Download pdf - Using the Innovations Exchange To Develop Health Professional Competencies

Using the Innovations Exchange to Develop Health Professional

Competencies

Web SeminarWeb Seminar

September 18, 2013September 18, 2013

Follow this event on Twitter Follow this event on Twitter Hashtag: @AHRQIXHashtag: @AHRQIX

Using the Webcast Console and Submitting Questions

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Click the Q&A widget to get the Q&A box to appear

To submit a question, type question here and hit submit.

Accessing Presentations

Download slides from console

Click on the “Download Slides” button for a PDF version

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What is the Health CareInnovations Exchange?

Publicly accessible, searchable database of health policy and service delivery innovations

Searchable QualityTools Successes and attempts Innovators’ stories and lessons learned Expert commentaries Learning and networking opportunities New content posted to the Web site every two weeks

Sign up at http://www.innovations.ahrq.gov under “Stay Connected”

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Innovations Exchange Web Event Series

Archived Event MaterialsAvailable within two weeks under Events & Podcasts http://www.innovations.ahrq.gov

Examples of Past EventsMay 9, 2013 A Close Look at Care Coordination within Patient-Centered Medical Homes

April 9, 2013 Promoting the Spread of Health Care Innovations

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PresenterPresenter

Kathleen Stevens, RN, EdD, FAANKathleen Stevens, RN, EdD, FAAN

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Professor and DirectorProfessor and DirectorAcademic Center for Evidence-Based PracticeAcademic Center for Evidence-Based Practice

Improvement Science Research NetworkImprovement Science Research NetworkUniversity of Texas Health Science Center San AntonioUniversity of Texas Health Science Center San Antonio

Catalysts for InnovationCatalysts for Innovation

Improving your work is our workImprovement requires changeNot all change lead to improvement

Test innovations…Plan, Do, Study, Act (PDSA)

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Recommendations and Initiatives

New Curricula Guidelines


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Patient Protection and Affordable Care Act:

Title V Health Care Workforce“…to improve access to and the delivery of health care services for all individuals, particularly low income, underserved, uninsured, minority, health disparity, and rural populations by…

enhancing health care workforce education and training…

providing support to the existing health care workforce …”


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Discovery Research

Evidence Summary

Translation to Guidelines

Process, Outcome Evaluation

Practice Practice IntegrationIntegration

Academic Center for Evidence-based Practice (ACE) Star Model of Knowledge Transformation

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USPSTFUSPSTF

Evidence Synthesis

AHRQ Health Care

Innovations Exchange

Is Innovation Difficult? Is Innovation Difficult? Watermelon SquaredWatermelon Squared

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Every title includes the innovation and the outcomes

Example 1: Patient- and Family-Activated Response Team

Averts Potential Problems and Generates High Levels of Patient, Family, and Staff Satisfaction

What They Did; Did It Work?What They Did; Did It Work?

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Every title includes the innovation and the outcomes

Example 2: Team-Developed Care Plan and Ongoing Care Management by Social Workers and Nurse Practitioners

Results in Better Outcomes and Fewer Emergency Department Visits for Low-Income Seniors

What They Did; Did It Work?What They Did; Did It Work?

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http://www.innovations.ahrq.gov/content.aspx?id=266815


Intensive care unit patients have life-threatening problems and complex care needs

Require a combination of many treatments and services to achieve timely recovery and discharge

Susceptible to preventable complications (i.e. ventilator-associated pneumonia, deep vein thrombosis, and catheter-associated bloodstream infections), which lead to suboptimal clinical outcomes and prolonged length of stay

Tools to improve communication and checklists to guide adherence to evidence-based interventions are known to improve outcomes, yet many hospitals have not adopted these initiatives

Problem AddressedProblem Addressed

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Created an improvement team

Established multiple initiatives designed to improve care including a comprehensive unit-based safety program (CUSP) to enhance the culture of patient safety and tools to expedite the translation of evidence into practice

Used evidence-based processes to reduce catheter-related bloodstream infections

Integrated proven interventions to reduce complications associated with mechanical ventilation

Adopted tools and tactics

What They DidWhat They Did

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Improved the culture of safety among participating ICUs

Prevented catheter-associated bloodstream infections 1,800 lives saved

140,000 hospital days avoided

$270 million in savings in 5 years

Evidence rating: moderate Pre- and post-implementation comparisons of safety culture survey

results and catheter-related bloodstream infections

Predictive model that estimated the number of lives, dollars, and hospital days saved over a 5-year period

Did It Work?Did It Work?

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Assessed the causes of the patient's poor blood pressure control

Developed a guideline-based treatment plan Monitored patients’ treatment response at regular

intervals Made recommendations as necessary to the treating

physician for medication adjustments designed to achieve good blood pressure control

What They DidWhat They Did

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Did It Work?Did It Work?

Improved blood pressure control, even in hard-to-treat patients with diabetes

Increased physician adherence to established treatment guidelines for hypertension

Evidence rating: strong Prospective, cluster randomized controlled trial at six community-

based family medicine residency programs

Measured pre- and post-implementation blood pressure levels, degree of adherence to established treatment guidelines, and self-reported patient adherence to the prescribed regimen

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Will It Work Here?Will It Work Here?

A Decisionmaker’s Guide to Adopting InnovationsA Decisionmaker’s Guide to Adopting Innovations Does this innovation fit? Does this innovation fit? Should we do it here? Should we do it here? Can we do it here? Can we do it here? How can we do it here? How can we do it here?

Taking Innovations to ScaleTaking Innovations to ScaleResources to assist innovators and adoptersResources to assist innovators and adoptersSpread success storiesSpread success storiesPresentations and reportsPresentations and reports

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Innovation is the one competence needed in the future…

--Peter Drucker

…early adoption is the second

--Kathleen Stevens

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PresenterPresenter

Judith Kunisch, BSN, MBAJudith Kunisch, BSN, MBA

Lecturer

Yale School of Nursing

Yale University

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Using the Innovations Exchange as an Effective Practical Teaching Tool:

A Case Study

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Background and GoalBackground and Goal

Health care professional study includes course work related to quality and safety and the business of healthcare

Innovations Exchange provides teaching opportunities for all levels of study Nursing undergraduates Masters level – MSN, MBA, MPA, MPH Doctoral level – DNP

Learning activities/assignments vary with the level of study and focus of the course

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Examples of Learning Examples of Learning Activities Activities

Quality and safety: nursing undergraduates, masters level

Innovation business plans: masters and doctoral level

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Masters Example: Masters Example: Leadership PracticeLeadership Practice

Advanced practice students Semester course; 100 students Practice competency in leadership/quality and

safety American Association of Colleges of Nursing (AACN)

Masters Essentials Quality and Safety Education for Nurses

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Masters Example (continued)Masters Example (continued)

Two part assignment: presentation, written memo

Innovations Exchange provides “contexts of care” Innovation adoption guide Profiles and quality tools organized by

subject areas

The Assignment: PresentationThe Assignment: Presentation

Working in pairs Small group presentation (leadership

communication) Single PowerPoint slide, 5-7 minute

presentation, 5 minute question and answer Single slide tells a visual story; useful in other

settings

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The Assignment: Written MemoThe Assignment: Written Memo

5-6 paragraph written memo to senior leader Practice writing (leadership communication) Translate the components of patient safety and

risk management to a current topic in quality improvement

Comment on the value of the innovation or tool Incorporate other relevant articles and references

Active “Hands On” LearningActive “Hands On” Learning

Student centered: learn to use the site, evaluate and analyze innovations/tools

Result: students will not forget the Innovations Exchange; updated and reliable

Without the assignment, teaching options include: Show them: passive learning, no motivation to use it Tell them: passive learning, no motivation to look at it “Wait until I am in practice and need to use it” or

“Maybe I will do this someday”

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Example: Student SlideExample: Student Slide

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Measurable Objectives Measurable Objectives

Students understand AHRQ selection criteria for innovations and quality tools

Each innovation or quality tool selection is relevant to student’s area of interest and practice

Student employs critical analysis of a specific innovation or tool

Students practice professional communication with a presentation and written memo

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Example Student Memos:Example Student Memos:Selected PhrasesSelected Phrases

“As an advanced practice nursing student of family psychiatry, I am particularly interested in interventions that aim to address the gaps in systems of care for youth with mental health illnesses ….”

“… strength of this intervention is the emphasis on care coordination to bridge the experience from treatment discharge to community reentry….”

“…. a tool with comprehensive information is important for treating every patient, but it is particularly important in Pediatrics …”

“If I was going to change anything at all, I would expand it to be a global pediatric cancer tool because it is so helpful….”

“Thank you for your time and for your dedication to quality improvement in healthcare.”

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Grading CriteriaGrading Criteria

Presentation Slide is easy to read; accompanies the oral presentation Not graded on public speaking ability – this is practice!

Memorandum Set up professionally Student opinion is reasonable and relevant to practice Overall writing demonstrates an understanding of the

innovation or tool and its relationship to practice Student compares it with other tools or innovations

he/she has observed or used in practice

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Questions?

Click me to get Q&A box to appear

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The Innovations Exchange

More information on Yale’s School of Nursing assignment:

http://innovations.ahrq.gov/resources/student/syllabus.aspx

Visit our AHRQ Health Care Innovations Exchange:

http://www.innovations.ahrq.gov/

Follow us on Twitter: @AHRQIX@AHRQIX

Send us email:

[email protected]

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