Patient Safety and Quality in Washington Hospitals

Patient Safety and Quality in Washington Hospitals

Washington Hospitals:Washington Hospitals:Basic FactsBasic Facts

Washington Hospitals:Washington Hospitals:Basic FactsBasic Facts

Washington HospitalsWashington Hospitals

• 98 hospitals in Washington State

Hospitals: The Ultimate Safety Net

Hospitals: The Ultimate Safety Net

• Hospitals are there when you need them, providing excellent care every day and at any hour

• Hospitals don’t turn emergencies away – everyone gets treated regardless of ability to pay

• In 2004, Washington hospitals provided over $180 million in charity care

Your Hospitals at WorkYour Hospitals at Work

• 580,000 admissions in 2003

• 9 million outpatient visits in 2003

• One-fourth of all inpatients are maternity and newborns

• Cardiac care• Orthopedics• General surgery

Hospitals Provide JobsHospitals Provide Jobs

• Hospitals are one of the largest employers in the state

• Washington hospitals employ 74,000 people

• 65,000 full-time equivalent positions

• Average compensation is $64,000 (salary + benefits)

Hospitals’ Economic ImpactHospitals’ Economic Impact

• Hospitals are major contributors to Washington’s economy– Purchasing goods and services locally

– Paying taxes (state, local, sales, B&O)

– For every dollar spent by hospitals about $2.40 in business activity is created – totaling $17.5 billion

Hospitals Provide Excellent CareHospitals Provide Excellent Care

41% 43%

83%

8%3%

0%

20%

40%

60%

80%

100%

Verysatisfied

Fairlysatisfied

TOTALvery/fairlysatisfied

Not toosatisfied

Not at allsatisfied

“Based on what you know or have heard, how satisfied are you with the quality of health care available at most hospitals in

Washington State, very satisfied, fairly satisfied, not too satisfied, or not at all satisfied?”

Poll of 600 Washington residents/May ’05(due to rounding, numbers may not add to 100%)

Making Great Care BetterMaking Great Care Better

• Washington hospitals are working to make great care even better through:– New science and technology

– Numerous patient safety and quality initiatives

– Empowering and educating patients

Washington Hospitals Work on Quality Collaboratively

Washington Hospitals Work on Quality Collaboratively

• Washington hospitals are sharing

information and resources to improve care

• High quality care across the state is our shared goal

Quality and Safety:Quality and Safety:Washington Hospitals’ StrategiesWashington Hospitals’ Strategies

Quality and Safety:Quality and Safety:Washington Hospitals’ StrategiesWashington Hospitals’ Strategies

• A national, voluntary campaign aimed at saving lives through improving patient safety

• All Washington hospitals are participating – a tremendous commitment

• Helps hospitals adopt new medical practices/procedures proven to save lives and improve care

• Already showing measurable results

100K Lives Campaign100K Lives Campaign

Washington 100K Lives Campaign Has Many Partners

Washington 100K Lives Campaign Has Many Partners

• Partnership of hospitals, doctors, nurses, pharmacists, and others

• Endorsed by professional groups and professional unions

• All working together to improve safety

Campaign Recommends Six New Interventions

Campaign Recommends Six New Interventions

1. Improve care for acute myocardial infarction (heart attack)

2. Reduce adverse drug events3. Prevent surgical site infections4. Prevent infections from lines inserted

into patient bloodstreams5. Prevent pneumonia for patients on

ventilators6. Implement teams to provide rapid

response to patients who appear to be deteriorating

Example: Prevention of Adverse Drug Events

Example: Prevention of Adverse Drug Events

• Hospitals are working to reconcile medications at:– Admission

– Transfers

– Discharge

• Ensures patients are given the right medication at the right time

• List of patient medications is important

Example: PreventingSurgical Site Infections

Example: PreventingSurgical Site Infections

• Giving patients the right antibiotics at the right time

• Appropriate hair removal (avoiding shaving)

• Glucose control

Example: Preventing Ventilator Associated Pneumonia

Example: Preventing Ventilator Associated Pneumonia

• Elevate head of the bed to 30 degrees

• Treat conditions that could lead to pneumonia

• Provide suction of secretions

• Provide routine breaks from sedation

• Give daily assessment of patient’s ability to come off the ventilator

Example: Preventing Central-Line Bloodstream Infections

Example: Preventing Central-Line Bloodstream Infections

• Half of ICU patients have central lines• Hospitals are preventing central-line

infection by:– Increasing hand hygiene– Using gown, mask, gloves when inserting the

central-line – Using appropriate antisepsis

solution – Using appropriate types of

tubing – Using only when necessary

and removing as soon as possible

Example: Rapid Response TeamsExample: Rapid Response Teams

• Multi-disciplinary, expert “swat” team• Summoned when patient is failing

before cardiac arrest– Change in heart rate

or blood pressure– Change in respiration– Change in conscious

state– When staff are worried

• More effective to help a patient before a crisis

• Potential to save the most lives

Example: Improving Care for Heart Attack Patients

Example: Improving Care for Heart Attack Patients

• Aspirin at admission and discharge

• Beta-blocker at admission and discharge

• ACE-inhibitor or ARB at discharge

• Timely removal of heart blockage

• Smoking cessation counseling

Hospital Quality InitiativeHospital Quality Initiative

• Spearheaded by the Centers for Medicare and Medicaid Services (CMS)

• Launched April 1, 2005

• Hospitals submit data to CMS

• Provides data on quality of care for all acute-care hospitals in Washington - www.hospitalcompare.hhs.gov

Rural Healthcare Quality NetworkRural Healthcare Quality Network

• Statewide project to improve quality at “critical access hospitals” (hospitals with fewer than 25 acute care beds)

• The Network’s doctors promote nationally recognized treatment guidelines

• The Network also builds local skills to lead quality improvement initiatives in local facilities

• Currently, the network is working to improve treatment for heart failure

• Also working to bring new technologies to rural hospitals, such as tele-medicine and tele-pharmacy

Safe Table Learning Collaboratives

Safe Table Learning Collaboratives

• Led by the state’s hospital association

• Hospital staff come together to:– Share best practices

– Learn from each other’s medical errors

– Learn from each other’s near misses

• Sharing of information improves care for all

First Safe Table: Infection ControlFirst Safe Table: Infection Control

• Hospital staff across the state are coming together to implement the best ways to reduce infections in hospitals

• National experts and best practices are being used

• Hospitals in Washington will become national leaders in preventing infections

New Technology Can Improve CareNew Technology Can Improve Care

• Computerized physician orders

• Barcoding prescriptions

• Tele-medicine and tele-pharmacy

• Electronic medical records

Patient Safety and Quality Initiatives Work

Patient Safety and Quality Initiatives Work

• Hospitals are reporting progress on the “100K Lives Campaign”

• New interventions and medical findings make better care possible

The Right Thing to Do . . . And It Saves Money

The Right Thing to Do . . . And It Saves Money

• The right care at the right time means patients:– Stay healthier

– Need less care

– Are discharged earlier

– Are re-admitted less frequently

• This impacts health care costs and reduces health care spending

Partners in QualityPartners in Quality

• Washington State Department of Health

• Washington State Medical Association

• Professional Nursing Organizations

• Qualis Health

• Joint Commission for the Accreditation of Health Care Organizations (JCAHO)

• And many other partners . . .

The Role of the PatientThe Role of the Patient

• Patients play a critical role

• Hospitals are committed to empowering and educating patients

• Hospitals and doctors in Washington have produced a patient safety brochure so patients can play an active role in safe care

• The brochure is available at hospitals and physician offices

Patient Safety Brochures(English and Spanish)

Patient Safety Brochures(English and Spanish)

Overview PosterOverview Poster

Hand Washing PosterHand Washing Poster

Medication PosterMedication Poster

Walking / Fall Prevention PosterWalking / Fall Prevention Poster

The Commitment of HospitalsThe Commitment of Hospitals

• Patient safety is a top priority for Washington hospitals

• We are committed to continuously improving the quality of care in our hospitals

• We want patients to be our partners in safety and quality