Enhancing Patient Safety: DCH Mission and Strategies
DCH is committed to improving patient safety through compassionate, accountable, and respectful care. Their mission focuses on serving the community with excellence, while their ultimate goal is to achieve top performance in quality and safety measures. Initiatives include reducing adverse events, improving healthcare practices, and addressing healthcare disparities through strategic partnerships.
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DCH Mission, Vision and Values DCH Mission, Vision and Values Mission: We Serve to Improve the Health of Our Patients and Community Vision: To be the provider of choice in West Alabama by delivering excellent care Care Values We are Compassionate We are Accountable We are Respectful We are Engaged 2
DCH Patient Safety Ultimate Goal DCH Patient Safety Ultimate Goal Continuously improve and inspire healthcare excellence for all people by promoting a just culture and utilizing evidence-based tools and resources to implement the best standards of care, all in pursuit of Zero Patient Harm. Strategic Goal: To achieve top quartile performance in quality and patient safety measures
Our Patient Safety Focus Our Patient Safety Focus Care Focus Safe Care Avoiding injuries to patients Effective Care Providing evidence-based healthcare services to those who need them Patient-centered Care Providing care that responds to individual preferences, needs and values Timely Care Reducing waiting times Efficient Care Avoiding waste Equitable Care Providing care that does not vary in quality on account of gender, ethnicity, and socio- economic status 4
2024 Quality and Patient Safety Tactics 2024 Quality and Patient Safety Tactics Improve our CMS STAR Rating and Leapfrog Patient Safety Grade Reduce preventable adverse events including: mortality, readmissions, healthcare associated infections and patient complications Increase utilization of best practices such as increasing hand hygiene, retaining nurse staffing, increasing use of computerized physician order entry, and barcode medication administration Initiate efforts to reduce healthcare disparity by identifying populations at risk, engaging key community stakeholders and taking action. 5
DCH Partnerships for Pursuing Excellence DCH Partnerships for Pursuing Excellence DCH actively seeks best practices through our national and regional partnerships ECRI is a patient safety organization that provides a total systems approach to safety. Providing DCH benefits such as: Benchmarking for adverse event reporting Risk assessments Educational opportunities Collaborative meetings Access to industry experts Literature services/searches best practices Vizient SE Outcomes Benchmarking Regulatory Compliance Surveys Performance Improvement Collaboratives 6
Leapfrog Patient Safety Public Reporting Leapfrog Patient Safety Public Reporting Leapfrog Patient Safety Group displays hospital performance using four performance categories ranked from four to one filled bars. Achieved the Standard (Best-4 bars filled) Considerable Achievement (3 bars filled) Some Achievement (2 bars filled) Limited Achievement (Worst-1 bar filled) 7
Preventing Patient Harm Safe Practices (Leapfrog Preventing Patient Harm Safe Practices (Leapfrog Highlights) Highlights) LEADERSHIP AND CULTURE Effective Leadership to Prevent Errors Staff Work Together to Prevent Errors Handwashing RMC NMC ACHIEVED THE STANDARD ACHIEVED THE STANDARD ACHIEVED THE STANDARD ACHIEVED THE STANDARD ACHIEVED THE STANDARD ACHIEVED THE STANDARD 8
What is a patient safety culture? What is a patient safety culture? Patient Safety culture is the extent to which an organization s culture supports and promotes patient safety. It refers to the values, belief, and norms that are shared by practitioners and other staff throughout the organization that influence their actions and behaviors. Shared beliefs, values and norms determines behaviors that are rewarded, supported, expected and accepted. https://www.ahrq.gov/sops/about/patient-safety-culture.html 9
Leadership and Culture: Why measure Culture of Leadership and Culture: Why measure Culture of Safety? Safety? Helps leaders identify opportunities for improvement focused on staff departments and roles. Poor caregiver safety perceptions are frequently associated with adverse patient events. Enhancing positive cultural perceptions may prevent or reduce errors 10
DCH Culture of Safety Highlights DCH Culture of Safety Highlights Survey was completed by 64.2% of caregivers. With responses from 2,807 employees from 133 departments. DCH Overall % Positive Perceptions was at 68.7% just slightly under the national average of 70%. 11
DCH Culture of Safety Highlights DCH Culture of Safety Highlights The following components were identified as DCH strengths Supervisor, Manager, or Clinical Leader Support for Patient Safety Communication about Error Communication Openness Organizational Learning Two additional components showed significant improvement from prior years 12
Why is preventing infection important? Why is preventing infection important? Leapfrog reports that on any given day, about 1 in 31 hospital patients has at least one healthcare associated infection. Healthcare associated infections are preventable when evidence-based protocols are followed such as handwashing, appropriate personal protective supplies and appropriate antibiotic use 13
Hand Hygiene Hand Hygiene DCH Hand Hygiene Observers monitor at least 100 hand hygiene opportunities in patient care areas monthly using secret direct observations. Hand hygiene compliance results are shared with caregivers and leaders and used to generate performance improvement plans. Current results demonstrate improved compliance at 97%. 14
Healthcare Associated Infections (Leapfrog) Healthcare Associated Infections (Leapfrog) Healthcare Associated Infections Regional Medical Center Northport Medical Center C. difficile Infection CONSIDERABLE ACHIEVEMENT ACHIEVED THE STANDARD Infection of the Urinary Tract ACHIEVED THE STANDARD ACHIEVED THE STANDARD MRSA Infection SOME ACHIEVEMENT ACHIEVED THE STANDARD 15
Why are nursing workforce safe practices Why are nursing workforce safe practices important? important? Evidence has shown that the total nursing hours per patient day is correlated with lower rates of patient falls and pressure injuries and other patient outcomes. Nurses spend more minutes per day caring for the patient directly than other care givers. They monitor the patient for changes in their condition, administer medications and provide other patient treatments.
Preventing Patient Harm Safe Practices Nursing Preventing Patient Harm Safe Practices Nursing Workforce Workforce Nursing Workforce Nursing and Bedside Care for Patients (Total number of Nursing Hours per Patient Day) Nursing for Patients (Number of Nursing Hours per Patient Day) RMC ACHIEVED THE STANDARD NMC ACHIEVED THE STANDARD ACHIEVED THE STANDARD ACHIEVED THE STANDARD
Healthcare Associated Urinary Tract Infections Healthcare Associated Urinary Tract Infections (Hospital Compare) (Hospital Compare) DCH Performance National Rate National Compare 0.310 0.624 Better 18
Why are safe medication practices important? Why are safe medication practices important? More than one million serious medication errors occur every year in US Hospitals. Serious medication errors result in preventable harm. Computerized Prescriber Ordering Systems can stop errors at the time medications are ordered. Over 30% of medication errors are committed at the point of administration. Barcode Medication Administration (Scanning) can stop errors at the point of administration.
Preventing Patient Harm Safe Practices (Leapfrog Preventing Patient Harm Safe Practices (Leapfrog Highlights) Highlights) Nursing Workforce RMC NMC Nursing and Bedside Care for Patients (Total number of nursing hours per patient day) ACHIEVED THE STANDARD ACHIEVED THE STANDARD Nursing for Patients (Number of nursing (RN) hours per patient day ACHIEVED THE STANDARD ACHIEVED THE STANDARD 20
Medication Safety Practices (Leapfrog Highlights) Medication Safety Practices (Leapfrog Highlights) Medication Safety Measures Regional Medical Center Northport Medical Center Safety Medication Ordering Computerized Prescribing Order Entry (CPOE) Safe Medication Administration Barcode Medication Administration ACHIEVED THE STANDARD ACHIEVED THE STANDARD ACHIEVED THE STANDARD ACHIEVED THE STANDARD DCH consistently achieves greater than 85% compliance with CPOE. Our EMR EXPANSE provides are prescribers and pharmacists with effective decision support for prescribing. DCH Barcode Scanning ensures the right patient, right medication, right dose and the right time. DCH has barcode scanning in our clinical locations and achieves greater than 95%. 21
Leapfrog Spring 2024 (RMC/NMC) Leapfrog Spring 2024 (RMC/NMC) NMC RMC 22
Hospital Compare Highlights (Lower is better) Hospital Compare Highlights (Lower is better) Measure DCH National Rate National Compare PSI 90 (Composite measure for 10 patient safety metrics) 0.95 1.0 Same Colon Surgery Surgical Site Infection 0.734 0.884 Same Hysterectomy Surgical Site Infection 0.535 0.959 Same Complications Hip-Knee Surgery 3.2 3.2 Same Readmission-30 Day All Cause Unplanned 14 14.6 Same 23
