Focus Areas

Focus Areas: 2008-2010 Completed & Ongoing

Coalition hospitals have a shared vision and challenge of making Indianapolis the safest city for healthcare. The ICPS has historically achieved accelerated outcomes by sharing resources, performance targets, accountability, funding, and learnings. ICPS members undertake projects that focus on patient-centered strategies to improve safety by addressing all of the barriers observed by patients and providers to achieving a standardized approach to patient care. The following are key initiatives of the Indianapolis Coalition for Patient Safety in focusing on solutions to patient safety issues:


High-Risk Drugs

Anticoagulants (blood thinners), insulin, narcotics/opiates, etc. are commonly used in hospitals, but are considered by experts to be "high risk drugs".

  • Anticoagulants: A city-wide list of anticoagulant patient safety practices was developed and implemented with assistance from the Institute for Safe Medicine Practices (ISMP). Completed in 2008
  • IV Pump High Risk Drug Alerts-Ongoing: The Coalition applied for and received a research grant from Cardinal Health Foundation to study infusion pump alerts for selected high risk drugs. The goal of the research is to conduct a common cause analysis by trending root causes for alerts and overrides, and take action to further reduce risk with use of high risk medications.
  • Insulin: A team of experts from Lilly led a “be the vial” exercise with hospital teams from Wishard Health Services and from the Indiana Heart Hospital. Strategies to eliminate potentially unsafe process steps were implemented and ongoing measurement continues to sustain the changes made to insure a safer environment for patients and staff. Completed in 2009
  • Standardized names, concentrations, and dosage units for high risk IV infusion medications: Standardizing IV infusion drug concentrations among Coalition hospitals reduces the chance of error as nurses frequently travel between systems. Tools and resources to assist hospitals with implementation were developed. Completed in 2009
  • The Medication List-Ongoing: A patient education campaign has been launched to stress the importance of patients maintaining a current list of their medications and presenting that list to each provider of care. Initially education will target hospital staff and their families. Moreover Eli Lilly and Co and Anthem Inc have joined the campaign targeting their own employees. Goodwill Industries are targeted for 2011.

Surgical Safety-Ongoing

One standard Universal Protocol has been implemented across all hospitals. The standardized set of practices will provide continuity to physicians and staff who travel between hospitals. Universal guidelines to prevent respiratory failure post operative from pain analgesia which include the use of Capnography were developed, published and implemented. Working on developing and implementing a simulation on surgical safety during the loss of power in the Operating room.





Peer Reviewed Root Cause Analysis Review-Ongoing

Indianapolis Coalition for Patient Safety, as a peer review organization, has shared information from more than seven adverse events to facilitate member learning so as to prevent the same event from occurring in other member hospitals.

Institute for Healthcare Improvement (IHI) Campaigns

The Coalition hospitals implemented the “Saving 100,000 Lives” initiatives aimed to protect patients from harm. Completed in 2008.

"Targeting Severe Sepsis"

The Coalition uses comparative mortality data to identify significant safety improvement opportunities. Sepsis emerged as a priority area due to increased patient length of stay and high mortality risk. Coalition hospitals pledged to improve utilization and implementation of evidence based treatment order sets and evidence based tools to screen for Sepsis. Completed in 2009.





Central Line Blood Stream Infections and Urinary Tract Infections-Ongoing

These are targeted as potential underlying causes for Sepsis .The coalition team developed and implemented evidence based protocols to prevent and lower risk of patients developing infections. Completed in 2010.

MRSA (Methicillin Resistant Staphylococcus Aureus)

Two Coalition hospitals are participating in Phase 2 the IU Center for Health Services and Outcomes Research collaborative aimed at reducing MRSA infection rates in Indianapolis hospitals. Completed in 2010.

Patient Alert Wristband Standardization

Many hospitals use color-coded patient wristbands to alert caregivers to certain patient risks such as allergies and fall risk. Coalition hospitals are adopting the American Hospital Association standardized colors for alert wristbands. Completed in 2009.

Preventable Congestive Heart Failure Patient Readmissions-Ongoing

The team collaborated with The Indiana Chapter of American College of Cardiology and developed implementable tactics to improve preventable heart failure readmissions. In process of implementing tactics.

Diabetes: Transitions In Care-Ongoing

The group has collaborated with the Robert Wood Johnson Aligning Forces Grant and Health Care Excel and Indiana Hospital Association to improve transitions of care from hospital discharge of patients with diabetes back to ambulatory care.

Patient Safety "Hero" Awards

Annually the Coalition recognizes an individual or a group within each member hospital that has championed a specific patient safety project. The 2010 award winner topics by hospital are listed below:

  • IU Health: pressure ulcer prevention teams (Methodist Hospital, Riley Hospital for Children, Indiana University Medical Center)

    IU Health
    pressure ulcer prevention teams (Methodist Hospital, Riley Hospital for Children, Indiana University Medical Center)


    From left to right:

    • Sam Odle
    • Mary Sitterding
    • Joyce Pittman
    • Greg Larkin
  • Community Health Network: MRSA reduction teams (North, South, East, The Indian Heart Hospital)

    Community Health Network
    MRSA reduction teams (North, South, East, The Indian Heart Hospital)


    From left to right:

    • Greg Larkin
    • Loretta Marsh
    • Bryan Mills
  • Richard L Roudebush VA Medical Center: Acute and Critical Care Committees

    Richard L Roudebush VA Medical Center
    Acute and Critical Care Committees


    From left to right:

    • Greg Larkin
    • Imtiaz Munshi
    • Tom Mattice
  • St Francis Hospital and Health Services: Shelley Voelz and Dr. Douglas Johnstone, St. Francis Hospitals and Health Centers, Indianapolis

    St Francis Hospital and Health Services
    Shelley Voelz and Dr. Douglas Johnstone, St. Francis Hospitals and Health Centers, Indianapolis


    From left to right:

    • Greg Larkin
    • Doug Johnstone
    • Shelley Voelz
    • Bob Brody
  • St Vincent Health: Beverly Reed, St. Vincent Indianapolis Hospital

    St Vincent Health
    Beverly Reed, St. Vincent Indianapolis Hospital


    From left to right:

    • Greg Larkin
    • Beverly Reed
    • Vince Caponi
  • Wishard Health Services: PCA Administration Team

    Wishard Health Services
    PCA Administration Team


    From left to right:

    • Greg Larkin
    • James Fuller
    • Betsy Vance
    • Lisa Harris
  • Suburban Health Organization: Patricia Owens, Hendricks Regional Health, Danville

    Suburban Health Organization
    Patricia Owens, Hendricks Regional Health, Danville


    From left to right:

    • Greg Larkin
    • Patricia Owens
    • John Sparzo




OUR METHODS

Using subject matter experts from Coalition hospitals, Coalition-wide multidisciplinary teams, on-site support where needed, and benchmarking measures the ICPS hospitals:

  1. Identify evidence based standards of practice
  2. Determine the best performer among the Coalition hospital members
  3. Work collaboratively to adopt a universal practice standard among all members
  4. Pilot test the change(s) to identify workable process design
  5. Use information gained from the pilot test to further refine individual hospital implementation plans
  6. Share lessons learned and barriers overcome among all ICPS hospitals

MEASURES

  1. Hospital Acquired Infections: mortality rates reduction
  2. Surgical Errors/Medication Errors: reduction in the number of reportable events published by the Indiana State Department of Health
  3. National Patient Safety Goals: full implementation of patient safety standards promulgated by the Joint Commission, NQF, and IHI to improve patient safety