Patient Safety and Quality in Washington Hospitals

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Patient Safety and Quality in Washington Hospitals
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Washington HospitalsBasic Facts
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Washington Hospitals

• 98 hospitals in Washington State

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Hospitals The Ultimate Safety Net

• Hospitals are there when you need them providing
  excellent care every day and at any hour
• Hospitals dont turn emergencies away everyone
  gets treated regardless of ability to pay
• In 2004 Washington hospitals provided over
  180 million in charity care

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Your Hospitals at Work

• 580000 admissions in 2003
• 9 million outpatient visits in 2003
• One-fourth of all inpatients are maternity and
  newborns
• Cardiac care
• Orthopedics
• General surgery

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Hospitals Provide Jobs

• Hospitals are one of the largest employers in the
  state
• Washington hospitals employ 74000 people
• 65000 full-time equivalent positions
• Average compensation is 64000 (salary
  benefits)

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Hospitals Economic Impact

• Hospitals are major contributors to Washingtons
  economy
• Purchasing goods and services locally
• Paying taxes (state local sales BO)
• For every dollar spent by hospitals about 2.40
  in business activity is created totaling
  17.5 billion

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Hospitals Provide Excellent Care

• Based on what you know or have heard how
  satisfied are you with the quality of health care
  available at most hospitals in Washington State
  very satisfied fairly satisfied not too
  satisfied or not at all satisfied
• Poll of 600 Washington residents/May 05
• (due to rounding numbers may not add to 100)

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Making Great Care Better

• Washington hospitals are working to make great
  care even better through
• New science and technology
• Numerous patient safety and quality initiatives
• Empowering and educating patients

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Washington Hospitals Work on Quality
Collaboratively

• Washington hospitals are sharing information and
  resources to improve care
• High quality care across the state is our shared
  goal

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Quality and SafetyWashington Hospitals
Strategies
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100K Lives Campaign

• A national voluntary campaign aimed at saving
  lives through improving patient safety
• All Washington hospitals are participating a
  tremendous commitment
• Helps hospitals adopt new medical
  practices/procedures proven to save lives and
  improve care
• Already showing measurable results

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Washington 100K Lives Campaign Has Many Partners

• Partnership of hospitals doctors nurses
  pharmacists and others
• Endorsed by professional groups and professional
  unions
• All working together to improve safety

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Campaign Recommends Six New Interventions

• Improve care for acute myocardial infarction
  (heart attack)
• Reduce adverse drug events
• Prevent surgical site infections
• Prevent infections from lines inserted into
  patient bloodstreams
• Prevent pneumonia for patients on ventilators
• Implement teams to provide rapid response to
  patients who appear to be deteriorating

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Example Prevention of Adverse Drug Events

• Hospitals are working to reconcile medications
  at
• Admission
• Transfers
• Discharge
• Ensures patients are given the right medication
  at the right time
• List of patient medications is important

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Example PreventingSurgical Site
Infections

• Giving patients the right antibiotics at the
  right time
• Appropriate hair removal (avoiding shaving)
• Glucose control

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Example Preventing Ventilator Associated
Pneumonia

• Elevate head of the bed to 30 degrees
• Treat conditions that could lead to pneumonia
• Provide suction of secretions
• Provide routine breaks from sedation
• Give daily assessment of patients ability to
  come off the ventilator

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Example Preventing Central-Line Bloodstream
Infections

• Half of ICU patients have central lines
• Hospitals are preventing central-line infection
  by
• Increasing hand hygiene
• Using gown mask gloves when inserting the
  central-line
• Using appropriate antisepsis solution
• Using appropriate types of tubing
• Using only when necessary and removing as soon
  as possible

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Example Rapid Response Teams

• Multi-disciplinary expert swat team
• Summoned when patient is failing before cardiac
  arrest
• Change in heart rate or blood pressure
• Change in respiration
• Change in conscious state
• When staff are worried
• More effective to help a patient before a crisis
• Potential to save the most lives

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Example Improving Care for Heart Attack Patients

• Aspirin at admission and discharge
• Beta-blocker at admission and discharge
• ACE-inhibitor or ARB at discharge
• Timely removal of heart blockage
• Smoking cessation counseling

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Hospital Quality Initiative

• Spearheaded by the Centers for Medicare and
  Medicaid Services (CMS)
• Launched April 1 2005
• Hospitals submit data to CMS
• Provides data on quality of care for all
  acute-care hospitals in Washington -
  www.hospitalcompare.hhs.gov

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Rural Healthcare Quality Network

• Statewide project to improve quality at critical
  access hospitals (hospitals with fewer than 25
  acute care beds)
• The Networks doctors promote nationally
  recognized treatment guidelines
• The Network also builds local skills to lead
  quality improvement initiatives in local
  facilities
• Currently the network is working to improve
  treatment for heart failure
• Also working to bring new technologies to rural
  hospitals such as tele-medicine and tele-pharmacy

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Safe Table Learning Collaboratives

• Led by the states hospital association
• Hospital staff come together to
• Share best practices
• Learn from each others medical errors
• Learn from each others near misses
• Sharing of information improves care for all

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First Safe Table Infection Control

• Hospital staff across the state are coming
  together to implement the best ways to reduce
  infections in hospitals
• National experts and best practices are being
  used
• Hospitals in Washington will become national
  leaders in preventing infections

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New Technology Can Improve Care

• Computerized physician orders
• Barcoding prescriptions
• Tele-medicine and tele-pharmacy
• Electronic medical records

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Patient Safety and Quality Initiatives Work

• Hospitals are reporting progress on the 100K
  Lives Campaign
• New interventions and medical findings make
  better care possible

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The Right Thing to Do . . . And It Saves Money

• The right care at the right time means patients
• Stay healthier
• Need less care
• Are discharged earlier
• Are re-admitted less frequently
• This impacts health care costs and reduces health
  care spending

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Partners in Quality

• Washington State Department of Health
• Washington State Medical Association
• Professional Nursing Organizations
• Qualis Health
• Joint Commission for the Accreditation of
  Health Care Organizations (JCAHO)
• And many other partners . . .

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The Role of the Patient

• Patients play a critical role
• Hospitals are committed to empowering and
  educating patients
• Hospitals and doctors in Washington have produced
  a patient safety brochure so patients can play an
  active role in safe care
• The brochure is available at hospitals and
  physician offices

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Patient Safety Brochures(English and Spanish)
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Overview Poster
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Hand Washing Poster
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Medication Poster
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Walking / Fall Prevention Poster
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The Commitment of Hospitals

• Patient safety is a top priority for Washington
  hospitals
• We are committed to continuously improving the
  quality of care in our hospitals
• We want patients to be our partners in safety
  and quality