AHRQ Safety Program for Surgery Sustainability AHRQ Pub No 1618000415EF December 2017 Learning Objectives After this session you will be able to Define sustainment and spread ID: 698014
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Slide1
Sustaining and Spreading Surgical Safety Improvements
AHRQ Safety Program for SurgerySustainability
AHRQ Pub. No. 16(18)-0004-15-EF
December 2017Slide2
Learning Objectives
After this session, you will be able to–Define sustainment and spreadDetermine if you are ready to sustainPlan key actions for sustainmentPrioritize needs for successful sustainmentSlide3
Sustainment Is. . .
What you do to continue to build on your successesHow your efforts to change culture and improve safety persistWhen you apply the process for improving surgical safety to new challengesSlide4
Adaptive or Technical?
Adaptive
CUSP
Technical
SSI
PreventionsSlide5
Why Worry About Sustainment?
Avoid recidivism, or backslidingRespect probability of failure over time Recognize risks to sustaining progressStaff turnoverOverlying priorities
Organizational changesSlide6
Definition of Spread
1“Spreading takes the process from the narrow, segmented population(s) or group(s) and broadens it to include all the population(s) or group(s) that will use the process.”
“Formalizing a process provides a reference to others: those new to the organization and those in the organization needing clarity about the specifics of the process.” Slide7
What Do Effective Teams Look Like?
Effective teams–Hold regular meetingsInclude active surgical champions who partner with othersHave executive leadership support Believe that progress is possible
Invent ways to create engagement (and then reinvent more ways)
Maintain frequent
communicationSlide8
What Sustainment Strategies Work?
Stick to formal processesTest changes on small scale firstMeasure and make data-driven decisionsMaintain access to continuous feedbackRequire current data to validate progressSlide9
What Sustainment Strategies Work?
Secure time and resourcesFormalize job responsibilities for patient safety improvement workDedicate financial resources and personnel, including protected time
Make data support available
Take care of your team
Plan for team growth and turnover
Offer highly engaged team members professional development opportunitiesSlide10
We Are Ready To Sustain: Now What?
Readminister Perioperative Staff Safety Assessment (two-question survey) at least every 12–18 monthsLearn from defects at least once each quarter
Share results and stories with frontline staff
Orient all new staff to the
Science of Safety
Continue updating staff on
patient safety activities
Continue collaborative activities
Revisit the “right team mix” and augment needs as team and projects
evolveSlide11
Preview of Premortem2
Looking AheadWhat if your teams’ gains in technical and adaptive work slip away?Why? List all possible reasons for a loss of your hard-earned gains
Review the CUSP
Pre
m
ortem
Tool and
record responsesSlide12
References
North Carolina Center for Hospital Quality and Patient Safety. North Carolina Prevent Catheter-Associated Urinary Tract Infections Collaborative. North Carolina; 2010.Klein G. Performing a Project Premortem. Harvard Business Review. Sept 2007. https://hbr.org/2007/09/performing-a-project-premortem. Accessed Aug 22, 2015.