ICU Safe Care Initiative/CUSP October 5, 2009 9:00 am – 3:30 pm.

ICU Safe Care Initiative/CUSPICU Safe Care Initiative/CUSP

October 5, 2009October 5, 20099:00 am – 3:30 pm9:00 am – 3:30 pm

ICU Safe Care Initiative/CUSPICU Safe Care Initiative/CUSP

• Pat Noga

• Richard de Filippi

• Paula Griswold

• John Combes

Objectives for the DayObjectives for the Day• Review the purpose and vision of the ICU Safe Care Initiative/Comprehensive

Unit-Based Safety Program (CUSP). Understand how your ICU and your hospital will benefit from participation.

• Build the skills of physicians, nurses, and other care team members in identifying and eliminating system defects that can result in patient harm, and in improving teamwork and building a safety culture.

• Engage in discussion with national experts on research and best practices in reducing infections, preventing central line infections, and going beyond the bundle.  Discuss how to apply in your hospital including the impact of reducing central line infections on costs and patient days.

• Discuss steps and timeline in implementation of the initiative.

Using Collaboratives to Reduce Using Collaboratives to Reduce Central Line-Associated Bloodstream Central Line-Associated Bloodstream

Infections (CLABSI):Infections (CLABSI): A National Implementation ProgramA National Implementation Program

Peter Pronovost, MD

John R. Combes, MD

National ContextNational Contextand Leadershipand Leadership

HHS Steering Committee for the HHS Steering Committee for the Prevention of HAIPrevention of HAI

• Charge: Develop an Action Plan to reduce, prevent, and ultimately eliminate HAIs

• Plan will:– Establish national goals for reducing HAIs– Include short- and long-term benchmarks– Outline opportunities for collaboration with

external stakeholders– Coordinate and leverage HHS resources to

accelerate and maximize impact

AHA’s Hospitals in Pursuit of AHA’s Hospitals in Pursuit of ExcellenceExcellence

• Reduce Surgical Infections and Complications

• Reduce Central Line-associated Blood Stream Infections (CLABSI)

• Reduce methicillin-resistant Staphylococcus aureus (MRSA)

• Reduce clostridium difficile infections (c diff)

• Reduce ventilator-associated pneumonia (VAP)

• Reduce catheter-associated urinary tract infections

• Reduce adverse drug events from high-hazard medications (e.g., anticoagulants, narcotics, opiates, insulin, sedatives)

• Reduce pressure ulcers

State ConsortiaState Consortia

8

State Consortia MembersState Consortia Members

• State hospital associations

• State patient safety coalitions• Quality improvement organizations (QIOs)

• State health departments

• May include others:– Payers – Patient Safety Organizations– Government officials– Business

State Consortia & SustainabilityState Consortia & Sustainability

• State consortia key to sustainability:– Train-the-trainer education to build capacity

for future patient safety innovations, e.g., On the CUSP: Decubiti

– Evaluation component to identify lessons, including critical success factors and barriers

HAI Elimination CollaborationHAI Elimination CollaborationPolicy Leadership

AHRQ CDC CMS AHA

Field LeadershipJHU Keystone HRET NW

Implementation Leadership

State Hospital Associations Patient Safety Coalitions

Department of HealthQuality Improvement Organizations

Keys to National ImprovementKeys to National Improvement

• National Commitment

• Strong Collaboration– Federal Agencies– Provider Organizations– State Stakeholders

• Local Consortia Sustainability– Unit Based Culturally Driven Improvements

Workshop ObjectivesWorkshop Objectives

• Describe the purpose and vision of the ICU Safe Care Initiative/Comprehensive Unit-Based Safety Program.

• Describe the process used to identify and eliminate system defects.

 • List three tools or strategies used to improve teamwork and build a safety

culture.

 • State research and best practices in reducing infections, preventing

central line infections, and going beyond the bundle.