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Infection Control in Home Care: Developing an Infection Control Program to
Effectively Help Chronically Ill Individuals Avoid
Unplanned Hospitalizations
Thursday, June 18, 2015
Margherita Labson, RN, MSHSA, CPHQ
Executive Director, Home Care Program
Ed Smith, RN, MSN
Associate Director, Standards Interpretation
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Joint Commission Program
Learning Objectives
Construct an appropriate organization-wide
infection control program
Determine methods to engage patients/clients
in effective ways of preventing infections
Examine ways to credibly evaluate the results
of an infection control plan
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This webinar is approved for 1.0 Continuing
Education Credit from:
Accreditation Council for Continuing Medical
Education (ACCME)
American Nurses Credentialing Center
(ANCC)
American College of Healthcare Executives
(ACHE)
Continuing Education Credit
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CE/CME/CEU credit is available for the live audio only.
Credits will not be available for webinar replays.
In order to claim credit you must have: Individually registered for the webinar through The Joint
Commission website.
Listened to the webinar in its entirety. Only those listening live on
the day of the call will be eligible to receive credit. Only Joint
Commission accredited organizations will be eligible for the
continuing education credit.
Completed a post-program evaluation/attestation. A link to the
post-program evaluation/attestation will be sent to your
registered email 24-48 hours after the webinar. After completion
of the survey, you will receive a certificate available to download.
Obtaining Continuing Education
Credit
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The following staff and speakers have disclosed that
neither they nor spouses/partners have any financial
arrangements or affiliations with corporate organizations
that either provide educational grants to this program or
may be referenced in this activity:
Margherita Labson, RN, MSHSA, CPHQ, Executive Director,
Home Care Accreditation Program, The Joint Commission
Edward Smith, RN, MSN, Associate Director, Standards
Interpretation, The Joint Commission
Disclosure Statement
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Stakeholder Involvement
Leadership: Accountability and Commitment– Endorse resource allocation
– Leverage the value of the program
Champion: Empower and Enable– Knowledgeable expert
– Results oriented
Cross-divisional representation– Facilitator: provides roadmap for action
– Representatives from all affected operational areas
– Work is considered an essential component of
operational readiness
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Community Assessment
– Geographic risks
External Assessment: Resources
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External Assessment: Resources
Geographic risks
Seasonal considerations
Local partners
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Internal Assessment: Resources
Capitalizing on your data
Vulnerabilities – Population served
– Services provided
– Referral sources
Risks posed by staff– Behavior economics
– Contracts
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Prioritizing Risk
External Environment
Patient/Client Chronically Ill
Population
Internal Environment
Patients/Client At risk
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Real World Example
Home Medical Equipment Organizational Centric View
Assumption Chronic Illness-External info
– Driven from intake information
– Informed by health care industry
Defined Attributes-Population
– Demographics
– Population characteristics
– External environment
Contractual Requirements-Internal info
– Payer base: HMO, PPO, FFS, Commercial
– Service delivery frequency and methodology
Operational Resources-Internal info
– Demographics of Staff
– Staffing capability
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Analyzing Priorities
Risks Identified
Respiratory related illness
– Seasonal influenza
– Cold virus
– Pneumonia
– Norovirus
Wound infection
– Staph infection
– Entercoccal infection
– MRSA
Implications for the plan
Influenza prevention program
– Vaccination program
– Educational efforts
– Measure and manage
Respiratory Care Program
– Staff education: PPE, time off
– Recognize, respond and replace
– Work with payers to promote
healthy behaviors
Control bacterial contamination
– Add norovirus policy
– Cleaning/disinfecting equipment
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Useful Tools Securing Leadership Buy In:
Opportunities and Threats
Opportunities Threats
↓rate of admission >5% =
premium rates
Improved resource utilization
and savings
Improved operational efficiency
Longer length of stay for
patients
Compelling data to attract new
customers
Improved patient satisfaction
and loyalty
Readmission for pneumonia >2%
=threatens contract
Patient satisfaction ↓ with repeat
admissions
Uncompensated supply
utilizations
Staff at higher risk for acquired
infection
↑ overtime if staff become ill
More difficult contract renewal
discussions
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Approver: one who can authorize and move the
boulders, sponsor or business leader whose approval
is required
Resource: an expert with skills/information needed
for a fixed period of time
Member: full-time team members who know the
work to be done
Interested Party: those who have a need to know
about the project
Right Representation: ARMI Analysis
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Designing a Plan
Professional standards and recommendations
Creating smart goals
Data driven management
Practical examples
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Managing Chronic Disease:
–COPD
–Diabetes
–Rheumatoid Arthritis
–Neuromuscular disorders
–Dementia spectrum
–Heart Disease
A Key Component of the Triple Aim
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Generational Differences:– Matures
– Boomers
– Gen Xers
– Millennials
Behavioral Economics– Purchasing power, high deductibles and co-pays
– Predictive analytics
Factors Influencing Engagement– Health care consumer as a partner
– Redefining the role of health care provider
Attributes of Health Care Consumers
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Patient/Client Centered Care
Right Tool for the Right Job
Relational vs Transactional
Working with provider partners and
payers
Methods of Engagement
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Consumer awareness linking out of pocket
savings to infection prevention activities
Programs w/Payers to incent patients
towards infection prevention
Leadership and staff accountability for
infection prevention
Physician-provider affiliated programs
Practical Applications
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Evaluating Program Results
Evaluating against the goal
Reporting and trending
Getting to the root cause of the issues
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Summary
Buy in is greater if plan is relevant
Patient partnership
Credible evaluation sustains
improvement
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Home Care Team ContactsJoint Commission Home Care Program
Help Desk: 630-792-5070 or [email protected]
www.jointcommission.org/accreditation/home_care.aspx