Transcript Washington Hospitals

Patient Safety and Quality in
Washington Hospitals
Washington Hospitals:
Basic Facts
Washington Hospitals
• 98 hospitals in Washington State
Hospitals:
The Ultimate Safety Net
• Hospitals are there when you need
them, providing excellent care every
day and at any hour
• Hospitals don’t turn emergencies
away – everyone gets treated
regardless of ability to pay
• In 2004, Washington
hospitals provided
over $180 million in
charity care
Your Hospitals at Work
• 580,000 admissions
in 2003
• 9 million outpatient
visits in 2003
• One-fourth of all
inpatients are
maternity and
newborns
• Cardiac care
• Orthopedics
• General surgery
Hospitals Provide Jobs
• Hospitals are one of the largest
employers in the state
• Washington hospitals employ 74,000
people
• 65,000 full-time equivalent positions
• Average
compensation is
$64,000 (salary +
benefits)
Hospitals’ Economic Impact
• Hospitals are major contributors to
Washington’s economy
– Purchasing goods and services locally
– Paying taxes (state, local, sales, B&O)
– For every dollar spent by
hospitals about $2.40 in
business activity is created
– totaling $17.5 billion
Hospitals Provide Excellent Care
100%
83%
80%
60%
41%
43%
40%
8%
20%
3%
0%
Very
satisfied
Fairly
satisfied
TOTAL
very/fairly
satisfied
Not too
satisfied
Not at all
satisfied
“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%)
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
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
Quality and Safety:
Washington Hospitals’ Strategies
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
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
Campaign Recommends
Six New Interventions
1. Improve care for acute myocardial
infarction (heart attack)
2. Reduce adverse drug events
3. Prevent surgical site infections
4. Prevent infections from lines inserted
into patient bloodstreams
5. Prevent pneumonia for patients on
ventilators
6. Implement teams to provide rapid
response to patients who appear to
be deteriorating
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
Example: Preventing
Surgical Site Infections
• Giving patients the right antibiotics at
the right time
• Appropriate hair removal (avoiding
shaving)
• Glucose control
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
patient’s ability to
come off the ventilator
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
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
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
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
Rural Healthcare Quality Network
• Statewide project to improve quality at
“critical access hospitals” (hospitals with
fewer than 25 acute care beds)
• The Network’s 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
Safe Table Learning
Collaboratives
• Led by the state’s hospital association
• Hospital staff come together to:
– Share best practices
– Learn from each other’s
medical errors
– Learn from each other’s
near misses
• Sharing of information improves care
for all
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
New Technology
Can Improve Care
• Computerized physician orders
• Barcoding prescriptions
• Tele-medicine and tele-pharmacy
• Electronic medical records
Patient Safety and Quality
Initiatives Work
• Hospitals are
reporting progress on
the “100K Lives
Campaign”
• New interventions
and medical findings
make better care
possible
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
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 . . .
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
Patient Safety Brochures
(English and Spanish)
Overview Poster
Hand Washing Poster
Medication Poster
Walking / Fall Prevention Poster
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