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2010 OPSI Best Practice Award Thank you to the 29 hospitals and health care organizations who submitted best practices for OPSI's second annual Best Practice Award. OPSI's Best Practice Award honors successful patient safety activities used in Ohio health care institutions. Criteria for judging includes:
In honor of Patient Safety Week, OPSI will highlight a 2010 Best Practice Award finalist each day this week. The winner will be announced Friday, March 12. Finalists Wednesday, March 10 - St. Elizabeth Health Center
Description: Improvement of Patient Safety in the ICU The Society of Critical Care Medicine maintains that improving ICU care can be accomplished by the use of standardized practice guidelines, parameters and protocols. Studies suggest that a culture of safety flourishes in an environment in which clinicians and front line staff feel included in the team and exchange goal-directed patient information in a meaning and respectful way. In 2008 our facility implemented a Leapfrog Initiative in the ICU with the goal to improve patient safety and outcomes. The rationale included to decrease length of stay (LOS), decrease ventilator days, decrease ventilator-associated pneumonia (VAP), decrease blood stream infections (BSI, decrease mortality, increase Palliative Care Consults and ultimately decrease costs.
Our ICU 2008 average LOS was 7.09, average ventilator days was 5.68, the incidence of VAP was 5 cases, the incidence of BSI’s was 8, the mortality rate was 31% and the incidence of Palliative Care Consults was 240. Costs included 1 day LOS = $29,175, 1 day on ventilator = $1,360, a VAP average = $40,000 and a BSI = $7,000 - $30,000. Disciplines involved include: Medical Executive Committee, VP of Medical Affairs/Chief Medical Officer, Intensivists, Senior VP of Nursing and Clinical Services, Director of Nursing Services and other health care professionals. The initiative is ongoing.
Implementation: Our VP of Medical Affairs/Chief Medical Officer established a contract with an Intensivist Team to develop an ICU collaborative model which was designed using the Leapfrog Guidelines with an implementation date of May 31, 2008. An intensivist oversees management of patients within the IC. An onsite intensivist and ICU Nurse Coordinator lead interdisciplinary collaborative daily rounds. Participants include the Nurse Coordinator, patients’ bedside nurse, Advanced Practice Nurse, Respiratory therapist, Clinical Pharmacist, Supportive Care Nurse, Nurse Case Manager, Medical Resident, patient and family members. Expert nurses provide crucial patent information to the team and contribute vital nursing perspectives top ensure optimal patient outcomes and an individualized plan of care. A revised “Daily Goals Worksheet” adopted from Johns Hopkins Hospital incorporates evidence-based quality parameters used to facilitate timely changes in practice. This initiative evolved into an ICU culture, focused on team decision making processes and the development and implementation of evidence-based guidelines, parameters, protocols, policies and procedures. Supporting this new culture was the development of a highly effective interdisciplinary ICU committee.
Results/Sustainability: The ICU Committee (Chair and Co-Chaired by an Intensivist and Advanced Practice Nurse) monthly reviews and analyzes data. Results and outcomes include: decreased average LOS to 3.53, decreased average ventilator days to 4.58, decreased VAP’s to 2 cases, decreased BSI’s to 2, decreased mortality rate to 24%, increased Palliative Care Consults to 420 and ultimately decreased costs. These results have continued to improve since inception of our Leapfrog Initiative.
Tuesday, March 9 - Euclid Hospital - Active Culture Surveillance to Eliminate MRSA Colonization
Monday, March 8 - Marietta Memorial Hospital - Catheter-Associated Urinary Tract Infection Reduction
2009 OPSI Best Practice Award Sen. Sherrod Brown (D) presented the first annual OPSI Best Practice Award at the OHA annual Meeting June 15 to The Children's Medical Center of Dayton for the Reduction of Ventilator-associated pneumonia in the children's population. Read more about the 2009 winner and the runner-ups.
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