Vibeke Rischel, programme director The Danish Society for Patient Safety
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1 Vibeke Rischel, programme director The
2 Programme overview TrygFonden, Danish Regions and the Danish Society for Patient Safety are working together on the Danish Safer Hospital Programme with expert assistance from the Institute for Healthcare Improvement, IHI. The Danish Safer Hospital Programme is designed to prevent inadvertent errors, injuries and deaths. Five hospitals participate in The Danish Safer Hospital Programme as exemplar sites. Positive results at the exemplar sites will be spread by an active effort to hospitals in the rest the country. 2
3 Hospitalsenheden Horsens Beds: 247 Employees: 1600 Discharges: Outpatients: Budget mio. Dkk (2009): 800 Sygehus Thy-Mors Beds: 142 Employees: 830 Discharges: Outpatients: Budget mio. Dkk (2009): 403 Hillerød Hospital Beds: 630 Employees: 4000 Discharges: Outpatients: Budget mio. Dkk (2009): 2211 Kolding Sygehus Beds: 292 Employees: 1906 Discharges: Outpatients: Budget mio. Dkk (2009): 1000 Næstved Sygehus Beds: 363 Employees: 2140 Discharges: Outpatients: Budget mio. Dkk (2009):
4 Aims for each hospital by the end of 2013 Reduction in HSMR by 15% Reduction in harm by 30% Reduction in cardiac arrest calls by 30% 0 (non) Central Line infections or 300 days between 0 (non) Ventilator associated pneumonias or 300 days between Reduction in hospital acquired pressure ulcers by 50% Reduction in 30 days post-operative mortality by 20% Reduction in post-operative readmission by 20% 4
5 12 pakker (bundles) Central Lines Sepsis Rapid Response System CHF AMI Safe Surgery High Risk Medication Med. Rec. Pressure Ulcer Urinary Catheter Ventilator (VAP) Periferal Venous Catheter 5
6 One out of four patients is harmed 6
7 Most frequent types of harm1 ThyMors Horsens Kolding Næstved Hillerød Hospital acquired infections Nausea/ vomiting Delayed discharge Hospital acquired infections Nausea/ vomiting Readmissons Falls Hospital acquired infections Hospital acquired infections Hospital acquired infections Pressure ulcer Pressure ulcer Peripheral venous line complications Postoperative bleeding Peripheral venous line complications Postoperative complications Falls Medication errors Diarrhea Constipation Pressure ulcer 1. Experiences with the Global Trigger Tool at Danish hospitals. Von Plessen et al International Forum. 7
8 Preparation Test and implementation Sustainability A P S D A P S D A P S D A P S D A P S D A P S D LS 1 LS 2 LS 3 LS 4 LS 5 LS 6 Learning Site visits Monthly phone conferences Monthly reporting of data May 10 Aug 10 Feb 11 Sep 11 Feb 12 Aug 12 Nov 12 May 13 LS: Learning seminars IHI, modificeret af DSFP 8
9 Measurement Real time data are used to identify opportunities for improvement and motivate caregivers to make rapid changes in order to track improvements. Dashboard in the ward corridor 9
10 Antal Fewer patients die from AMI Horsens Hospital has succesfully implemented the AMI bundle, a checklist for treatment of patients with heart attack. Team from cardiology in Horsens Karen Dodt and Kirsten Lysdahl presented preliminary result at the international forum i Paris AMI-cases between deaths Indlæggelse nr Frontpage story in a national newspaper, july
11 Procent Dage Procent Central Line Bundle compliance 100% Insertion CVK-anlæggelser med alle elementer opfyldt, Intensiv Afdeling, Kolding 95% 90% Days between CLI, Kolding 85% 80% 75% Dage mellem CVK-infektioner, Intensiv Afdeling, Kolding % Måned Daily review of line necessity CVK'er med relevant indikation, Intensiv Afdeling, Kolding % 60% Dato 40% 20% 0% Måned 11
12 Zero pressure ulcers on two hospitals Hospitalwide count 16. oct. 15. nov Category 1 Category 2-4*** Admissions pr year (2010) Sygehus Thy-Mors Horsens Hospital Kolding Sygehus Næstved Sygehus Hillerød Hospital * ** 15* * 3 of unknown kategori, ** Estimated from 18 dage, *** None 3 and 4 12
13 Celebration of goal 300 days, CLI, Næstved 300 days, CLI, Kolding 300 days, VAP, Næstved 600 days, VAP, Horsens 300 days, pressure ulcers, Thy-Mors 300 days, CLI, Hillerød 13
14 Celebration and events 73 % have celebrate a positive resultat* Of these: 92 % at unit level 26 % at hospital level (ie. with board of directors) 48 % with external participants (ie. PSS diploma) Local in-unit celebration is prefered by frontline clinicians (58 %) *Survey with 239 attendees from LS5 by Ida Hoeck Analyse og Rådgivning 14
15 A proactive media strategy has resulted in positive press coverage 15
16 Media coverage 83 % experience positive coverage* Intranet/hospital news letter/program website (> 50 %) Local paper, radio and tv (24-34 %) Professional journals (22 %) National media (11 %) Prefered media* Professional journals(56 %) Intranet/hospital news letter/program website(29-42 %) Local/national paper (21-31 %) Local/national radio and tv(9-20 %) * Survey with 239 attendees from LS5 by Ida Hoeck Analyse og Rådgivning 16
17 Celebrations and media coverage build will for further improvement Celebration* Creates unity at the ward (70 %) Increases the desire to work for continuous improvement (58 %) Increases professional pride (63 %) Positive media coverage* Creates unity at the ward (95 %) Increases the desire to work for continuous improvement (94 %) Increases professional pride (88 %) *Survey with 239 attendees from LS5 by Ida Hoeck Analyse og Rådgivning Side 17
18 90% of units have a public data board with real time
19 The Nordic Improvement Program A collaboration between Danish Society for Patients Safety and the Norwegian Patients Safety Campaign. 1 cohort started January 2013 with 20 Norwegian and 20 Danish participants. 19
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