This material was prepared by American Institute for Research (AIR), partner in the IPRO Hospital Quality Improvement Contractor Program (HQIC).
Racial, ethnic, and socioeconomic disparities in hospital safety and quality outcomes demonstrate that care is not equitable across all populations. The Centers for Medicare & Medicaid Services (CMS) and the HQIC program recognize that Person and Family Engagement (PFE) is a promising mechanism to help hospitals achieve equity in both quality and safety.
This document outlines strategies and addresses barriers to guide hospitals in meaningfully engaging patients and families in health care. Each strategy is mapped to the five HQIC PFE practices and offers tactics to help hospitals operationalize efforts to achieve equity in care quality and safety through equitable PFE.
IPRO & Telligen Hospital Quality Improvement Contractors (HQICs)
The LAN included:
- A presentation of aggregated results from the IPRO & Telligen HQIC Hospital Baseline Assessment specific to pressure injury
- An interactive discussion with quality and performance improvement subject matter experts on pressure injury identification, prevention, and management.
Attendees had the opportunity to discuss:
- Pressure injury challenges in small rural and critical access hospitals (in general and with COVID-19)
- Approaches to overcome these challenges, including patient and family engagement and health equity strategies.
Hospitals left “in action” with a variety of strategies and 17 salient resources for the front-line to further efforts in All-Cause Harm (Pressure Injury) prevention and management.
American Hospital Association (AHA) Institute for Diversity and Health Equity (IFDHE)
To support hospitals and health systems starting from different points on their journey to achieve health equity, the AHA’s Institute for Diversity and Health Equity (IFDHE) is releasing a series of toolkits to share evidence-based practices to inform organizational next steps for the following topics:
- Data collection, validation, stratification and application of patient information to address disparate outcomes
- Cultural humility and implicit bias training and education
- Diversity and inclusion in leadership and governance roles
- Sustainable community partnerships focused on improving equity
Each toolkit is designed to be informative, whether organizations have already deployed health equity tactics and strategies or if they are at the early stages of implementation. Each helps lay the groundwork for an in-development equity roadmap to support hospitals’ and health systems’ efforts toward achieving high-quality, equitable care for all. This toolkit focuses on training and education strategies and approaches to encourage cultural humility and overcome implicit bias.
Centers for Disease Control (CDC)
Provides information on the basic principles and interventions recommended for the prevention of Clostridioides (formerly known as Clostridium) difficile infection (CDI) in acute care facilities. The strategies are intended to facilitate implementation of CDI prevention efforts by state and local health departments, quality improvement organizations, hospital associations, and healthcare facilities. Core strategies for the prevention of CDI in acute care facilities include:
1. Isolate & Initiate Contact Precautions
2. Confirm CDC in Patients
3. Perform Environmental Cleaning
4. Develop Infrastructure
5. Engage the Facility Antibiotic Stewardship Program
Centers for Disease Control (CDC)
CDC’s Still Going Strong campaign speaks directly to older adults, age 65 and older, and their caregivers. We want to raise awareness about preventable injuries among older adults. This campaign has two goals:
- Educate about common risk factors for falls and motor vehicle crashes, as well as traumatic brain injuries that happen from falls and motor vehicle crashes.
- Empower older adults and their caregivers to take simple steps that will help them maintain their independence and age without injury.
Resources, videos, ads and social media:
- Older Adults: Information for adults age 65 and older on how to age without injury.
- Caregivers: Information for caregivers to help your loved ones age without injury
- Healthcare Providers: Information for healthcare providers to help your older patients age without injury.
A CDC report has found that unintentional falls are the cause of more than 90% of emergency department visits in adults aged 65 years or more.
European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance
In 2019, a full set of Clinical Practice Guidelines were developed, by the European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guidelines, The International Guideline and can be purchased for a fee. In addition, a Quick Reference Guide (QRG), which provides a summary of the recommended guidelines can be downloaded for no charge.
Hospital and Healthsystem Association of Pennsylvania (HAP)
- Overview: Pressure Injury Prevention and Treatment in the Acute Care Setting
- Overview: Pressure Injury Prevention and Treatment in the Acute Care Setting: It Takes a Village
- Overview: Pressure Injury Prevention and Treatment in the Acute Care Setting: Prevention of Pressure Injuries
- Overview: Pressure Injury Prevention and Treatment in the Acute Care Setting: Treatment of Pressure Injuries
- Overview: Pressure Injury Prevention and Treatment in the Acute Care Setting: Measuring Performance
- Overview: Pressure Injury Prevention and Treatment in the Acute Care Setting: Process Improvement
Note: In 2019, a full set of Clinical Practice Guidelines were developed, by the European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guidelines, The International Guideline and can be purchased for a fee. In addition, a Quick Reference Guide (QRG), which provides a summary of the recommended guidelines can be downloaded for no charge.
Please refer to the most updated guidelines for clinical practice.
Citation: European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers/Injuries: Quick Reference Guide. Emily Haesler (Ed.). EPUAP/NPIAP/PPPIA: 2019.
American Institutes for Research (AIR) and IPRO Hospital Quality Improvement Contractor (HQIC)
The American Institutes for Research (AIR) and the IPRO HQIC hosted the March 2021 Patient and Family Engagement (PFE) webinar, titled Partnering with Patients and Families During the COVID-19 Pandemic.
During this 45-minute interactive event, the AIR team provided an overview of five PFE best practices and described how engaging patient and families can help both patients and clinical staff address the emergency. The event featured real-world examples of how hospitals are partnering with patients and families during the COVID-19 pandemic. The event will include time for a discussion among attendees about opportunities and lessons learned in partnering with patients and families around this all-consuming crisis.
March 30: Partnering with Patients and Families During the COVID-19 Pandemic – IPRO QIN-QIO
Centers for Disease Control and Prevention (CDC)
This interactive, web-based training features self-paced learning, case-based content, knowledge checks, and integrated resources to help healthcare providers gain a deeper understanding of the CDC Guideline for Prescribing Opioids for Chronic Pain. Find tips on implementing the Guideline in primary care practice and overcoming challenges. Earn free CE.
Center for Disease Control and Prevention (CDC)
Clinical practice guidelines encourage use of the PDMP prior to prescribing to assess a patient’s history of controlled substance use. It is possible to improve the way opioids are prescribed, reducing the number of people who misuse, abuse, or overdose from them, while making sure patients have access to safe, effective pain management. A prescription drug monitoring program (PDMP) is an electronic database that tracks controlled substance prescriptions. PDMPs can help identify patients who may be misusing prescription opioids or other prescription drugs and who may be at risk for overdose.
North American Thrombosis Forum (NATF)
The North American Thrombosis Forum is dedicated to saving lives through education and prevention. A major part of this is helping healthcare professionals stay up-to-date on the latest research in the rapidly changing field of thrombosis. Through educational events and informative articles geared specifically towards clinicians, NATF provides clinicians with the information they need to best treat their patients. Topics covered include thrombosis, stroke prevention, atrial fibrillation, diabetes, cardiovascular-related illnesses, and more. Check back regularly for important updates on everything from the development of new medications, to the release of novel research.
The Joint Commission: Sentinel Event Alert
While DOACs offer ease of use to patients, stopping bleeding events in patients on DOACs is more complicated, requiring different strategies than those for patients on warfarin (Coumadin®) and heparin. Unlike the more widely available reversal agents for warfarin and heparin, reversal agents for DOACs are lesser known and may not be available in every care setting. Also, some DOACs have no FDA-approved reversal agent at this time. Therefore, bleeding complications can be severe if these patients are not assessed according to guidelines on the management of DOACs. Intracranial hemorrhage is the most serious emergent bleeding risk.
In response to an increase in adverse events related to these widely prescribed medications, this alert provides guidance on the safe use and management of DOACs to all medical practitioners and health care organization leaders, particularly chief medical officers, pharmacists, emergency department clinicians, and quality and safety officers.