Integrating Patients and Families on Quality Improvement (QI) Teams

IPRO HQIC

This resource offers guidance to HQIC hospitals and QI coaches on how to include patient and family advisors on hospital quality improvement (QI) teams. The resource will help hospital leaders and staff: (1) understand how patient and family members can contribute to a QI team as an advisor; (2) how to recruit patient and family advisors for a QI team; and (3) how to prepare patient and family advisors to contribute to a QI team.

Stop Sepsis Now

Prepared by IPRO NQIIC

Sepsis is the body’s extreme response to an infection. It is a life-threatening medical emergency.  According to the Centers for Disease Control and Prevention, at least 1.7 million adults in America develop sepsis each year. Nearly 270,000 Americans die as a result of sepsis.

The IPRO QIN-QIO developed the following materials for patients, both in English and Spanish, along with provider-facing resources and training materials.

Joint HQIC Antibiotic Stewardship: Quick Wins for Improving Duration of Therapy – November 8, 2022

Prepared by IPRO HQIC

Antibiotic Stewardship (AS) remains a national priority aimed at optimizing antibiotic use to effectively treat infections, protect patients from harms caused by unnecessary use and combat antibiotic resistance. This event features national antibiotic use and duration of therapy (DOT) trending data, strategies to address AS challenges, examples of best practice to improve antibiotic discharge prescribing, and a hospital’s success with engaging leaders, providers and front-line staff in a hospital-wide initiative to improve DOT and outcomes.

IPRO HQIC December 2022 Person and Family Engagement LAN: Leveraging Lessons Learned in 2022 to Move Forward in Action in 2023

Prepared by IPRO HQIC

The event provides a recap of PFE implementation for the HQIC during 2022 and looks forward to opportunities to implement and utilize PFE in 2023.  The information can help hospitals measure their own progress and set goals for future work in PFE.

IPRO HQIC March 2023 PFE LAN: Reducing Harms Through the Five PFE Best Practices

Prepared by AIR for IPRO HQIC

This learning event focuses on how the PFE Best Practices can be used to partner with patients and designated family caregivers to avoid harms during their hospital stay. Guest speakers share their personal experiences using PFE Best Practices to avoid harms. The event also introduces a new tool to help hospitals apply the five PFE best practices to reducing all-cause harms.

View Slides

Watch Presentation

Connecting PFE Best Practices to All-Cause Harm Reduction

Prepared by AIR for IPRO HQIC

This tool provides a crosswalk of the five Person and Family Engagement Best Practices being implemented by HQIC hospitals with the eight all-cause harms that HQIC hospitals are working to reduce. This tool provides a table of examples demonstrating how each PFE Best Practice can be used to engage patients in actions that contribute to the reduction or prevention of each of the eight all-cause harm areas. Not every hospital may need to apply all five PFE Best Practices to every all-cause harm. Hospitals can identify patients at greatest risk of any harm to prioritize partnership at the point of care (PFE Best Practices 1, 2, & 3). Additionally, harm measurements of concern for the hospital may be the focus of partnership in hospital operations (PFE Best Practices 4 & 5). For user convenience, each Row of the table (showing how a single PFE Best Practice can be applied to all eight all-cause harms) has been separated in Appendices A – H, and each Column of the table (showing how each all-cause harm can be applied to the five PFE Best Practices) has been separated in Appendices I – M.

Connecting PFE Best Practices to All-Cause Harm Reduction

APPENDIX A: SEPSIS

APPENDIX B: CAUTI

APPENDIX C: CLABSI

APPENDIX D: C DIFFICILE AND ANTIBIOTIC STEWARDSHIP

APPENDIX E: ADVERSE DRUG EVENTS

APPENDIX F: UNPLANNED READMISSION

APPENDIX G: PRESSURE INJURY

APPENDIX H: OPIOID STEWARDSHIP/BEHAVIORAL HEALTH

APPENDIX I: PFE 1

APPENDIX J: PFE 2

APPENDIX K: PFE 3

APPENDIX L: PFE 4

APPENDIX M: PFE 5

How to Rebuild, Reengage and Reenergize Your Patient and Family Advisory Council (PFAC)

Prepared by IPRO HQIC

In recent months, hospitals have begun to reengage their Patient and Family Advisory Councils (PFACs) after the adverse impact that the COIVD-19 pandemic had on their healthcare systems, including the ability to have in-person PFAC meetings. As a result, some hospital PFACs are even better and stronger than ever before. Wills Memorial Hospital, a 25-bed critical access hospital (CAH) located in Washington, GA will present on the rebuilding and reenergizing of their PFAC, identifying and prioritizing several key areas of concern, and implementing projects based on greatest need.

LEARNING OBJECTIVES:

  • Explain the five Patient and Family Engagement metrics and other key measures of the Hospital Quality Improvement Contractor (HQIC) program.
  • Discuss the PFAC infrastructure and the importance of listening to the patient’s voice to improve patient care.
  • Illustrate how one hospital implemented training for the patient care team based on PFAC discussions and how the training has improved quality outcomes.

View Slides

Watch Video

Collection:  Antibiotic Stewardship Guidelines and Algorithms Compendium

Compiled by IPRO HQIC

Urinary Tract Infection – Guidelines

Guidelines for Treatment of Urinary Tract Infections Michigan Hospital Medicine Safety (HMS) Consortium

Urinary Tract Infection and Asymptomatic Bacteriuria Guidance Nebraska Medicine

URINARY TRACT INFECTIONS IN ADULTS Michigan Medicine, University of Michigan

Clinical Practice Guidelines for the Antibiotic Treatment of Community-Acquired Urinary Tract Infections NIH

UTI References

International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update. Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases 

Topic: Urinary Tract Infection (UTI) AHRQ

UTI Toolkit

Toolkit for Reducing CAUTI in Hospitals AHRQ

Appendix K. Infographic Poster on CAUTI Prevention (ahrq.gov)

UTI Clinical Pearls

Single-Dose Aminoglycoside for Cystitis: An Oldie but Goodie – KY Antimicrobial Stewardship Innovation Consortium

Staphylococcus aureus in a urine culture – KY Antimicrobial Stewardship Innovation Consortium

Aminopenicillins for Enterococcal Cystitis: Teaching an Old Dog New Tricks – KY Antimicrobial Stewardship Innovation Consortium

Skin and Soft Tissue Infection

Cellulitis: A Review (JAMA)

Cellulitis: A Review (NIH)

Cellulitis: Information for Clinicians (CDC)

IDSA Skin & Soft Tissue guidelines 2014

Skin and Soft Tissue Infections: Treatment Guidance Jasmine R Marcelin MD, Trevor Van Schooneveld MD, Scott Bergman PharmD Reviewed by: Mark E Rupp MD, M. Salman Ashraf MBBS

AAFP patient education materials

UCSF Medical Center Guideline for the Management of Suspected Skin and Soft Tissue Infections in Adults Original Author(s): Jennifer S. Mulliken, MD and Sarah M. Doernberg, MD, MAS

SHC Clinical Guideline: Outpatient Management of Skin and Soft Tissue Infections

Prophylaxis/SSI

Strategies to prevent surgical site infections in acute-care hospitals: 2022 Update with essential practices. 

Additional guidelines (all adapted from consensus guidelines):

ASHP Clinical Practice Guidelines for Prophylaxis in Surgery.

Stanford Health Care- Surgical Prophylaxis Guidelines

University of Michigan- Surgical Prophylaxis Guidelines

University of California San Francisco- Surgical Prophylaxis Guidelines

ICHE Compendium 2022- Updated Surgical Site Infection Prevention Compendium

IV to PO Conversion

Article – Intravenous-to-Oral Switch Therapy: Overview, Antibiotics, Antidepressants (medscape.com)

Article – (2023) – Switching patients from IV to oral antimicrobials – The Pharmaceutical Journal (pharmaceutical-journal.com) (from the UK)

Guidelines

Galway Antimicrobial Prescribing Policy / Guidelines (GAPP) – Galway: GAPP (megsupporttools.com)

 (2018) Intravenous to Oral Conversion for Antimicrobials (northernhealth.ca)

SHC-IV-to-PO-Interchange-Protocol.pdf (stanford.edu)

A Resource To Help With Changing From IV To PO Antibiotics (idstewardship.com)

Public Health Ontario: https://www.publichealthontario.ca/-/media/documents/A/2016/asp-iv-oral-conversion.pdf

Community Acquired Pneumonia- Updated Recommendations ATS and IDSA 2020

ATS/IDSA Guidelines for Diagnosis and Treatment of Adults with Community Acquired Pneumonia 2019

C. difficile

Clinical-Pearl-CDI-Risk-2.8.23.pdf (kymdro.org)

CDI Prevention Strategies- https://www.cdc.gov/cdiff/clinicians/cdi-prevention-strategies.html

MN Department of Health C difficile guidelines  https://www.health.state.mn.us/diseases/cdiff/hcp/guidelines.html

UC Davis Guidelines 2021  https://health.ucdavis.edu/antibiotic-stewardship/pdfs/cdi_tx_ucd.pdf

University of Nebraska  2021 https://www.unmc.edu/intmed/_documents/id/asp/clinicpath-cdi_final.pdf

UNC Medical Center 2022  https://www.med.unc.edu/pediatrics/cccp/wp-content/uploads/sites/1156/gravity_forms/1-c06e424ddddee8826f29e1bc5926a251/2022/11/CASP-UNCMC-CDI-Guideline_FINAL.pdf

AHRQ  Best Practices in the Diagnosis and Treatment of C difficile 2019  

Management of C difficile in adults: review and comparison of IDSA/SHEA, ESCMID and ASID guidelines

IDSA C difficile clinical practice guidelines in adults: 2021 Update by SHEA/IDSA

February 28, 2023 Joint HQIC LAN – I Want to, I Just Don’t Know How: A Practical Guide for Advancing Health Equity

Prepared by IPRO HQIC

This session will highlight best practices and examples for
successfully implementing health equity strategies within hospital
settings. Rosa Abraha, MPH, Alliant HQIC’s health equity lead, will
address frequently asked questions from hospitals and engage in a
discussion with participants.

Slides

Recording

March 21, 2023, Joint HQIC LAN – Acute Pain Alternatives: The Impact of Avoiding Opioids on Hospital Delirium

Prepared by IPRO HQIC

Join us for this special presentation featuring real-world strategies for preventing hospital delirium! Delirium affects as many as 50% of hospitalized patients over the age of 65. Furthermore, delirium accounts for increased length of stay, hospital readmissions, emergency department visits and institutionalization of older adults. Delirium is often precipitated by opioid use for pain management. Don’t miss this discussion on alternatives, using an example of a successful hospital project. These initiatives will inspire you to take on delirium prevention at your facility!

Slides

Recording

Fall and Injury Prevention: Enhancing Capacity- Reengineering Fall and Fall Injury Programs: Infrastructure, Capacity and Sustainability

May 3, 2023 @ 2:00 pm – 3:00 pm

Prepared by IPRO NQIIC in collaboration with Dr. Pat Quigley

Falls represent a major public health problem around the world and continue to be the most common adverse event in healthcare settings.The IPRO Hospital Quality Improvement Contractor (HQIC), in collaboration with Dr. Pat Quigley, Nurse Consultant, invites you to participate in a patient safety webinar program beginning May 3, 2023.

The Fall and Injury Prevention webinar series features six monthly webinars, each followed by open forum/coaching sessions.

This program is appropriate for direct healthcare providers, managers, administrators, risk managers, educators, and researchers of any discipline who are involved in fall and fall injury prevention programs.

Your participation will:

  • Support organizational systems and teams to expand program infrastructure and capacity.
  • Help you redesign your fall prevention and injury reduction program; Complement your evaluation program; and
  • Provide access to an online learning community to increase exchange of experiences, innovations, and best practice implementations.

April 2023 Joint HQIC LAN – Transitions in Care: Preventing Sepsis-Related Readmissions

April 27, 2023 @ 1:00 pm – 2:00 pm

Prepared by IPRO HQIC

Anyone can develop sepsis, a life-threatening, complex and challenging condition to manage. There are significant human and financial costs associated with it. Every year more than 1.7 million adults in the U.S. develop sepsis, leading to over 270,000 deaths. Roughly 19% of sepsis survivors are readmitted to the hospital within 30 days, leading to $3.1 billion in annual costs. Well-defined systems and processes across the continuum are crucial to delivering the right care at the right time to the right patient.

This event will feature proactive transitions in care and hand-off strategies to the next level of care provider to improve patient outcomes and prevent sepsis-related readmissions. The patient voice will be highlighted via a sepsis survivor story. Key discharge planning, patient and family engagement, health equity, infection prevention and patient education tactics will also be shared.

Learning Objectives:
Through this program, participants will:

  • Review successful care coordination and partnership strategies across the care continuum to prevent sepsis-related hospital readmissions.
  • Explore promising practices for overcoming challenges that affect handoffs to the next level of care.
  • Learn how to engage patients and families as partners and integrate their health-related social needs into the discharge planning process to improve patient outcomes.
  • Hear about a sepsis survivor story.

Who Should Attend:
Nurses, Sepsis Coordinators, Care Coordinators, Front-line and Emergency Department Staff, Infection Preventionists, Clinical and Hospital Leaders, Physicians, Patient Safety and Quality Professionals.

View Slides

Watch the Recording

Opioid Stigma Resources Collection

Compiled by IPRO HQIC

The following are websites where you can find resources related to Opioid Stigma:

Articles:

  1. CDC. “Patients’ Frequently Asked Questions | CDC’s Response to the Opioid Overdose Epidemic | CDC.” Www.cdc.gov, 19 Oct. 2021, www.cdc.gov/opioids/patients/faq.html. Spanish Language version available here.
  2. CDC. “Stigma Reduction.” Www.cdc.gov, 25 July 2023, www.cdc.gov/stopoverdose/stigma/index.html. Accessed 10 Oct. 2023.
  3. IPRO HQIC. “Naloxone Saves Lives – HQIC Resource Library.” IPRO HQIC Resource Library, 20 Sept. 2022, hqic-library.ipro.org/2022/09/20/naloxone-saves-lives/. Accessed 10 Oct. 2023. Spanish language version available here.
  4. IPRO HQIC. “People Matter, Words Matter – IPRO QIN-QIO Resource Library.” IPRO HQIC Resource Library, 28 July 2023, qi-library.ipro.org/2023/07/28/people-matter-words-matter/. Accessed 10 Oct. 2023.
  5. Where Opioid Use Disorder Stigma Comes From and How to Prevent It Opioid Use Disorder Stigma: Causes, Impact, Prevention (healthline.com) 
  6. 4 Factors That Add to Stigma Surrounding Opioid Use Disorder 4 factors that add to stigma surrounding opioid-use disorder | American Medical Association (ama-assn.org) 
  7. Stop Overdose: Stigma Reduction Stigma Reduction (cdc.gov) (PDF flyer REDUCING STIGMA (cdc.gov)) 
  8. The stigma that undermines care The stigma that undermines care (apa.org) 
  9. Stigma: Overcoming a Barrier to Pain Treatment and Addiction Recovery Stigma: Overcoming a Barrier to Pain Treatment and Addiction Recovery | NIH HEAL Initiative 
  10. Substance Use Disorder Stigma: What it is and How You Can Prevent it Substance Use Disorder Stigma: What it is and How You Can Prevent it | USU 
  11. Punishing Drug Use Heightens the Stigma of Addiction Punishing Drug Use Heightens the Stigma of Addiction | National Institute on Drug Abuse (NIDA) (nih.gov) 
  12. Medical Stigma and Patients with Substance Abuse Disorder Medical Stigma and Patients with Substance Abuse Disorders | Psychology Today 
  13. Panel Discussion: Stigma Around Opioid Use Disorder Presents Challenges to Treatment Stigma Around Opioid Use Disorder Presents Challenges to Treatment | The Pew Charitable Trusts (pewtrusts.org) 
  14. Stigma of opioids a hurdle to solving crisis Stigma of opioids keeps users from seeking help, taints views of medical professionals – Harvard Gazette 
  15. Why Opioid Addiction Should Be Viewed-And Treated-Like a Chronic Disease Opioid Use Disorder: Managing Stigma & Treatment | The Well by Northwell 

Blogs Posts:

  1. Part 1: Guiding Principles for Addressing the Stigma on Opioid Addiction Guiding Principles for Addressing the Stigma on Opioid Addiction | Bloomberg American Health Initiative (jhu.edu) 
  2. Part 2: A Roadmap to Reduce Stigma on Opioid Addiction A Roadmap to Reduce Stigma on Opioid Addiction | Bloomberg American Health Initiative (jhu.edu) 

Journal Articles:

  1. Confronting the Stigma of Opioid Use Disorder- and Its Treatment Confronting the Stigma of Opioid Use Disorder—and Its Treatment | Substance Use and Addiction Medicine | JAMA | JAMA Network 
  2. Social Stigma Toward Persons with Prescription Opioid Use Disorder: Associations With Public Support for Punitive and Public Health-Oriented Policies Social Stigma Toward Persons With Prescription Opioid Use Disorder: Associations With Public Support for Punitive and Public Health–Oriented Policies | Psychiatric Services (psychiatryonline.org) 
  3. Portraying mental illness and drug addiction as treatable health conditions: Effects of a randomized experiment on stigma and discrimination Portraying mental illness and drug addiction as treatable health conditions: Effects of a randomized experiment on stigma and discrimination – ScienceDirect 
  4. The Impact of Stigma on People with Opioid Use Disorder, Opioid Treatment, and Policy The Impact of Stigma on People with Opioid Use Disorder, Opioid Treatment, and Policy – PubMed (nih.gov) 
  5. Stigma, discrimination and the health of illicit drug users Stigma, discrimination and the health of illicit drug users – PubMed (nih.gov) 
  6. The role of stigma in U.S. primary care physicians’ treatment of opioid use disorder The role of stigma in U.S. primary care physicians’ treatment of opioid use disorder – ScienceDirect 
  7. Addressing Bias and Stigma in the Language We Use With Persons With Opioid Use Disorder: A Narrative Review Addressing Bias and Stigma in the Language We Use With Persons With Opioid Use Disorder: A Narrative Review – PubMed (nih.gov) 
  8. Opioid use-related stigma and healthcare decision-making Opioid use-related stigma and health care decision-making – PubMed (nih.gov)