Focus Areas

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).
  • IV Pump High Risk Drug Alerts: The Coalition applied for and received a research grant from Cardinal Health Corporation 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.
  • 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.
  • The Medication List: a patient education campaign will be 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.

Surgical Safety

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.

Peer Reviewed Root Cause Analysis Review

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

Institute for Healthcare Improvement Campaigns

The Coalition hospitals pledge to cooperate and implement the initiatives aimed to protect patients from incidents of medical harm in U.S. hospitals.

"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 pledge to improve utilization and implementation of evidence based treatment order sets and evidence based tools to screen for Sepsis.

Central Line Blood Stream Infections and Urinary Tract Infections

These are targeted as potential underlying causes for Sepsis with the goal of implementing one standardized clinical bundle within all Coalition hospitals.

MRSA (Methicillin Resistant Staphylococcus Aureus)

Four 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.

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.

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 2008 award winner topics by hospital are listed below:

  • Clarian: Pediatric Culture of Safety Survey Initiative for IV Assessments

    Clarian
    Pediatric Culture of Safety Survey Initiative for IV Assessments


    From left to right:

    • Judy Monroe, MD - Indiana State Dept. of Health - State Health Commissioner
    • Marilyn Cox, RN, MSN - Quaility and Patient Safety Team - Riley Hospital
    • Daniel F. Evans, Jr. - President & CEO - Clarian Health Partners
  • Community Health Network: Private Room Neonatal Intensive Care Unit

    Community Health Network
    Private Room Neonatal Intensive Care Unit


    From left to right:

    • Judy Monroe, MD - Indiana State Dept. of Health - State Health Commissioner
    • Scott Lakin - IT Site Director - Private Room NICU Team - Community Hospital North
    • Denise Hartman - Clinical Director, Private Room NICU Team
    • William E. Corley - President & CEO - Community Health Network
  • Richard L Roudebush VA Medical Center: Cardiac Surgery Glucose Control

    Richard L Roudebush VA Medical Center
    Cardiac Surgery Glucose Control


    From left to right:

    • Judy Monroe, MD - Indiana State Dept. of Health - State Health Commissioner
    • William Watson, RN, BSN - Cardiac Surgery Glucose Control Surgery Team
    • Thomas Mattice - Medical Center Director - Roudebush VA Medical Center
  • St Francis Hospital and Health Services: medication error events and analysis process

    St Francis Hospital and Health Services
    Medication error events and analysis process


    From left to right:

    • Judy Monroe, MD - Indiana State Dept. of Health - State Health Commissioner
    • Charles Kinsella, MD - MEDS Team
    • Theresa Staublin, PharmD - MEDS Team
    • Robert Brody, President & CEO, St. Francis Hospital and Health Services
  • St Vincent Health: Implementation of Hourly Rounding With Patients and Families

    St Vincent Health
    Implementation of Hourly Rounding With Patients and Families


    From left to right:

    • Vincent Caponi - CEO - St. Vincent Health
    • Eileen Schneider, RN, BSN - Hourly Rounding Team
    • Judy Monroe, MD - Indiana State Dept. of Health - State Health Commissioner
  • Wishard Health Services: Emergency Department Diversion Avoidance

    Wishard Health Services
    Emergency Department Diversion Avoidance


    From left to right:

    • Judy Monroe, MD - Indiana State Dept. of Health - State Health Commissioner
    • Tracy Martin - Director, Emergency Department - Diversion Avoidance Team
    • Margie Payne - CEO, Midtown Mental Health - Vice President, Mental Health
      Operations - Diversion Avoidance Team
    • Lisa E. Harris, MD - CEO & Medical Director - Wishard Health Services
  • Suburban Health Organization: Leadership In Patient Safety

    Suburban Health Organization
    Leadership In Patient Safety


    From left to right:

    • Judy Monroe, MD - Indiana State Dept. of Health - State Health Commissioner
    • Lynn Bowers, MD - Patient Safety Leadership
    • Dennis Dawes - CEO, Hendrics Regional Health - Suburban Health Organization


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. Refine implementation plan to include error proofing strategies
  6. Use information gained from the pilot test to further refine individual hospital implementation plans
  7. 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