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Partnering to Reduce Pressure Ulcers

Partnering to Reduce Pressure Ulcers. Empire Quality Partnership January 27, 2008. Caring Together: Pressure Sore Improvement Training Program. CCLC is an affiliate of the Greater New York Hospital Association. Overview of Caring Together. 80 health care organizations

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Partnering to Reduce Pressure Ulcers

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  1. Partnering to Reduce Pressure Ulcers Empire Quality Partnership January 27, 2008

  2. Caring Together: Pressure Sore ImprovementTraining Program CCLC is an affiliate of the Greater New York Hospital Association

  3. Overview of Caring Together • 80 health care organizations • Long term care providers (NHs & HHAs) • Hospitals • Joint training across settings • Building a common perspective, vocabulary, and basic understanding • Movement toward building partnerships across settings

  4. Terminology • Pressure Ulcer (NPUAP) – • localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction. • A number of contributing or confounding factors are associated with pressure ulcers and are yet to be elucidated. • Decubitis Ulcer • Bedsore • “Pressure Sore” – to recognize the team-based nature of the training

  5. Why do we need to focus on pressure sore improvement?

  6. Percentage of High-Risk Long-Stay Residents Who Have Pressure Sores

  7. Percentage of Low-Risk Long-Stay Residents Who Have Pressure Sores

  8. Percentage of Short-Stay Residents with Pressure Sores

  9. Hospital Picture: Decubitus Ulcers • US Hospitals, 2004: 26.051 • NYS Hospitals, 2005: 34.6 • NYS Hospitals, 2006: 33.8 Source: The Health Economics and Outcomes Research Institute (THEORI) of GNYHA analysis of risk-adjusted AHRQ Patient Safety Indicators

  10. Perspectives • Centers for Medicare and Medicaid Services • NYS Department of Health • Bureau of Residential Services • Pay for Performance • Quality Improvement Organizations • Advancing Excellence in America’s Nursing Homes • NYS Office of the Medicaid Inspector General • Residents or Patients

  11. Part of the Solution: Pressure Sore Improvement Training • NYS Health Workforce Training Initiative (HWRI) • CCLC’s Quality Improvement Consortium Training Programs • Focus: improving team-based approach to pressure sore improvement • Need for additional collaborative opportunities

  12. CCLC’s Quality Improvement Consortium (QIC)Training Program Tier FourCaring Together:Pressure Sore Improvement Spring 2008 Train-the-Trainer Spring 2008 through Winter 2009 Local Training

  13. Engaging the Hospital Community • Curriculum development • Announcement through GNYHA’s hospital quality channels • Invitation to partner through CCLC’s long term care members • Attend trainer workshops together • Ongoing communication & local training

  14. Timeline • Development of curriculum, 2007 • January 2008: Pilot training • March 17: Executive Briefing • March 24: First train the trainer workshop • Through May/June 2008 • Local training at member organizations • Through Winter 2009 • Ongoing coordination with CCLC & QISN • Development of standard measurement tool • Identification of deeper clinical education needs • Assistance with partner relationships

  15. St. Elizabeth Ann’s Health Care and Rehabilitation Center – SVCMC • 300-bed facility on Staten Island • Specialty populations - ventilator, HIV/AIDS, neurobehavioral, subacute • Challenges and opportunities for pressure sore improvement • Experience with training collaborative • Next steps

  16. Village Care of New York • VCNY nursing homes • Village Nursing Home: 200-bed going through significant changes • Rivington House: 206-bed HIV/AIDS • Challenges and opportunities for pressure sore improvement • Experience with training collaborative • Next steps

  17. Next Steps • Standardized tracking tool • Assistance with hospital partnerships • Additional and targeted training

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