Facility Informational Webinar Option B

Male:Excuse me, everyone. We now have all our speakers in conference. Please note that participation on this call is by expressed written invitation from the AHA for AHA members only. Unauthorized participants and/or any party that aids an unauthorized participant may be subject to criminal and civil penalties under both states and federal law, including the Electronic Privacy Act.

Please be aware that each of your lines is in a listen-only mode. At the conclusion of today's presentation, we will open the floor for questions. At that time, instructions will be given [as to the 00:00:29] procedures to follow if you would like to ask a question. I would now like turn the conference over to Helen Plass. Ms. Plass, you may begin.

Helen:Hello, everyone. Welcome to today's webinar. I am Helen Plass, Program Manager at HRET, and I will be your host. You have logged in to the Cohort 3, Facility Informational Webinar, Option B. By now, you should be logged in and see the presentation materials on your computer screen. Before we begin, a quick reminder that today's call is being recorded and will be available on the project website at ltcsafety.org within 48 hours.

The slides are currently available to download in the discussion area at the left of your screen. We've placed everybody's line on mute, so if you have a question about the materials we are covering today, please use the chat feature to ask questions and we will host a question and answer period at the end of the presentation. Please note that any questions we do not cover in today's live event will be answered in the followup email.

We also ask you to complete a brief evaluation after today's webinar. All feedback provided helps us plan for future webinars. A special note, for everyone joining us today from VHA Community Living Centers, please contact Beth [King 00:01:42] with all of your questions. Beth is the Organizational Lead for all VHA Community Living Centers and will gladly assist you.

Today's speakers are from the National Project Team. They include Marcia Cooke, Director of Clinical Quality, Amanda Wilkins, Program Manager, AJ Rolle, Program Manager, Louella Hung, Senior Program Manager, and me, Helen Plass, Program Manager. At this point, I'd like to hand it over to you, Marcia.

Marcia:Thanks, Helen. As you can see on your slide, here are the various topics that we're going to cover in the next 45 minutes or so. Over the next 45 minutes, we're going to share with you some important elements of the AHRQ Safety Program for Long-Term Care related to healthcare-acquired infections and CAUTI. You're going to hear from several HRET staff regarding the benefits of the program, the approach to education, the responsibilities of the various stakeholders, as well as the key dates. Let's begin.

Looking at why this project matters, there's many reasons that we can site. To begin with, there are anywhere from one to three million serious infections occurring annually in long-term care facilities, and up to 380,000 residents die of these infections. This project impacts residents, families, hospitals, and long-term care facilities.

When you look at healthcare-associated infections in long-term care facilities, the most common are urinary tract infections, lower respiratory tract infections, skin and soft tissue infections, and gastroenteritis. 12% to 30% of residents have a UTI annually, and the population most affected are women.

Infections are among the most frequent cause of transfer and readmission from long-term care facilities to hospitals, suggesting a need for a shared protocol for infection prevention. 25% to 50% of transfers for infections results in a 150,000 to 300,000 hospital admissions each year. The high prevalence of urinary catheters in patients that hospitals transfer to long-term care facilities also suggest the need for a shared protocol for removal of unnecessary catheters prior to transfer.

Our overall aim is to improve the safety and quality of life for residents and their families. When you look at the top causes for rehospitalizations from long-term care facilities, you can see that UTIs account for 28% of the reasons for readmission. [Let's look next 00:04:19] at how this project can be useful in reducing the statistics.

What's in it for long-term care facilities? Well, there's many benefits, but I just want to highlight a few from this list. Certainly, one of the benefits is to improve care, as well as resident and family satisfaction. In addition, involvement in the project will create alignment with the CMS 11th Scope of Work related to reducing healthcare-acquired conditions in nursing homes.

Also, we've recently completed a redesign of our curriculum to better meet the needs of those who work in long-term care facilities. The learning modules are created by [content 00:04:59] experts and are designed to be used for continuing education, orientation, in-service education, [or our 00:05:06] self-learning modules.

The train-the-trainer approach eliminates the need for the facilities to create their own educational materials. Finally, in the next few months, we'll begin offering Continuing Nursing Education credits for several of the learning activities. This is beneficial to those individuals who need continuing education credits for maintenance of licensure and/or certification.

Another benefit is to help facilities avoid penalties for violations of F 315. The F 315 regulation requires long-term care facilities to ensure that each resident's clinical condition demonstrates that urinary catheterization is necessary. In 2013, 15% of long-term care facilities nationally were cited for this violation. So, part of our teaching will include how to recognize when a catheter is needed so that the need can be documented, as well as when to remove the catheter. These are just few of the benefits, as well as the others that are listed on this slide.

The primary goals of our project are to reduce CAUTI and improve safety culture. The models that we use focuses on both the technical aspects of care as well as the [socio-adaptive 00:06:22] elements of culture. The elements of the program are based on evidence-based practices and are designed for the long-term care population.

The secondary goals are to support infection prevention efforts. As we all know, patient care doesn't occur in a vacuum, so as we discuss hand hygiene and other infection prevention principles, the effects may be evident with other infections and conditions at the facility. The same can be said for the safety culture aspect.

The project is really gaining momentum, and we currently have 25 states represented. In Cohorts 1 and 2, there's 223 facilities in 15 states. We don't yet have the number for Cohort 3, but our aim is to represent all 50 states, as well as Washington, D.C. and Puerto Rico. Now I'm going to turn it over to Amanda Wilkins to discuss some specific project goals. Amanda?

Amanda:Great. Thank you, Marcia, and thank you, everyone, for being here today. I'm going to go through some of the project goals here, starting with our clinical interventions and our cultural interventions on how we'll achieve these goals. To achieve the project goals of preventing CAUTI and other infections and improving the safety culture, we'll be teaching you about various interventions and provide you with tools to implement these interventions in your facilities.

For the clinical interventions, we'll be covering information on infection prevention in a long-term care setting, and when to order urine cultures or prescribe our antibiotics. We'll also discuss how these practices influence the transitions of care to and from hospitals. For cultural interventions, we'll be discussing what it means to have a good safety culture and how to incorporate this project into work you're already doing.

We'll also lead you through proven communication exercises that anyone on staff can use to improve your communication with one another, with physicians, and with residents and family members. On the next couple of slides, I will describe some of the upcoming educational events that you'll participate in, should you decide to join Cohort 3.

After you register in the project, the first educational event you'll attend is a learning session. There will be a total of three. Your organizational lead will host these meetings, one at the beginning to kick off the project in April, another partway through the project, and a final one at the end.

The first learning session, you'll hear from National Project Faculty about clinical and cultural interventions, more details on the data you'll be expected to collect and submit for the project, and begin planning how you'll roll this project out to the rest of your facility team. You'll be doing this with other facility teams that your organizational lead recruited in the project [so you'll 00:09:15] be able to get to know each other and share ideas with one another as you embark on this journey.

You'll then begin a series of educational activities at the end of April. That's in the chart there that you see. The first four onboarding topics, we'll host a live webinar each week for your facility team lead. This may be you or somebody else that you've identified on the team to be the main person leading and coordinating the project. It also may be, or is likely, an administrator, director of nursing, infection preventionist, or quality improvement person.

The education is designed to teach the facility team lead what they need to know to get started in the project and provide them with the train-the-trainer materials to teach front-line staff what they need to know about the topic and what their role and responsibility is in this. We recognize that it's difficult to pull front-line staff off their shift to attend webinars and that the responsibilities they have around infection prevention and safety culture vary and are different from the facility team lead.

We also recognize that education occurs at facilities in various ways such as in in-services, stand-up meetings, rounds, and daily huddles. Therefore, your facility team leads will have a flexibility to use and customize the training materials that include a [slide set 00:10:39] [with speakers' notes 00:10:39], videos, and activities to educate the rest of their team. Each of these topics is designed to be short for front-line staff. Generally, 15 minutes at the max.

After these four onboarding topics, we'll then move into our training modules. There are four of them. We will provide the facility team lead with a few short videos on each topic. One of the videos will be specifically for the facility team lead for the train-the-trainer materials. The others will be for all front-line staff and the facility team lead to learn about the infection prevention topic and skills related to it.

The next row you see there is the Culture Survey Results Forum. One of the data elements for this project is the nursing home survey on patient safety, which AJ will review soon. You and your facility staff will complete a survey twice. One is at the beginning and at the end of the project. You'll then receive the baseline results after the survey has been completed and we have some time to analyze it. Once the training modules are completed, we'll host one webinar [for 00:11:56] the facility team leads to understand what to do with those baseline results, and how to identify some action steps around safety culture.

For the remainder of the project, the facility teams will participate in monthly content webinars beginning in July. These will cover how to implement various project interventions. These webinars will also be designed with train-the-trainer materials for the facility team leads to use with their front-line staff.

Also, just so everyone is aware, all of these webinars and educational events are recorded and archived on the project website. So, if, for some reason, you have to miss a webinar and you don't have somebody that can back up and support you for that event in particular, you can go back and watch it at any time.

Here's a list of the training topics the Educational Series Schedule will cover, beginning after the first learning session in April. Again, the Onboarding Series is to help you get oriented in the project and understand what you need to know to get started, the Training Module Series is focused on infection prevention practices, and then the other educational events, we would at least like the facility team lead to attend.

Those are monthly content webinars which I had mentioned. Remember, you'll also have two more learning sessions hosted by the organizational lead about midway through the project, and then that final one at the end. The schedule is listed there, too, for the live events, and then the release dates for the Training Module Series.

In addition to the educational support, you'll also receive coaching support. These coaching calls are ... You'll start attending monthly content webinars in July. You'll also start participating in monthly coaching calls held by your organizational lead. This isn't any formal education like the educational topics I had mentioned previously.

Instead, these calls are for you and other facilities that your organizational lead recruited to review data as a group, to ask each other questions about how things are going in the project, and to share how facilities are using the project education and resources. You'll be able to learn from each other about best practices or share challenges and successes as we go along.

Every call will have an assigned faculty coach from our National Project team that has expertise in infection prevention and safety culture in long-term care settings. You'll also have an advisor from HRET such as Justin, Rachel or Ashley that you see on the right to answer any general operational questions in the beginning as you get started.

Just to summarize everything I have spoken about here, we [give you 00:15:07] the education sessions and coaching support to help you achieve these project goals. In addition to those resources, your organizational lead will be your point person who is managing the project for you, checking in and communicating with you about upcoming events and deadlines or any data elements that we are wanting to focus on.

You'll also have access to the project website, which is ltcsafety.org. It will ask you for a user name and password. Both of them are ltcsafety, as listed there, and it's all lowercase. The website has useful pages like an online calendar of educational events with registration information for Cohort 3.

You can take a look at that if you are unsure what the events are. We'll also post tools and resources like pocket cards on the signs and symptoms to look for when diagnosing a CAUTI, infographics you can print to hang on your walls, and brochures to use when talking to residents and families about antibiotics.

As I mentioned, we archive all the webinars we host like this one on our website. It includes the slides, the recording, evaluation results, any handouts, and all of these things are available within about 72 hours after the event. You can share those slides or recordings with any other colleagues or administrators if they couldn't make today's webinar.

We'll also provide the organizational lead with weekly newsletters that remind them of any upcoming deadlines, webinars, or useful resources, making it very easy to keep track of what you need to be doing by when. Your organizational lead may also share those with you. I mentioned each of you will be assigned a coach from the National Project team for the coaching calls and learning sessions to support you in implementing the clinical or safety culture questions you have about the project as well.

Finally, you'll have data support, whether it's general technical assistance to specific questions about databases or the surveys that you'll be implementing. With that, I think this is a great segue to turn the presentation over to AJ who will review some of these data elements and how you'll track your progress towards achieving these project goals.

AJ:Thanks, Amanda. Good morning everyone, or, I guess, good afternoon, depending on your time zone. Before I talk about measuring progress, I just want to quickly summarize what we've discussed so far. Marcia discussed the potential impact of this project and also identified their overall program goals. Reducing CAUTI and improving safety culture are our two primary goals, as well as providing support on [expanded 00:18:00] infection prevention efforts for [inaudible 00:18:02], UTIs, and other HAIs.

Then Amanda just outlined the different interventions and education that we're providing to achieve these goals. So, the clinical interventions, outlining things such as catheter management, antibiotic stewardship, and CAUTI prevention, and then a cultural intervention. So, how to improve teamwork, communication, and resident safety in your facilities.