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MA ICU Safe Care Initiative: Comprehensive Unit Based Safety Program (CUSP)

MA ICU Safe Care Initiative: Comprehensive Unit Based Safety Program (CUSP). October 25, 2010. CUSP and CLABSI Interventions. CUSP. CLABSI. Primarily technical interventions: CVC line insertion CVC line management. Improving the culture of safety: 1. Educate on the science of safety

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MA ICU Safe Care Initiative: Comprehensive Unit Based Safety Program (CUSP)

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  1. MA ICU Safe Care Initiative:Comprehensive Unit Based Safety Program (CUSP) October 25, 2010

  2. CUSP and CLABSI Interventions CUSP CLABSI Primarily technical interventions: • CVC line insertion • CVC line management Improving the culture of safety: 1. Educate on the science of safety 2. Identify defects 3. Learn from defects 4. Assign executive to adopt unit 5. Implement teamwork tools

  3. Framework for MA ICU Safe Care Initiative Improvement Collaborative • Hospital Association and Patient Safety Organization • Work together as state leads • Recruitment of hospital teams and resources to the teams • State “hub” for managing ongoing participation and improvement • Role of National Project Team • Two Year Collaborative • Data Collection – CareCounts website • Improvement • Monthly Content Calls • Monthly Coaching Calls • Resources at: www.onthecuspstophai.org/Stop-7611.html

  4. Communication Among Care Providers:Percent Understanding Patient Care Goals Daily Goals Percent understanding patient care goals 5

  5. Impact of Daily Goals on ICU Length of Stay Daily Goals 654 New Admissions = $7 Million Additional Revenue 6

  6. Safety Climate- Culture of Safety Survey % of respondents within an ICU reporting good safety climate

  7. Culture of Safety- Michigan Teamwork Climate Across Michigan ICUs

  8. Culture of Safety- Michigan Safety Climate Across Michigan ICUs % of respondents within an ICU reporting good safety climate

  9. "Needs Improvement“ Statewide Michigan CUSP ICU Results • Less than 60% of respondents reporting good safety climate =“needs improvement” • Statewide in 2004 84% needed improvement, in 2006 41% • Non-teaching and Faith-based ICUs improved the most • Safety Climate item that drives improvement: “I am encouraged by my colleagues to report any patient safety concerns I may have”

  10. No BSI = 6 months or more w/ zero No BSI 21% No BSI 44% No BSI 31% Teamwork Climate Across Michigan ICUs The strongest predictor of clinical excellence: caregivers feel comfortable speaking up if they perceive a problem with patient care % of respondents within an ICU reporting good teamwork climate

  11. 2 yr CLABSI Results from ICUs in Michigan Pronovost NEJM 2006

  12. 4 yr CLABSI Results from ICUs in Michigan Pronovost BMJ 2010

  13. Results • Lives Saved – 1,729* • Patient Days Saved – in excess of127,000* • Dollars Saved – 0ver $246 Million* • Culture of Safety improved 28% • Teamwork improved 15% * Based on the Johns Hopkins Opportunity Calculator

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