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May 21, 2013 Della M. Lin, M.D. dlinmdconsult@yahoo

Hawaii Surgical Unit Safety Program: The Journey Begins with the Comprehensive Unit-Based Safety Program. May 21, 2013 Della M. Lin, M.D. dlinmdconsult@yahoo.com. Hawaii Safer Care SUSP.

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May 21, 2013 Della M. Lin, M.D. dlinmdconsult@yahoo

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  1. Hawaii Surgical Unit Safety Program: The Journey Begins with the Comprehensive Unit-Based Safety Program May 21, 2013 Della M. Lin, M.D. dlinmdconsult@yahoo.com Hawaii Safer Care SUSP

  2. “the most common cause of failure in leadership is produced by treating adaptive challenges as if they were technical problems.” Ron Heifetz

  3. Comprehensive Unit-based Safety Program (CUSP) • Assign executive to adopt unit • Educate staff on science of safety • Identify defects • Learn from one defect per month/quarter • Implement teamwork tools Pronovost J, Patient Safety, 2005

  4. It Takes Three! Robust Data Implementation of Evidence-Based Measures Effective Safety Culture

  5. Hawaii CUSP-CLABSI collaborative

  6. Hospital Acquired Infections (CLABSI) SIR scores: CMS Hospital Compare PR 1.58 MS 0.91 MD 0.87 ME 0.84 LA 0.81 RI 0.76 MH 0.76 TN 0.72 AL 0.72 MT 0.69 SC 0.67 NJ 0.67 WV 0.66 NY 0.66 DC 0.63 • VA 0.62 • NE 0.59 • OK 0.58 • GA 0.58 • WI 0.55 • CA 0.54 • WI 0.54 • UT 0.54 • CO 0.53 • TX 0.52 • NM 0.52 • NC 0.51 • IA 0.51 • Fl 0.51 • MA 0.50 • KS 0.33 • MI 0.32 • SD 0.24 • HI 0.17 • IL 0.50 • WY 0.49 • VT 0.48 • OR 0.47 • PA 0.46 • MO 0.46 • ID 0.45 • OH 0.44 • AR 0.44 • WA 0.42 • IN 0.41 • MN 0.38 • DE 0.37 • ND 0.37 • AK 0.35 Accessed 8/20/2012 http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalCompare.html

  7. “During the 36-month study period, the overall CLABSI rate was reduced by 82%... …Importantly, the tools were not viewed as simple technical interventions but were instead designed as interventions with an adaptive component that would shape a culture of safety.”

  8. Comprehensive Unit-based Safety Program (CUSP) • Assign executive to adopt unit • Educate staff on science of safety • Acknowledge safety is a property of a system • Standardize what you can • Use safe design principles • Identify defects • Learn from one defect per month/quarter • Implement teamwork tools

  9. What makes CUSP unique? • Pearls for the CUSP approach • Horizontal: Comprehensive UNIT-BASED approach • Vertical: Intentional Executive Leadership role and participation • Trans Dimensional: Multidisciplinary Team Tools for ensuring diverse and independent input • Adaptive: Leverage tools that promote behavior change to model mental model change

  10. What will you do differently? How will you do it differently?

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