after implementation 9
10 tst-handoff-communications/
11 Results Hospital to Skilled Nursing Facility 11
12 Improving Hand-off Communications The Targeted Solutions Tool outlines specific steps to improve hand-off communications. Forms, tools and tips for recording and interpreting defects in the hand-off communications process Instructions for pinpointing the solutions that will work best at your organization Guidelines for maintaining success 12
13 Organizational Timeline and Goal You should start to see results within 16 to 21 weeks 13
14 1. Getting Started 2. Training Data Collectors 3. Measuring Compliance 4. Determining Factors 5. Implementing Solutions 6. Sustaining The Gains SIX EASY STEPS 14
15 Real-Time Reports 15
16 Data & Solutions Driven 16
17 Targeted Implementation Guides 17
18 Online Tools for Implementation and Control of Solutions 18
19 Data Aggregation: Combine Data Across Your System 19
20 What s in it for You? Proven, Tested Tools and Solutions Easy to Use Web-based Application Standardization Sender-Receiver Focus Built In Real-Time Data Analysis Change Management Measure Defects Manage Performance Collaborative Framework Access to Performance Improvement Expertise NO COST to Maryland JC Hospitals and Partners 20
21 Next Steps Registration Training Schedule Supports 21
22 22
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