Playing it Safe on Memphis Medical News

Playing it Safe

By: CINDY SANDERS

When the Tennessee Hospital Association (THA) officially launched its new Tennessee Center for Patient Safety (TCPS) several weeks ago, it represented the culmination of nearly two years of outlining strategic plans, writing grant applications and seeking input from other healthcare organizations on ways to accelerate efforts for patient safety and quality improvement.

Now the real work begins.

“Our board started looking at what they viewed as the Achilles heel in healthcare. If we have one, I think it’s around quality and patient safety issues,” said THA president Craig Becker. “The two main principles the THA board has endorsed are that hospitals should create a culture of safety and look to system approaches for solutions versus the old finger-pointing blame game.”

He added that it is difficult to argue for meaningful healthcare reform unless you are doing your job safely and effectively. Becker also pointed out that many Tennessee hospitals have already begun the process and made great strides.

“We’ve seen some remarkable results … particularly out of Memphis and Knoxville,” he said regarding the implementation of quality and safety measures. “In Knoxville, they have cut back ventilator-acquired pneumonia almost to nil.”

The new center, which is designed to replicate such success stories statewide, falls under the purview of Chris Clarke’s departmental responsibilities. As senior vice president for clinical services, Clarke, an RN, is excited about the opportunity to channel education, expertise, resources and support to assist healthcare providers in implementing evidence-based practices to improve patient safety and enhance performance to meet or exceed national quality benchmarks.

The THA is working in collaboration with state and regional organizations representing hospital systems, private corporations, governmental agencies and healthcare associations to achieve widespread implementation of ideas and strategies.

“We’ve developed a very diverse group to serve as an advisory council,” Clarke said. “We realize we can get more done together. Bringing all our resources to bear is how we can accelerate improvement.”

She continued, “We’ve selected the focus areas for the center based on national trends where our members felt there was the greatest opportunity for improvement.”

The TCPS will emphasize the 12 interventions in care outlined by the Institute for Healthcare Improvement’s “5 Million Lives Campaign”
Clarke added that the Tennessee Nursing Partners collaborative is harnessing the expertise of the Tennessee Organization of Nurse Executives (TONE), the Tennessee Nurses Association and other key nursing groups “to work together on the nurse’s role in patient safety and key work environment and retention strategies.”

At the CNO Summit in late September, speakers and workgroups homed in on four areas: 1) building a culture of safety and teamwork; 2) providing staffing to meet the individual needs of patients; 3) sharing hospital performance measures and 4) addressing the workforce shortage.

Another major area of focus is the Hospital Collaborative on Reducing Healthcare-Acquired Infections.

“We want to focus on a couple of things we know work well and get broad implementation across the state,” Clarke said of the starting point.

One example is the goal to reduce central line infections by at least 25 percent by 2010.

“There are several bundles of care to reduce the risk of central line infections that have been proven quite successful,” Clarke noted, adding that many Tennessee hospitals are already implementing such measures.

The collaborative will focus on improvements using the national Surgical Care Improvement Project (SCIP) recommendations and is working locally with the Tennessee Chapter of the American College of Surgeons.

Overseeing the TCPS work plan is the recently hired director, Darlene Swart, RN.

“She has the task of implementing all our grand ideas and initiatives … and she’s the perfect person to do it,” said Clarke.

Although Swart’s task is a large one, Clarke and Becker said she would find a constituency committed to change.

“The culture of safety has to start at the top,” said Becker. He added that big changes could come from small improvements, but improvement requires constant attention to detail. “You have to have people thinking all the time.”

Clarke added, “When it comes to patient safety, healthcare professionals are very committed. No one wakes up and says, ‘Gee, I hope I make an error today,’ but you can’t just will (improvements) to be done. It takes a tremendous amount of teamwork, leadership, focus and creativity.”

The Tennessee Center for Patient Safety received a three-year grant of a little more than $900,000 to launch its ambitious program of work. The initial funding was made possible through the BlueCross BlueShield of Tennessee Health Foundation.

5 Million Lives Campaign

The Tennessee Center for Patient Safety is working with state hospitals and healthcare providers to adopt the 12 interventions espoused by the Institute for Healthcare Improvement’s “5 Million Lives Campaign.”

The IHI staff behind the national initiative to enlist 4,000 hospitals hopes to save lives and reduce injuries by promoting evidence-based best practices in a dozen areas where hospitals sometimes fall short.

The 12 interventions are as follows:

Prevent methicillin-resistant Staphylococcus aureus (MRSA) infection … by reliably implementing scientifically proven infection control practices throughout the hospital.

Reduce harm from high-alert medications … starting with a focus on anticoagulants, sedatives, narcotics and insulin.

Reduce surgical complications … by reliably implementing changes in care recommended by the Surgical Care Improvement Project (SCIP).

Prevent pressure ulcers … by reliably using science-based guidelines for prevention of the serious and common complication.

Deliver reliable, evidence-based care for congestive heart failure ... to reduce readmissions.

Get Boards on board … by defining and spreading new and leveraged processes for hospital Boards of Directors, so that they can become far more effective in accelerating the improvement of care.