MHSC HOSPITAL SURVEY RESULTS Michigan Patient Safety Conference March 30, 2006 AkkeNeel Talsma, PhD, RN Clinical and .


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MH&SC HOSPITAL SURVEY RESULTS Michigan Patient Safety Conference March 30, 2006 AkkeNeel Talsma, PhD, RN Clinical and Research Consultant to MH&SC. Objectives. Review 2005 MH&SC Hospital Survey background and scoring of survey Findings and utilization of MH&SC Hospital Survey 2005
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MH&SC HOSPITAL SURVEY RESULTS Michigan Patient Safety Conference March 30, 2006 AkkeNeel Talsma, PhD, RN Clinical and Research Consultant to MH&SC

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Objectives Review 2005 MH&SC Hospital Survey foundation and scoring of overview Findings and use of MH&SC Hospital Survey 2005 Review patterns healing center study information 2002 - 2005 Future advancements

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1. Audit 2005 MH&SC Hospital Survey Background, Reporting, and Scoring

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1. MH&SC Joint Hospital Survey: Background MH&SC study led since 2002; together with The Leapfrog Group since 2003 Survey things created with multi-disciplinary support from healing facilities and doctors all through the state Clinical specialists met workgroup to audit existing confirmation, build up current best practice Survey things were produced in view of gathering accord and close down by Oversight workgroup

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1. MH&SC Joint Hospital Survey: Background Goal is to gather information required by both MH&SC and The Leapfrog Group utilizing a solitary overview apparatus: diminishes information accumulation load on doctor\'s facilities and wellbeing arranges permits Leapfrog to give relative information to national buyers permits MH&SC to fortify development towards best practices in Michigan healing centers in included territories of care Content has remained about indistinguishable, taking into account slant examinations

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1. MH&SC Joint Hospital Survey: Background Results are distributed on MH&SC site for buyers ( www.mihealthandsafety.org ) Hospitals that present the overview get a CD with their synopsis comes about Results are imparted to Michigan wellbeing arrangements to help with contract choices Presentation to MH&SC individuals and results are shared at open gatherings

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2. MH&SC Joint Hospital Survey: Public Reporting and Utilization Please visit: www.mihealthandsafety.org

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1. MH&SC 2005 Survey: Categories Scoring Methodology Volume edges that reflect late confirmation based literature and clinical master assessment Open Heart Surgery; Recommended Minimum Annual Volume: 200 Percutaneous Coronary Intervention Annual Volume: 400 Abdominal Aortic Aneurysm Annual Volume: 20 Carotid Endarterectomy Annual Volume: 50 Esophagectomy Annual Volume: 7 Low Birthweight Infants Annual Volume: 70 Two perspectives measured in review: Volume: reported however not scored Non-volume exercises: reported and rundown score

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1. MH&SC 2005 Survey: Categories Scoring Methodology Structure, process and result attributes identified with nature of care and patient security Two perspectives: Volume (not scored) Non-volume exercises (scored) Volume viewpoint is exhibited as a crude esteem contrasted with the limit volume Non-volume exercises are identified with three substance ranges: medicinal suitability (half) hazard conformity (25%) and cooperation (or readiness to take an interest) in a statewide database (25%) Each rule is scored independently; most extreme score is 100%

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1. MH&SC 2005 Survey: Categories Scoring Methodology Non-volume exercises are identified with three substance ranges: Medical Appropriateness (half) Does your healing center\'s restorative staff have suitability criteria for deciding the medicinal need of <this procedure>? Does your healing facility require the medicinal staff to utilize the suitability criteria for clinical case audits of <this procedure>? Structure, Process, Outcome Measures (half) Does your doctor\'s facility have a hazard conformity framework for <this procedure>? Does your healing facility gather hazard balanced mortality information for <this procedure>? Does your healing facility gather hazard balanced dreariness markers for <this procedure>? Does your healing facility as well as its <specialty> specialists willing to submit clinical information identified with <this procedure> to an exhaustive statewide information base? Every rule is scored independently. The most extreme score is 100%

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1. MH&SC 2005 Survey: Scoring Methodology Please visit: www.mihealthandsafety.org

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1. MH&SC Joint Hospital Survey: Public Reporting and Utilization MH&SC Hospital Survey comes about accessible to Consumers: www.mihealthandsafety.org Health arrangements and safety net providers: get abridged data Hospitals: get study outline and benchmarking subtle element Public gatherings: show current overview results and patterns all through the state Future distribution?

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2. Discoveries MH&SC Hospital Survey 2005

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2. Discoveries MH&SC Hospital Survey 2005 Results are assessed by: Peer aggregate, see Appendix I for definitions MHA district Health framework Meeting least strategy understanding volumes Meeting 80% of prescribed exercises (4 shots) Consistency of entries

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Total Number of Hospital Responses: BCBSM Peer Group* : Respond Total N(%) Peer 1:Teaching Hospital 27 (27%) 28 (96%) Peer 2: Large Urban Hospital 13 (13%) 21 (62%) Peer 3: Small Urban Hospital 18 (18%) 22 (56%) Peer 4: Rural Hospital 11 (11%) 22 (half) Peer 5: Small Rural Hospital 31 (31%) 43 (72%) Other 0 (0%) 2 (0%) Total 100 138 (72.5%) *Definition of Peer gathering accessible in Appendix I 2. 2005 MH&SC Survey Response Rate: By BCBSM Peer Group

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2. 2005 MH&SC Survey Response Rate: Distribution by Region # Hospitals/# Hospital Region Region Responses (%)* Southeast 41 (30%) 37 (90%) Southwest 14 (10%) 8 (57%) West Central 26 (19%) 20 (77%) Mid Michigan 10 (7%) 5 (half) East Central 20 (15%) 15 (75%) North Central 12 (9%) 8 (67%) Upper Peninsula 15 (11%) 7 (47%) Total 138 (100%) 100 (72.5%) List of taking an interest clinics is accessible in Appendix II

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2. MH&SC 2005 Survey Response by BCBSM Peer Group and Region

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Guideline Open Heart (200) N = 23/29 (79.3%) 21 (72.4%) 22 (75.9%) PCI (400) N = 24/27 (88.9%) 18 (66.7%) 22 (81.5%) AAA (20) N = 33/52 (63.5%) 23 (44.2%) 29 (55.8%) Carot. Endart (50) N = 36/57 (63.2%) 27 (47.4%) 35 (61.4%) Esophagectomy (7) N = 9/31 (29.0%) 2/34 (5.9%) 17/34 (half) LBW Infants (70) N = 11/22 (50.0%) 11 (50.0%) 15 (68.2%) Cong. Anom. (70) N = 11/22 (50.0%) 8 (36.4%) 18 (81.8%) ICU Physician NA 20 (25.0%) 29 (36.3%) Staffing Met Volume Met 95% Met 80% Threshold Activities 2. Yearly MH&SC Joint Hospital Survey: 2005 Results by Category

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2. MH&SC Joint Hospital Survey: RCA and HFMEA Patient Safety Tools: Root Cause Analysis (RCA) Healthcare Failure Mode Effect Analysis (HFMEA) This segment is NOT scored nor are results posted on the MH&SC purchaser report Use comes about as a gauge to decide the requirement for shared change endeavors around there

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2. MH&SC Joint Hospital Survey: RCA and HFMEA Root Cause Analysis (RCA) Root-case examination is a review subjective process went for revealing the basic cause(s) of a mistake by taking a gander at the "sharp end" of a blunder to the empowering inert conditions that added to or empowered the event of the blunder A RCA concentrates principally on frameworks and procedures, not singular execution. The outcome is an activity plan that recognizes the systems that the association means to actualize to diminish the danger of comparable occasions happening later on

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2. MH&SC Joint Hospital Survey: RCA and HFMEA Health Failure Mode Effects Analysis (HFMEA) HFMEA\'s ("FMEA") objective is to keep blunders from happening by endeavoring to distinguish the greater part of the ways a gadget or process can fall flat, assess the likelihood and result of every disappointment, and after that make a move to keep the potential disappointments from happening HFMEA is regularly directed by multidisciplinary groups in a HCO on a wide range of patient care forms, including gadget plan

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2. MH&SC Joint Hospital Survey: RCA and HFMEA 99 of 100 doctor\'s facilities (99%) reacted to overview questions RCA is frequently led (n=88), consistently surpassing the base JCAHO necessities Sentinel occasion: n=79 lead RCA Adverse occasion: n=69 direct RCA Improvement arrange takes after RCA (n=94) Improvement arrange additionally assessed (n=81) Small varieties accordingly by companion aggregate

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2. MH&SC Joint Hospital Survey: RCA and HFMEA 98 of 100 (98%) clinics demonstrated directing HFMEA 20/98 (20%) doctor\'s facilities lead HFMEA more than 5 times each year The larger part of healing facilities (68/98, 69%) direct between 1 – 3 HFMEA\'s a year. On the off chance that a HFMEA is led, it is about dependably took after by a hazard diminishment movement (n=89/98, 91%) The HFMEA related hazard decrease action is regularly assessed (n=79/89, 89%)

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2. Dispersion leading RCA/HFMEA by associate gathering

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3. MH&SC Joint Hospital Survey: 2002-2005 Trends

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3. MH&SC Survey Response Rate: 2002-2005 Trend

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3. Yearly MH&SC Joint Hospital Survey: 2002 - 2005 Trends Nearly h alf (47%) of all healing centers presented the overview every one of the 4 years Over a third (34%) of all clinics presented a review in any event once

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3. Yearly MH&SC Joint Hospital Survey: 2002 - 2005 Trends Peer 1 healing facilities were well on the way to present an overview all years (69% of all associate 1 doctor\'s facilities) Almost 50% of companion 2 (46%) and peer 3 (48%) doctor\'s facilities presented a study for all years Over half (55%) of Peer 5 clinics and just 24% of associate 4 doctor\'s facilities took an interest in all study years

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3. MH&SC Survey Multi-year Response Rates * Please allude to The Leapfrog Group Definition in Appendix III

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3. Yearly MH&SC Joint Hospital Survey: Trended Results by Category

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3. Connection amongst\'s volume and meeting prescribed exercises Correlation between NICU volume and meeting recom

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