Chapter CallMay 18th, 2010

Objective: Meet other Chapter Leaders, share ideas, and learn updates from the Open School team

Agenda• Introductions/Review WebEx (5 min)

• University of California - San Francisco (20 min)

• Northeast Hospitals (10 min)

• IHI: Developing Countries (5 min)

• Other Chapter Updates? (5 min)

• IHI Open School Team Updates (5 min)

• Discussion (10 min)

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Agenda• Introductions/Review WebEx (5 min)

• University of California - San Francisco (20 min)

• Northeast Hospital Corporation (10 min)

• IHI: Developing Countries (5 min)

• Other Chapter Updates? (5 min)

• IHI Open School Team Updates (5 min)

• Discussion (10 min)

IHI Open School at UCSF

Chapter Leader Call

May 18, 2010

Outline

• Chapter History and Leadership

• Accomplishments 2009-10

• Seminar Series

─Goals

─Methods

─Results and Conclusions

─Challenges

• Chapter Leadership and Goals 2010-11

Chapter History

• UCSF

─Medical, pharmacy,

nursing, dentistry,

physical therapy, and

graduate schools

• IHI Open School

─ Introduced to UCSF in

September 2008 by

Christine Lui and Jane

Hirsch, RN, MS

Chapter Leadership 2009-10

Student Leaders

• Manisha Bahl, MPH

4th Year Medical Student

• Cynthia Nguyen

2nd Year Pharmacy Student

• Shin Hye Park, RN

Doctoral Student

Chapter Leadership 2009-10

Faculty Advisors

• Mary Blegen, RN, PhD (Nursing)

• Niraj Sehgal, MD, MPH (Medicine)

• Arpana Vidyarthi, MD (Medicine)

• Eleanor Vogt, RPh, PhD (Pharmacy)

Accomplishments 2009-10

• Established campus presence of IHI Open

School at UCSF

• Created IHI listserv with 200+ students

• Organized eight interprofessional seminars

• Conducted evaluations of each event

• Participated in Surgical Safety webcast

• Developed collaboration with UCSF

Interprofessional Education Task Force

Seminar Series: Goals

• To develop and evaluate a series of

interprofessional seminars for health

professional students at UCSF

─To generate awareness of and advance

competencies in quality improvement (QI) and

patient safety (PS)

─To promote interprofessional collaboration

Seminar Series: Methods

• Recruited SF Bay Area leaders in QI and PS

• Secured funding from UCSF

• Advertised via:

─ IHI Open School at UCSF listserv

─School listservs/calendars

─Flyers

─Campus-wide calendar

─Facebook and Twitter

─ In-class announcements

Seminar Series: Schedule

Date Event Speakers

October 1 Viewing/Discussion

of “Beyond Blame”

Jane Hirsch, RN, MS, Arpana Vidyarthi, MD,

Eleanor Vogt, RPh, PhD (UCSF)

November 10 Lecture/Q&A Brigid Ide, RN, MS (UCSF)

December 3 Lecture/Case Study Theresa Manley, RN, BSN, MBA (California

Patient Safety Action Coalition)

January 14 Viewing/Discussion

of “Do No Harm”

Jane Hirsch, RN, MS, Arpana Vidyarthi, MD

(UCSF)

February 9 Lecture/Q&A Robert Wachter, MD (UCSF)

March 10 Case Studies/Q&A Kim Pardini-Kiely, RN, MS (Stanford)

April 9 Lecture/Q&A Cathy Camenga, RN, MS (Sutter)

May 4 Lecture/Case

Studies

Susan Barbour, RN, MS, Maureen Buick, RN,

MS, Carla Graf, RN, MS (UCSF)

Seminar Series: Results

• Attendance and Interest in Events

• Overall Value of Events

• Interprofessional vs. Multiprofessional Events

• Differences in Attitude Change among

Medical, Nursing, and Pharmacy Students

Seminar Series: ResultsAttendance and Interest in Events

• Events attended by

300+ students

• Surveys completed by

176 students

• Reasons for attendance:

─General interest

─Positive experience at

previous events

─Recommendation by

faculty and classmates

Pharmacy45%

Nursing 30%

Medicine 20%

Dentistry and PT

5%

First-year 61%

Second-year 26%

Other13%

Note: All differences are

statistically significant (p < 0.05)

.

1 2 3 4 5 6 7 8 9

Other health professions have unique knowledge and skills.

I understand the roles of other health professions on an interprofessional team.

I am confident in my understanding of the role of my profession on an interprofessional team.

I welcome the opportunity to share lectures, tutorials, or workshops with other health

professional students.

Learning with other students will make me a more effective member of a health care team.

Learning how to improve quality of care, patient safety, and teamwork is an appropriate use of

time in clinical training.

Student Level of Agreement

Sta

tem

en

t

Pre

Post

Seminar Series: ResultsOverall Value of Events

1 3 5 7 9

I am confident in my understanding of the role of my

profession on an interprofessional team.

The information I learned today and/or the skills I acquired today will likely have an impact on my

future practice.

This event provided me with new or different perspectives on

quality improvement and patient safety.

Student Level of Agreement

Sta

tem

en

t

Multiprofessional

Interprofessional

Note: All differences are

statistically significant (p

< 0.05)

Seminar Series: ResultsInterprofessional vs. Multiprofessional Events

StatementPre Post Pre Post Pre Post

Learning how to improve quality of care, patient safety,

and teamwork is an appropriate use of time in clinical

training.

8.32 8.56 8.73 8.89 8.45 8.71

Learning with other students will make me a more

effective member of a health care team.

6.63 6.83 7.59 7.92 6.40 6.85

I am confident in my understanding of the role of my

profession on an interprofessional team.

8.16 8.06 8.32 8.78 8.30 8.31

Other health professions have unique knowledge and

skills.7.47 7.56 8.50 8.58 8.24 8.38

Medicine Nursing

Note: All red-highlighted differences are statistically significant (p < 0.05)

Pharmacy

Seminar Series: ResultsDifferences in Attitude Change

Seminar Series: Conclusions

• Overall students reported significant benefit

from the interprofessional series

• More pronounced attitude changes occurred:

─After interprofessional events compared to

multiprofessional events, suggesting that

student interaction is most effective

─Among pharmacy and nursing students

compared to medical students, suggesting

that more innovative approaches might be

required

Seminar Series: Challenges

• Upperclassmen involvement

• Dentistry and physical therapy student

involvement

• Diverse audience

• Material redundancy

Chapter Leadership 2010-11

Student Leaders

• Leader: Cynthia Nguyen (Pharmacy)

• Co-Leaders: Breanne Cisneros (Nursing), Eric

LaMotte (Medicine), Marlene Morcos

(Pharmacy), Bruce Ryon (Nursing)

Chapter Goals 2010-11

• Recruit core group of enthusiastic members

• Develop elective in quality and safety

• Become resource for students interested in

pursuing projects in quality and safety

• Develop collaborations with:

─UCSF Interprofessional Task Force

─ IHI Open School at UC-Berkeley

IHI Open School at UCSF

Questions?

Contact:

Manisha Bahl: mbahl4@gmail.com

Cynthia Nguyen: cynthia.nguyen@ucsf.edu

Shin Hye Park: shin.park@ucsf.edu

Arpana Vidyarthi: arpana@medicine.ucsf.edu

Join our Facebook group “IHI Open School at UCSF”

Become a follower of “UCSFIHIOpenSchool” on Twitter

Agenda• Introductions/Review WebEx (5 min)

• University of California - San Francisco (20 min)

• Northeast Hospital Corporation (10 min)

• IHI: Developing Countries (5 min)

• Other Chapter Updates? (5 min)

• IHI Open School Team Updates (5 min)

• Discussion (10 min)

IHI Open School

Northeast Hospitals Chapter

Summary of Activity

2009-2010

Our Chapter

• Endicott College

• NorthShore Community College

• Salem State College

• Northeast Health Systems

Student Ideas for Improvement in

Nursing Education

• Brainstorming Sessions

• Medication Administration identified as an

area of concern

• Believe that practicing this skill leads to

confidence which leads to safer practice.

Our Chapter Project

• Determine both student and faculty

perceptions of medication administration

─Surveys developed on survey monkey

─Good response rate for student surveys –

now in analysis

─Poor response rate from faculty – will resend

in the fall.

Other Project Identified

(But not started)

• Students are in a unique position to

assess many different medication

administration policies and systems

through clinical rotations.

• Students create the “Best” medication

administration policy and system by taking

the best from each of their experiences.

─“Best” needs to be defined. Possibly the

safest, easiest, fastest, and most reliable

system.

Open School Activity applied to a

Nursing Research Class• “Hear Our Stories” Campaign

• Elizabeth Bradbury presented to a Nursing Research Class.

• Students collected patient experience stories to be shared on the IHI website.

• Reinforced qualitative data collection techniques.

• Next spring, students in this course will evaluate these stories for quality improvement themes

─ reinforcing qualitative data analysis

Agenda

• Introductions/Review WebEx (5 min)

• University of California - San Francisco (20

min)

• Northeast Hospital Corporation (10 min)

• IHI: Developing Countries (5 min)

• Other Chapter Updates? (5 min)

• IHI Open School Team Updates (5 min)

• Discussion (10 min)

Introduction to the Developing

Countries Portfolio

March 18th 2010Lauren Hayden

Project Coordinator

Program Areas

Ghana

South Africa

Malawi

Content Focus

• Ghana – Under 5 Mortality

• South Africa – HIV care – PMTCT and

HAART initiations

• Malawi – Maternal Mortality

Ghana – Under 5 Mortality

The Need:• Nearly 40% of under-five deaths occur during the

neonatal period with 50% of those occurring in the first

day of life and 75% in the first week.

Ghana – Under 5 Mortality

The Aim:

• To accelerate the achievement of MDG 4

in Ghana

─a 66% reduction in mortality in children under

five from an estimated 110 to less than 40 per

1,000 live births by 2015

Ghana – Under 5 Mortality

• Participants:─ Funded by the Bill & Melinda Gates Foundation

Project Fives Alive!Is a partnership of…

National Catholic Health Secretariat of Ghana

Ghanaian Health Service

Institute for Healthcare Improvement

Ghana – Under 5 Mortality

• The Project:

─QI methodology to find process failures that

cause death in labor and delivery, the

postnatal period, and children up to age 5.

─National Spread by 2012

Start-up:

months

1 – 8

Total Pop’n:Under 5 Pop’n:

Nov 2007

Wave 1:

months

9 – 22

350,00060,000

Jul 2008

Wave 2:

months

23 – 44

5 million500,000

Sept 2009

Wave 4:

months

45 – 60

22 million3.3 million

Wave 3:

months

24 – 60

11 million1.7 million

Oct 2009

Ghana – Under 5 Mortality

Results:

• Skilled delivery coverage for women in the Wave

1 catchment area improved by 11%

• Postnatal care within two days of birth increased

from 10% to 60%, while follow up on day 6 or 7

increased from 0% to 30%

South Africa – HIV care

The Need:

• The health system struggles to provide

safe, reliable, effective care

• Every year 30,000 babies are born with

HIV and 250,000 people with HIV do not

begin life-saving treatment

South Africa – HIV care

The Aim:• Eliminate the gap between those who need HIV

treatment and those who receive it by 2012

• Prevent 20,000 new HIV infections in newborns each

year by reducing the mother-to-child HIV transmission

rate to less than 5% by 2011

• Develop 1,000 “quality health facilities” by 2012, and

build capacity for QI support to these facilities within the

SADoH

South Africa – HIV care

Project:• KwaZulu- Natal: 20,000+ Partnership aims to reduce perinatal

transmission of HIV from 21% to 5% in three districts

• Gauteng: IHI and Reproductive Health & HIV Research Unit aims to

rapidly scale up HIV care and treatment services in Johannesburg and

Ekurhuleni District to meet national goals

• National Accelerated Plan: IHI led a coalition of NGO partners in

collaboration with the DoH to reduce perinatal HIV transmission

country-wide to less than 5% within 6 months

• National Quality Programme: IHI provides strategic planning and advice

to senior DoH officials to develop and execute a NQP focused on health

system transformation

Malawi – Maternal Mortality

The Need:• 807 maternal deaths per 100,000 live births

• 31 neonatal deaths per 1,000 live births

• One of the highest rates of maternal death in the world

Malawi – Maternal Mortality

Aim: Reduce maternal and neonatal

mortality by 30% by 2012 in three districts

Participants: •Sponsored by The Health Foundation

•MaiKhanda is a local NGO

Working in partnership with…

• IHI

• Women and Children First

• Cincinnati Children’s Hospital

• University College London- Institute for Child

Health

Malawi – Maternal Mortality

Project:

• Three-district Intervention

• Combines QI approach in health facilities and community

mobilization through women’s groups

• Goal is to improve access to maternal and neonatal care

• “Three Delays” Model

─ Delay in deciding to seek care

─ Delay in reaching the health facility

─ Delay in receiving timely and effective care upon arrival at a

facility

Malawi – Maternal Mortality

• Results:

─Sustained improvement in neonatal case

fatality rate in 10 facilities from an average of

29 neonatal deaths per 1,000 live births in

2006 to 22 in 2009

─45% reduction in maternal case fatality rate in

10 facilities from a median of 345 maternal

deaths per 100,000 live births in Jan06-Nov08

to 195 in Dec08-Dec09

Agenda• Introductions/Review WebEx (5 min)

• University of California - San Francisco (20 min)

• Northeast Hospital Corporation (10 min)

• IHI: Developing Countries (5 min)

• Other Chapter Updates? (5 min)

• IHI Open School Team Updates (5 min)

• Discussion (10 min)

Agenda• Introductions/Review WebEx (5 min)

• University of California - San Francisco (20 min)

• Northeast Hospital Corporation (10 min)

• IHI: Developing Countries (5 min)

• Other Chapter Updates? (5 min)

• IHI Open School Team Updates (5 min)

• Discussion (10 min)

Upcoming: Summer 2010 Courses• Patient Safety 104: Root Cause and Systems Analysis By

Samuel Huber, MD, and Greg Ogrinc, MD, MS

• Patient Safety 105: Communicating with Patients After Adverse

Events By Frank Federico, RPh, and Allan Frankel, MD

• Patient Safety 106: Introduction to the Culture of Safety By

Michael Leonard, MD, and Allan Frankel, MD

• Patient- and Family-Centered Care 101: Dignity and Respect –

based on a curriculum by Children’s Hospital of Philadelphia

• Managing Health Care Operations 101: How to Achieve

Breakthrough Quality, Access, and Affordability – by Steven

Spear, DBA, MS, and Tom Downes, MBBS, MRCP, MBA

Chapter Network

232 Chapters

Upcoming Events• May 19-June 30 IHI Network Team WHO Surgical Safety

Checklist Call Series

• Jun 17-18 Student Quality Leadership Academy (Cambridge, MA)

• Aug 30-31 Mayo Clinic Teaching QI and Patient Safety in Medical Education Workshop (Rochester, MN)

• Dec 6-9 2010 National Forum and IHI Open School Chapter Congress (Orlando, FL)

August 10

Agenda• Introductions/Review WebEx (5 min)

• University of California - San Francisco (20 min)

• Northeast Hospital Corporation (10 min)

• IHI: Developing Countries (5 min)

• Other Chapter Updates? (5 min)

• IHI Open School Team Updates (5 min)

• Discussion (10 min)

Thank you for joining the Chapter Call!

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Thank you to our May call host Chapter:

University of California - San Francisco

• University of California - San Francisco •Manisha Bahl, Manisha.Bahl@ucsf.edu

• Northeast Hospitals•Nancy Meedzan, nmeedzan@endicott.edu

• IHI: Developing Countries •Lauren Hayden, lhayden@ihi.org

• Is there something you’d like to share? • Email smills@ihi.org