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Compass HIIN Work Plan Preparation Template page 1
PfP Compass HIIN Reporting Database Work Plan Template
Primary HIIN Contact:
Email:
Quality Lead:
Email:
Infection Preventionist:
Email:
1) Prior to scheduled admission, hospital staff provides and discusses a planning checklist that is
similar to CMS’ Discharge Planning Checklist with every patient, allowing time for questions and
comments from patient and family. ☐ YES ☐ NO
2) Hospital conducts shift change huddles and does bedside reporting with patients and family
members in all feasible cases. ☐ YES ☐ NO
3) Hospital has a dedicated person or functional area that is proactively responsible for patient and
family engagement and systematically evaluates patient and family engagement activities.
☐ YES ☐ NO
4) Hospital has an active Patient and Family Engagement Committee or at least one former patient
that serves on a patient safety or quality improvement committee or team. ☐ YES ☐ NO
5) Hospital has at least one or more patient(s) who serve on a governing or leadership board and
serves as a patient representative. ☐ YES ☐ NO
1) Hospital has regular quality review aligned with Partnership for Patients. ☐ YES ☐ NO
2) Hospital has a public commitment to safety improvement with transparency in sharing more
than CORE hospital measurement data with the public. ☐ YES ☐ NO
3) Hospital staff, all or nearly all, have a role or perceived goal in patient safety (e.g., can be explicit
in HR goals or a group bonus based on patient safety target). ☐ YES ☐ NO
4) Hospital board of trustees has a quality committee established; with regular review of patient
safety data, including review and analysis of risk events. ☐ YES ☐ NO
Hospital Information
Facility Name:
HIIN Survey Questions
Patient and Family Engagement
Leadership Criteria
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Compass HIIN Work Plan Preparation Template page 2
Primary HIIN Contact: Name
Champion (Responsibility Party): Name
Bedside Best Practice Leader: Name
Plan to improve this focus area?
Timeline for improvement:
☐ STAAR Model
☐ Post-hospital follow-up care
☐ Real-time handover communications
☐ Implementation of community care transitions program
☐ Post discharge phone calls and follow up communication strategies
☐ Implementation of Person and family engagement (PFE) strategies
☐ Bedside huddles
☐ Implementation of discharge planning checklist
☐ Hourly rounding
☐ Enhanced assessment of discharge needs, including readmission risk assessment (LACE tool)
☐ Integration of health literacy concepts, such as Teach Back
☐ Other:
☐ PDSA (Plan, Do, Study, Act)
☐ Lean
☐ TeachBack
☐ TeamSTEPPS
☐ Other:
Readmissions
Actions/Best Practice Bundle to be Implemented: (check all that apply)
Performance Improvement Methods to be Utilized: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 3
☐ On-site technical assistance
☐ Content expert faculty
☐ Leadership
☐ Physician Engagement
☐ Data
☐ Other:
☐ QIN/QIO
☐ State Department
☐ Transforming Clinical Practice Initiative (TCPI)
☐ State Innovation Model (SIM)
☐ Community-based Care Transitions Program (CCTP)
☐ Previously worked with HIIN
☐ Other:
Does your facility have a policy for Readmissions? ☐ YES ☐ NO
Currently Working With: (check all that apply)
Opportunities for Assistance from IHC HIIN: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 4
Primary HIIN Contact: Name
Champion (Responsibility Party): Name
Bedside Best Practice Leader: Name
Plan to improve this focus area?
Timeline for improvement:
☐ Prompt removal of unnecessary urinary catheters
☐ Nurse driven protocol
☐ Use CAUTI bundle
☐ Daily review of necessity
☐ ED implementation of CAUTI bundle
☐ Ensure aseptic insertion and maintenance techniques
☐ Conduct periodic nursing competencies
☐ Use of closed systems
☐ NHSN Surveillance and monitoring
☐ Integration of PFE in CAUTI prevention activities/education
☐ Other:
☐ PDSA (Plan, Do, Study, Act)
☐ Lean
☐ TeachBack
☐ TeamSTEPPS
☐ Other:
Catheter-associated Urinary Tract Infections (CAUTI)
Actions/Best Practice Bundle to be Implemented: (check all that apply)
Performance Improvement Methods to be Utilized: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 5
☐ On-site technical assistance
☐ Content expert faculty
☐ Leadership
☐ Physician Engagement
☐ Data
☐ Other:
☐ QIN/QIO
☐ State Department
☐ Transforming Clinical Practice Initiative (TCPI)
☐ State Innovation Model (SIM)
☐ Community-based Care Transitions Program (CCTP)
☐ Previously worked with HIIN
☐ Other:
Does your facility have a policy for foley catheter insertion and maintenance? ☐ YES ☐ NO
Does your facility have a procedure for foley catheter insertion? ☐ YES ☐ NO
Currently Working With: (check all that apply)
Opportunities for Assistance from IHC HIIN: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 6
☐ This section does not apply to my facility.
Primary HIIN Contact: Name
Champion (Responsibility Party): Name
Bedside Best Practice Leader: Name
Plan to improve this focus area?
Timeline for improvement:
☐ Use of insertion and maintenance bundle
☐ Use of insertion checklist
☐ NHSN surveillance and monitoring
☐ Daily review of necessity
☐ Use of chlorhexidine for dressing changes and daily skin cleaning
☐ Scrub the Hub
☐ CUSP
☐ CLIP
☐ Integration of PFE in CLABSI prevention activities/education
☐ Other:
☐ PDSA (Plan, Do, Study, Act)
☐ Lean
☐ TeachBack
☐ TeamSTEPPS
☐ Other:
Central Line-associated Bloodstream Infections (CLABSI)
Actions/Best Practice Bundle to be Implemented: (check all that apply)
Performance Improvement Methods to be Utilized: (check all that apply)
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☐ On-site technical assistance
☐ Content expert faculty
☐ Leadership
☐ Physician Engagement
☐ Data
☐ Other:
☐ QIN/QIO
☐ State Department
☐ Transforming Clinical Practice Initiative (TCPI)
☐ State Innovation Model (SIM)
☐ Community-based Care Transitions Program (CCTP)
☐ Previously worked with HIIN
☐ Other:
Does your facility have a policy for central line insertion and maintenance? ☐ YES ☐ NO
Does your facility have a procedure for central line insertion? ☐ YES ☐ NO
Currently Working With: (check all that apply)
Opportunities for Assistance from IHC HIIN: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 8
☐ This section does not apply to my facility.
Primary HIIN Contact: Name
Champion (Responsibility Party): Name
Bedside Best Practice Leader: Name
Plan to improve this focus area?
Timeline for improvement:
☐ NHSN Surveillance and monitoring
☐ Project Joints
☐ Surgical safety checklist
☐ CHG shower and prep
☐ Implementation of standardized guidelines to ensure use of basic aseptic techniques
☐ Temperature regulation for all surgical procedures
☐ Blood glucose control in all surgical patients
☐ Standardized antibiotic administration order sets for each surgical procedures
☐ Adherence to catheter removal protocol – removal within 24-48 hours postop
☐ Integration of PFE in SSI prevention activities/education
☐ Other:
☐ PDSA (Plan, Do, Study, Act)
☐ Lean
☐ TeachBack
☐ TeamSTEPPS
☐ Other:
Surgical Site Infections (SSI)
Actions/Best Practice Bundle to be Implemented: (check all that apply)
Performance Improvement Methods to be Utilized: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 9
☐ On-site technical assistance
☐ Content expert faculty
☐ Leadership
☐ Physician Engagement
☐ Data
☐ Other :
☐ QIN/QIO
☐ State Department
☐ Transforming Clinical Practice Initiative (TCPI)
☐ State Innovation Model (SIM)
☐ Community-based Care Transitions Program (CCTP)
☐ Previously worked with HIIN
☐ Other: Does your facility have a policy for infection prevention in the operating room (OR)?
☐ YES ☐ NO
Does your facility have any procedures related to infection prevention in the OR?
☐ YES ☐ NO
Currently Working With: (check all that apply)
Opportunities for Assistance from IHC HIIN: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 10
☐ This section does not apply to my facility
Primary HIIN Contact: Name
Champion (Responsibility Party): Name
Bedside Best Practice Leader: Name
Plan to improve this focus area?
Timeline for improvement:
☐ Implementation of ventilator bundle
☐ NHSN surveillance and monitoring
☐ Integration of PFE in VAE prevention activities/education
☐ Implementation of CUSP 4 MVP strategies
☐ Elevate head of bed
☐ Spontaneous awakening trials
☐ Spontaneous breathing trials
☐ Oral care every 2 hours with chlorhexidine
☐ Daily early and progressive mobility
☐ Use of delirium assessments
☐ Use of low tidal volume ventilation
☐ Enhanced nurse to nurse and interdisciplinary communication
☐ Other:
☐ PDSA (Plan, Do, Study, Act)
☐ Lean
☐ TeachBack
☐ TeamSTEPPS
☐ Other:
Actions/Best Practice Bundle to be Implemented: (check all that apply)
Performance Improvement Methods to be Utilized: (check all that apply)
Ventilator-asscoiated Event (VAE)
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☐ On-site technical assistance
☐ Content expert faculty
☐ Leadership
☐ Physician Engagement
☐ Data
☐ Other:
☐ QIN/QIO
☐ State Department
☐ Transforming Clinical Practice Initiative (TCPI)
☐ State Innovation Model (SIM)
☐ Community-based Care Transitions Program (CCTP)
☐ Previously worked with HIIN
☐ Other:
Does your facility have a policy for the prevention of VAE? ☐ YES ☐ NO
Does your facility have a procedure for mechanical ventilation? ☐ YES ☐ NO
Currently Working With: (check all that apply)
Opportunities for Assistance from IHC HIIN: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 12
Primary HIIN Contact: Name
Champion (Responsibility Party): Name
Bedside Best Practice Leader: Name
Plan to improve this focus area?
Timeline for improvement:
☐ Medication reconciliation
☐ EMR integration – use of alerts and hard stops, such as INR hard stop
☐ Implementation of a post discharge med reconciliation program
☐ Include pharmacist as part of quality team
☐ Basal bolus insulin protocol
☐ Development and implementation of anticoagulation protocol
☐ Completion of ISMP self-assessment
☐ NCC-MERP error classification system
☐ Implementation of ADE trigger system or surveillance system
☐ Physician and pharmacy education and engagement
☐ Implementation of Opioid Overdose prevention toolkit
☐ Use of surveillance systems to monitor opioid use/abuse
☐ Development of opioid prescribing protocols/guidelines
☐ Integration of PFE in ADE prevention activities and education
☐ Other:
☐ PDSA (Plan, Do, Study, Act)
☐ Lean
☐ TeachBack
☐ TeamSTEPPS
☐ Other:
Adverse Drug Events (ADE)
Actions/Best Practice Bundle to be Implemented: (check all that apply)
Performance Improvement Methods to be Utilized: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 13
☐ On-site technical assistance
☐ Content expert faculty
☐ Leadership
☐ Physician Engagement
☐ Data
☐ Other:
☐ QIN/QIO
☐ State Department
☐ Transforming Clinical Practice Initiative (TCPI)
☐ State Innovation Model (SIM)
☐ Community-based Care Transitions Program (CCTP)
☐ Previously worked with HIIN
☐ Other:
Does your facility have a policy for ADE? ☐ YES ☐ NO
Does your facility have a procedure for ADE? ☐ YES ☐ NO
Does your facility have an anticoagulation policy that addresses INR >5? ☐ YES ☐ NO
Currently Working With: (check all that apply)
Opportunities for Assistance from IHC HIIN: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 14
Primary HIIN Contact: Name
Champion (Responsibility Party): Name
Bedside Best Practice Leader: Name
Plan to improve this focus area?
Timeline for improvement:
☐ Risk assessment on admission and upon change in status
☐ Patient and family education and engagement
☐ Standardized interventions for fall risk
☐ Customized interventions for high risk patients
☐ Use of multidisciplinary team to design and implement facility wide fall prevention program.
☐ Post fall huddles as well as root cause analysis of all falls
☐ Integration of PFE in fall prevention activities
☐ Other:
☐ PDSA (Plan, Do, Study, Act)
☐ Lean
☐ TeachBack
☐ TeamSTEPPS
☐ Other:
☐ On-site technical assistance
☐ Content expert faculty
Falls & Immobility
Actions/Best Practice Bundle to be Implemented: (check all that apply)
Performance Improvement Methods to be Utilized: (check all that apply)
Opportunities for Assistance from IHC HIIN: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 15
☐ Leadership
☐ Physician Engagement
☐ Data
☐ Other:
☐ QIN/QIO
☐ State Department
☐ Transforming Clinical Practice Initiative (TCPI)
☐ State Innovation Model (SIM)
☐ Community-based Care Transitions Program (CCTP)
☐ Previously worked with HIIN
☐ Other:
Does your facility have a policy for Falls and Immobility? ☐ YES ☐ NO
Does your facility have a procedure for Falls and Immobility? ☐ YES ☐ NO
Currently Working With: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 16
Primary HIIN Contact: Name
Champion (Responsibility Party): Name
Bedside Best Practice Leader: Name
Plan to improve this focus area?
Timeline for improvement:
☐ Admission risk assessment for all patients
☐ Reassessment of risk for all patients daily and upon change in status
☐ Pressure ulcer prevention bundle for high risk patients
☐ Daily skin inspections
☐ Management of moisture
☐ Optimize nutrition and hydration
☐ Minimize pressure
☐ Integration of PFE in pressure ulcer prevention activities/education
☐ Other:
☐ PDSA (Plan, Do, Study, Act)
☐ Lean
☐ TeachBack
☐ TeamSTEPPS
☐ Other:
☐ On-site technical assistance
☐ Content expert faculty
☐ Leadership
Pressure Ulcers
Actions/Best Practice Bundle to be Implemented: (check all that apply)
Performance Improvement Methods to be Utilized: (check all that apply)
Opportunities for Assistance from IHC HIIN: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 17
☐ Physician Engagement
☐ Data
☐ Other:
☐ QIN/QIO
☐ State Department
☐ Transforming Clinical Practice Initiative (TCPI)
☐ State Innovation Model (SIM)
☐ Community-based Care Transitions Program (CCTP)
☐ Previously worked with HIIN
☐ Other:
Does your facility have a policy for Pressure Ulcers? ☐ YES ☐ NO
Does your facility have a procedure for Pressure Ulcers? ☐ YES ☐ NO
Currently Working With: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 18
Primary HIIN Contact: Name
Champion (Responsibility Party): Name
Bedside Best Practice Leader: Name
Plan to improve this focus area?
Timeline for improvement:
☐ Admission risk assessment for all patients
☐ Provide appropriate VTE prophylaxis based on standardized national guidelines
☐ Provide discharge instructions for all patients at risk for VTE
☐ Integration of PFE in VTE prevention activities/education
☐ Physician and pharmacy education and engagement
☐ Other:
☐ PDSA (Plan, Do, Study, Act)
☐ Lean
☐ TeachBack
☐ TeamSTEPPS
☐ Other:
☐ On-site technical assistance
☐ Content expert faculty
☐ Leadership
☐ Physician Engagement
Venous Thromboembolism (VTE)
Actions/Best Practice Bundle to be Implemented: (check all that apply)
Performance Improvement Methods to be Utilized: (check all that apply)
Opportunities for Assistance from IHC HIIN: (check all that apply)
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☐ Data
☐ Other:
☐ QIN/QIO
☐ State Department
☐ Transforming Clinical Practice Initiative (TCPI)
☐ State Innovation Model (SIM)
☐ Community-based Care Transitions Program (CCTP)
☐ Previously worked with HIIN
☐ Other:
Does your facility have a policy for the prevention of VTE? ☐ YES ☐ NO
Does your facility have a procedure for VTE prevention? ☐ YES ☐ NO
Currently Working With: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 20
Primary HIIN Contact: Name
Champion (Responsibility Party): Name
Bedside Best Practice Leader: Name
Plan to improve this focus area?
Timeline for improvement:
☐ Hand hygiene compliance program and monitoring
☐ Implementation of C. diff reduction bundle
☐ Enhanced surveillance and monitoring, within the hospital setting as well as the surrounding community
☐ Education and implementation of appropriate environmental cleaning techniques
☐ Implementation of ED and OR cleaning procedures
☐ Development and implementation of Antimicrobial stewardship program
☐ Integration of PFE in CDI prevention activities/education
☐ Other:
☐ PDSA (Plan, Do, Study, Act)
☐ Lean
☐ TeachBack
☐ TeamSTEPPS
☐ Other:
☐ On-site technical assistance
Clostridium Difficile (C. Diff)
Actions/Best Practice Bundle to be Implemented: (check all that apply)
Performance Improvement Methods to be Utilized: (check all that apply)
Opportunities for Assistance from IHC HIIN: (check all that apply)
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☐ Content expert faculty
☐ Leadership
☐ Physician Engagement
☐ Data
☐ Other:
☐ QIN/QIO
☐ State Department
☐ Transforming Clinical Practice Initiative (TCPI)
☐ State Innovation Model (SIM)
☐ Community-based Care Transitions Program (CCTP)
☐ Previously worked with HIIN
☐ Other:
Does your facility have a policy for C. diff prevention? ☐ YES ☐ NO
Does your facility have a procedure for C. diff prevention? ☐ YES ☐ NO
Currently Working With: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 22
Primary HIIN Contact: Name
Champion (Responsibility Party): Name
Bedside Best Practice Leader: Name
Plan to improve this focus area?
Timeline for improvement:
☐ Use of early detection sepsis screening tool in inpatient units as well as ED
☐ EMR integration – use of alerts
☐ Implementation of Surviving Sepsis campaign bundle
☐ Use of 3 and 6-hour sepsis bundles
☐ Development of standardized order sets for care
☐ Utilize modified early warning score (MEWS) system with existing sepsis bundle to facilitate identification of sepsis
☐ Other:
☐ PDSA (Plan, Do, Study, Act)
☐ Lean
☐ TeachBack
☐ TeamSTEPPS
☐ Other:
☐ On-site technical assistance
☐ Content expert faculty
☐ Leadership
☐ Physician Engagement
Sepsis
Actions/Best Practice Bundle to be Implemented: (check all that apply)
Performance Improvement Methods to be Utilized: (check all that apply)
Opportunities for Assistance from IHC HIIN: (check all that apply)
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☐ Data
☐ Other:
☐ QIN/QIO
☐ State Department
☐ Transforming Clinical Practice Initiative (TCPI)
☐ State Innovation Model (SIM)
☐ Community-based Care Transitions Program (CCTP)
☐ Previously worked with HIIN
☐ Other:
Does your facility have a policy for Sepsis recognition and treatment? ☐ YES ☐ NO
Does your facility have a procedure for Sepsis treatment/management? ☐ YES ☐ NO
Currently Working With: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 24
☐ This section does not apply to my facility.
Primary HIIN Contact: Name
Champion (Responsibility Party): Name
Bedside Best Practice Leader: Name
Plan to improve this focus area?
Timeline for improvement:
☐ Hand hygiene compliance program and monitoring
☐ Enhanced surveillance and monitoring of resistant organisms
☐ Education and implementation of appropriate environmental cleaning techniques
☐ Adherence to isolation precautions
☐ Utilization of decolonization strategies, where appropriate, to eradicate carriage of organism
☐ Implementation of ED and OR cleaning procedures
☐ Development and implementation of Antimicrobial stewardship program
☐ Integration of PFE in MDRO prevention activities/education
☐ Other:
☐ PDSA (Plan, Do, Study, Act)
☐ Lean
☐ TeachBack
☐ TeamSTEPPS
☐ Other:
☐ On-site technical assistance
Actions/Best Practice Bundle to be Implemented: (check all that apply)
Performance Improvement Methods to be Utilized: (check all that apply)
Opportunities for Assistance from IHC HIIN: (check all that apply)
Multi Drug Resistant Organism (MDRO)
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Compass HIIN Work Plan Preparation Template page 25
☐ Content expert faculty
☐ Leadership
☐ Physician Engagement
☐ Data
☐ Other:
☐ QIN/QIO
☐ State Department
☐ Transforming Clinical Practice Initiative (TCPI)
☐ State Innovation Model (SIM)
☐ Community-based Care Transitions Program (CCTP)
☐ Previously worked with HIIN
☐ Other:
Does your hospital have an antimicrobial stewardship program in place? ☐ YES ☐ NO
Currently Working With: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 26
☐ This section does not apply to my facility.
Primary HIIN Contact: Name
Champion (Responsibility Party): Name
Bedside Best Practice Leader: Name
Plan to improve this focus area?
Timeline for improvement:
☐ Implementation of exposure control plan designed to eliminate or minimize worker exposure blood borne pathogens
☐ Use of devices with safety features engineered to prevent sharps injuries
☐ Implementation of sharps injury prevention plan
☐ Implementation of timely post exposure management plan
☐ WSHA Safe Patient handling
☐ Use of safe patient handling checklist on all direct patient care units
☐ Employee education regarding ergonomics and back safety
☐ Other:
☐ PDSA (Plan, Do, Study, Act)
☐ Lean
☐ TeachBack
☐ TeamSTEPPS
☐ Other:
☐ On-site technical assistance
Worker Safety
Actions/Best Practice Bundle to be Implemented: (check all that apply)
Performance Improvement Methods to be Utilized: (check all that apply)
Opportunities for Assistance from IHC HIIN: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 27
☐ Content expert faculty
☐ Leadership
☐ Physician Engagement
☐ Data
☐ Other:
☐ QIN/QIO
☐ State Department
☐ Transforming Clinical Practice Initiative (TCPI)
☐ State Innovation Model (SIM)
☐ Community-based Care Transitions Program (CCTP)
☐ Previously worked with HIIN
☐ Other:
Does your facility have a policy for safe patient handling? ☐ YES ☐ NO
Does your facility have a sharps injury prevention plan? ☐ YES ☐ NO
Currently Working With: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 28
☐ This section does not apply to my facility.
Primary HIIN Contact: Name
Champion (Responsibility Party): Name
Bedside Best Practice Leader: Name
Plan to improve this focus area?
Timeline for improvement:
☐ Promote safe use of medical imaging devices
☐ Promotion of Choosing Wisely campaign tools
☐ Implementation of hospital wide imaging protocols
☐ Standardized dosing policies establishing use of lowest effective dose
☐ Implementation of strategies for monitoring and tracking radiologic dose exposure
☐ Integration of PFE strategies in reducing radiation exposure
☐ Other:
☐ PDSA (Plan, Do, Study, Act)
☐ Lean
☐ TeachBack
☐ TeamSTEPPS
☐ Other:
☐ On-site technical assistance
☐ Content expert faculty
Undue Exposure to Radiation
Actions/Best Practice Bundle to be Implemented: (check all that apply)
Performance Improvement Methods to be Utilized: (check all that apply)
Opportunities for Assistance from IHC HIIN: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 29
☐ Leadership
☐ Physician Engagement
☐ Data
☐ Other:
☐ QIN/QIO
☐ State Department
☐ Transforming Clinical Practice Initiative (TCPI)
☐ State Innovation Model (SIM)
☐ Community-based Care Transitions Program (CCTP)
☐ Previously worked with HIIN
☐ Other:
Does your facility have a policy for collecting data on the total amount of radiation delivered to
a patient during a CT scan? ☐ YES ☐ NO
Does your facility have a procedure for collecting total amount of radiation delivered during CT
scans? ☐ YES ☐ NO
Currently Working With: (check all that apply)
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Compass HIIN Work Plan Preparation Template page 30
☐ This section does not apply to my facility.
Primary HIIN Contact: Name
Champion (Responsibility Party): Name
Bedside Best Practice Leader: Name
Plan to improve this focus area?
Timeline for improvement:
☐ Hard-stop policy for non-medically indicated deliveries (induction and C-section)
☐ Induction/C-section scheduling process
☐ Physician leadership of hard-stop policy and scheduling process
☐ Protocols for the diagnosis and management of obstetric hemorrhage
☐ RRT for obstetric emergencies
☐ Implementation of MEWS (Maternal Early Warning Signs)
☐ Guidelines and/or protocols for early recognition and response to preeclampsia
☐ Perform drills/simulations for obstetric emergencies
☐ Other:
☐ PDSA (Plan, Do, Study, Act)
☐ Lean
☐ TeachBack
☐ TeamSTEPPS
☐ Other:
Actions/Best Practice Bundle to be Implemented: (check all that apply)
Performance Improvement Methods to be Utilized: (check all that apply)
Obstetrical Adverse Events
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☐ On-site technical assistance
☐ Content expert faculty
☐ Leadership
☐ Physician Engagement
☐ Data
☐ Other:
☐ QIN/QIO
☐ State Department
☐ Transforming Clinical Practice Initiative (TCPI)
☐ State Innovation Model (SIM)
☐ Community-based Care Transitions Program (CCTP)
☐ Previously worked with HIIN
☐ Other:
Currently Working With: (check all that apply)
Opportunities for Assistance from IHC HIIN: (check all that apply)