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TMIT WEBINAR 8/16/2012
1
1© 2012 TMIT
Welcome to
News in Continuing Educationand Professional Development
From Knowledge to Competency
Hosted by TMIT
For resource downloads go to:
www.safetyleaders.org
2© 2012 TMIT
Charles Denham, MD
Chairman, TMITEditor-in-Chief, Journal of Patient Safety
Adjunct Professor, Health Services EngineeringMayo College of Medicine
Chairman, Global Patient Safety ForumChairman, Leapfrog Safe Practices Sub-program
TMIT High Performer WebinarAugust 16, 2012
Welcome
3© 2012 TMIT
With regard to webinar soundvolume, please check the WebExvolume (see example above in redbox), computer volume, and anyexternal speaker volume.
If you are still having difficultyhearing the webinar, please click on“Request Phone” button to receivea toll dial-in number (see exampleon right-hand side in red box).
6© 2012 TMIT
If you wish to follow us on Twitter,go to: http://twitter.com/TMIT1or use #safetyleaders hashtag
Also, go to:www.facebook.com/SafetyLeaders
and related sites
TMIT WEBINAR 8/16/2012
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7© 2012 TMIT
TMIT Mission
Accelerate performance solutions thatsave lives, save money, and build valuein the communities we serve andventures we undertake.
8© 2012 TMIT
The following panelists certify:
that unless otherwise noted below, each presenter provided full disclosure information, does notintend to discuss an unapproved/investigative use of a commercial product/device, and has nosignificant financial relationship(s) to disclose. If unapproved uses of products are discussed,presenters are expected to disclose this to participants.
Regina Holliday: Has no relevant financial interests in this presentationJann T. Balmer: Employed by University of Virginia School of MedicineJennifer Dingman: Has no relevant financial interests in this presentation
Charles Denham: Chairman, TMIT; TMIT education grantee of CareFusion and AORN with co-production byDiscovery Channel for Chasing Zero documentary and Toolbox including models, education grantee of GEwith co-production by Discovery Channel for Surfing the Healthcare Tsunami documentary and Toolboxincluding models. HCC is a contractor or former contractor for GE, CareFusion, and Siemens.Chasing Zero® is a registered trademark of CareFusion
Disclosure Statement
9© 2012 TMIT
TMIT certifies that:
• No funder or educational grantor had any influence or anydirect contact with researchers, analysts, or hospital leaderscontracted with TMIT involved in generation of models,impact calculators, or consensus panels.
• Confidentiality of collaborators, patient data, and populationdata has been and will be strictly maintained.
Disclosure Statement
10© 2012 TMIT
Voice of the Patient and Family
Jennifer Dingman
Founder, Persons United Limiting Substandardsand Errors in Healthcare (PULSE), Colorado Division
Co-founder, PULSE American DivisionTMIT Patient Advocate Team Member
TMIT High Performer WebinarAugust 16, 2012
11© 2012 TMIT
Panelists
Charles Denham Regina HollidayJann Balmer Jennifer Dingman
12© 2012 TMIT
Charles Denham, MD
Chairman, TMITEditor-in-Chief, Journal of Patient Safety
Adjunct Professor, Health Services EngineeringMayo College of Medicine
Chairman, Global Patient Safety ForumChairman, Leapfrog Safe Practices Sub-program
TMIT High Performer WebinarAugust 16, 2012
Safe Practice Overview& Critical Test Results: Do You Have a Rory Staunton Story?
TMIT WEBINAR 8/16/2012
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1313© 2012 TMIT
Information Transferand Clear Communication
Medication Management
Healthcare-AssociatedInfections
Condition- &Site-Specific Practices
Consent & Disclosure
Culture
Workforce
Consent and Disclosure
2010 NQF Report
© 2006 HCC, Inc. CD000000-0000XX 14© 2012 TMIT
Culture
1515© 2012 TMIT
Direct Patient Input: A structureand system should be establishedto obtain direct feedbackfrom patients about theperformance of the organization.Patient satisfaction surveysare not enough.
16© 2012 TMIT
S.U.C.C.E.S. and Switch
SimpleUnexpectedConcreteCredibleEmotionalStories
1717© 2012 TMIT
Quaid D, Thao J, Denham CR. Story power: The secret weapon. J Patient Saf 2010 Mar;6(1):5-14.
1818© 2012 TMIT
TMIT WEBINAR 8/16/2012
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1919© 2012 TMIT 2020© 2012 TMIT
Captain Sullenberger: Learning from Aviation
21© 2006 HCC, Inc. CD000000-0000XX 22© 2012 TMIT 22
At the Leadership-Practices-Technology Intersection
Leadership
PracticesTechnology
The High Performance Envelope
2323© 2012 TMIT 24© 2012 TMIT
TRUTH HEAD
TRUST HEART
TEAMWORK HANDS
TRAININGVOICE
TMIT WEBINAR 8/16/2012
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25© 2012 TMIT
Jann Torrance Balmer, RN, PhD
Director, Continuing Medical EducationUniversity of Virginia School of Medicine
TMIT High Performer WebinarAugust 16, 2012
High Performance Continuing Educationand Professional Development
LINKING CONTINUING
PROFESSIONAL DEVELOPMENT TO
PATIENT SAFE PERFORMANCE
Jann T. Balmer RN PHD
Director, Continuing Medical Education
University of Virginia School of Medicine
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CHANGES TO HEALTH CARE
EXPECTATIONS
Institute of Medicine Reports – 1999-2010
Highlight the fragmentation of healthcaredelivery that compromises patient outcomes andincreases cost
Inadequate coordination of care that incorporatesa patient-centric focus in care
Proliferation of systems that support thehealthcare system that may not be directlyrelated to improved patient outcomes
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CORE ELEMENTS IN CONTINUING
PROFESSIONAL DEVELOPMENT
Profession-specific continuing educationand learning – (CME/CNE/CPE ) providesessential knowledge and skills specific to theindividual professional about theirresponsibilities
Interprofessional education – two or moreprofessions learn with, from, and about eachother to improve collaborative practice and thequality of care (CAIPE 2002)
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LINKING PROFESSIONAL DEVELOPMENT TO
PATIENT SAFE PERFORMANCE
Educational context needs to be consistent withpractice settings
Requires multiple strategies that incorporateprofession-specific CE with interprofessionaleducation that is patient-centric/systems-based
Profession-specific CE should address requiredperformance elements/competencies for eachprofession
Interprofessional CE – clarifies roles andresponsibilities of each team member,communication and overall team work
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ASSESSMENT OF CURRENT AND POTENTIAL
FOR BEST ACHIEVABLE PERFORMANCE
Assess systems processes and issues that affectpatient outcomes
Assess individual profession knowledge, skills,and abilities for competence
Determine patient-centric needs, requirementsconsistent with current standards of care
Identify team members essential to optimumpatient outcomes
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TMIT WEBINAR 8/16/2012
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PROFESSIONAL ENGAGED IN OVERSIGHT
OF HEALTHCARE DELIVERY
Profession-specific CE is monitored by thenational licensing boards and professionalorganizations
Systems based care monitored by JointCommission, CMS, and other healthcareregulatory agencies
Quality Improvement Initiatives – focus onmonitoring/tracking organizational performance(AHRQ, IHI, NQF)
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THE IDEALIZED DESIGN FOR COMPREHENSIVE
CPD AND PATIENT SAFE CARE
Create an overall education plan that identifieseducational programming specific to the patientsafety goals for the institution
Educational initiatives/programs need to betailored to the practice environments, strengths,and needs of the organization/setting
Seek alternatives that leverage existingresources and build on mission and desiredoutcomes for the organization
Provide support to healthcare professionals andteams
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BEST ACHIEVABLE PERFORMANCE
ALL HOSPITALS
Outline priorities for education and patientsafety performance expectations
Determine which educational programs areinstitution-specific and need to be addressedwithin the hospital/organization
Outline external resources for profession-specificCE that can be accessed by healthcareprofessionals
Create a master plan for educationalprogramming – interprofessional education
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BEST ACHIEVABLE PERFORMANCE
HOSPITALS
Perform analysis about currentpractices/approaches that meet desirable patientoutcomes
Identify gaps in performance
Outline strengths in knowledge, skills, andperformance that can be leveraged intoimprovement plans for gap areas
Design or license educational programming thatsupports the mission/objectives of optimumperformance
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BEST ACHIEVABLE PERFORMANCE
HOSPITALS
Review existing education/performanceimprovements – and revise
Ensure that all healthcare professionals aremembers involved in the design andimplementation of the CPD program
Create case-based forums that focus on patientsafe care and organizational priorities
Example: Morbidity and Mortality conferences –historically physician only – make team-based
Example: Best practice conference – highlightteam-based performance that meets/exceedsperformance
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BEST ACHIEVABLE PERFORMANCE
HOSPITALS – EXAMPLES
Example 1: Morbidity and Mortality conferences– historically physician only – make team-based
Example 2: Best practice conference – highlightteam-based performance that meets/exceedspatient safe performances
Determine which criteria and elements arespecific to Best Achievable Performance withinyour hospital
Create consistent analysis measures forassessment and review of cases
36
TMIT WEBINAR 8/16/2012
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BEST ACHIEVABLE PERFORMANCE
CAREFUL CONSIDERATIONS
Size and services provided by the hospital
The needs and priorities of critical accesshospitals are going to be very different than fortertiary care hospitals
Determine the healthcare professional engagedin the delivery of care – team members
The numbers and characteristics of thehealthcare team members will change based onthe services provided by the hospital
37
SUMMARY – LINKING CPD AND
BEST ACHIEVABLE PERFORMANCE
Create an education plan that meets the specificneeds of your hospital/institution
Link the education and patient safety approachesinto a comprehensive plan to enhance individualand team performance
Make optimum patient care the core value for allefforts
Give all healthcare professionals a voice in theprocess
Scale the effort to your mission and goals forpatient safe care.
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39© 2012 TMIT
Panelists
Charles Denham Regina HollidayJann Balmer Jennifer Dingman
40© 2012 TMIT
Regina Holliday
Patient Rights Arts Advocate
TMIT High Performer WebinarAugust 16, 2012
Partnership with Patients SummitOverview
Partnership with Patients
A presentation before CMS/Partnership for Patients, June 13, 2012, by Regina Holliday
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Two Measurable Goals
Keep patients from getting injured or sicker.
By the end of 2013, preventable hospital-acquiredconditions would decrease by 40% compared to2010.
Help patients return home without complication.
By the end of 2013, preventable complications during atransition from one care setting to another would bedecreased so that all hospital readmissions would bereduced by 20% compared to 2010.
42
TMIT WEBINAR 8/16/2012
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CMS Innovation Center is investing up to $1 billion for two Partnership for Patients initiatives:
Hospital Engagement Networks (HENs)Organizations awarded funding by CMS tocollaborate with hospitals to find solutions toimprove patient safety and quality
1.HAC (Hospital-Acquired Condition) 2.HAI(Hospital-Acquired Infection) 3.OB adverse events 4.Reduce Readmissions
43
CCPT Community-based Care Transitions Program
To aid in care transitions from inpatient hospitalto other care settings, improve quality, and reducereadmissions.
44
What can patients do to reduce healthcare harm?
45
Patient, Family, & Community-Driven Care
Chronic Care Model
CommunityResources &PoliciesSelf-management Support
Health SystemHealthcare Organization
Delivery System DesignDecision Support
Clinical Information Systems
InformedActivated
Patient
Prepared,Proactive
Practice Team
FamilyCaregiverSelf
Pop cultureFriends
NeighborsCivic organizations
Religious institutionsSocial media
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PENs Patient Engagement Networks
A PEN is really good at writing about injustice and then telling the whole world.
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Street ArtinHealthcare?
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TMIT WEBINAR 8/16/2012
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~Patient Safety Posters as Art
~Funded Art Competitions to designeye-catching posters to address
~Artists donate designs for the cause
Set of 10 of these18x24 $99.00
Joint Commission
Free to downloadJoint Commission
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1-800-Number for Healthcare Harm
This 1-800 vender is contracted withMore than 800 facilities for reports of violationsfrom patients or providers
Pro-Publica Patient Harm on FacebookMore than 700 members are members of this onlinegroup, reporting instances of harm nationwide.
When Twitter AttacksWhen we have no recourse we will complain online
QR Code Guerilla Action
Could placement of a QR direct patients to help?
If we want to address harm we must be able to report it…
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A name tag defines us51
What if we had a resource that depicted the reality of care visually?
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Patient Education
Who taught you how to be a patient?
Look at children as they play
They play “school.”They play “house.”They play “store.”
And they play “doctor”?
How can we own our patientexperience if we are not included?
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Include the Patient Voice
We must encourage every committee,sub-committee, and hospital boardto actively recruit and include patientsin every aspect of the care process fromdesign to implementation to resolution.
SpeakerLink.org
From the exam room to the board room.
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TMIT WEBINAR 8/16/2012
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Welcome to the Walking Gallery.
Telling the patient story one jacket at a time.
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Technology and Design should be the wind at your back, not your face.
Social Media ~ HIT ~ UX design ~ Meaningful Use ~ Venders ~ Programmers ~ Patient Portals
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Patients are really goodat connecting the silos of care.
To make this goal we must all worktogether hand in hand.
It is a partnership for all.
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To register/sponsor and get hotel/other info, go to:https://partnershipwithpatients.eventbrite.com/?nomo=1
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This conference is two-fold in its mission. We will be working on strategies for grass-rootssupport of the Partnership for Patients campaign. We will also help enable patients byproviding a place to network, learn, and grow as patient advocates that focus on healthpolicy. You can read more about this on our website.
59© 2012 TMIT
Voice of the Patient and Family
Jennifer Dingman
Founder, Persons United Limiting Substandardsand Errors in Healthcare (PULSE), Colorado Division
Co-founder, PULSE American DivisionTMIT Patient Advocate Team Member
TMIT High Performer WebinarAugust 16, 2012