CLARION Competition Presentation 2013

welcome to the presentation of the MIzzou victorious teams Clarion competition presentation this is really quite a treat to be able to say victorious team in there Im Dr. Myra Aud from the Scool of Nursing and i’m one of the faculty who were in
the background cheering them on Suzanne Boren is here, my other colueges are Dr. Kristofer Hagglund and Dr. Amanda Allmon uh… didn’t have a lot to do did we Sue? were just sort of the cheering section for these but who i really want to introduce you to today, are the members of the victorious team Scott and Terri and Sabrina and Kaci and together they took a complicated case provided by the competition competition organizers did the analysis went to Minneapolis presented the analysis and recommendations for a solution to a complex case with implications for patients safety, and quality of practice to a panel of judges and brought home the first place honors now what can i say, just really great stuff Clarion began just as a local competiton
in Minneapolis an the University of Minnesota but in 2005 it went national with universities sending teams, one team per university the team always includes someone from medicine, and someone from nursing the other two team members, its always a four member team are from allied health professions this year from public health and from health management
informatics for us which i think is a very great matchup given this case so the team has done their work the presentations has happened and i’m going to sit down and give the microphone to them because that’s who you want to hear from who starts? okay, this is Terri Hi, and welcome thank you so much for coming
today to hear our presentation over the next twenty minutes our inter-professional team is going to present to you our recommendations for reducing COPD readmission
to our local hospital, we were given a fictitious hospital in ohio called Odenia we were given a case study as for the
other nine universities what about that nine universities and we’re going to
embarrass as most embarrassing medicines from the hospital third and four k scenarios uh… of situations with an offer of
help patients were having their care delivered saboteur given me uh… opportunities develop
what you’re going to see today we’re getting twenty minutes to present this lady equal ourselves and we presented as in front of an panel
of judges senior house executives from across the country once and that’s the top for demand that
afternoon anymore cynicism we had a more members
of the land anymore there was a wonderful experience wonderful team
members with israeli there isn’t a lot of work that is the word itself the
clarion has a wonderful organizations superstar reason peace now so it was an issue today recommendations and play and force you listen reduction
strategies plays an overview representation already
introduced the problem the u_n_ root cause analysis i recommended interventions i had so
analysis and their conclusions so why are we here today uh… dennis penman noted by our chief
executive officer that we had twenty five percent retention rate in our
community hospital julia in ohio uh… of for ceo beating remissions silicon breast to recommend beckon interventions release of their
aluminum is great c_n_b_c_ has a chronic obstructive
pulmonary disease as the family and i think that the united states and by
twenty thirty eight predicted to be that there is a public health global problem fifty percent of policy l_p_d_ lessons
are available through the care transitions the u_s_ affordable care act twenty ten
has good for us to see a message is the centers for medicare and medicaid angry uh… custserv diagnoses right now
hospitals are being penalized forever when faced with the admissions
for netanyahu thank you and i n_c_-seventeen jessica cellular it for
granted edcia deal will be one of those next
selecting conditions lastname byron recommended minimum
student who is constantly being penalized finances the initial here
doing anything in the hospital aggressiveness in as many as we had his
health as well as the family some statistics about community hospital uh… by hastily nad twenty five percent
still believe their delivery is missing great the national average is twenty one
percent and for those of the cases in the
patients coming to the emergency department ten percent as halcion p_d_
diagnosis with teams and politicians are awful had
implemented diagnosis now ten dash sincerely guidelines call
inter-lining guidelines and that sense of local initiative obstructed lung
disease metals and what was being done we’re
finding and we’ll talk more about that at the guidelines are not involved in
our community hospital so i am saying that this reduces that
meeting thirty minutes away from twenty-five percent to twenty percent within one year
through the implementation of hour recommended interventions so that’s why i was traced the c_r_b_
cyclic coming with his medications experiencing
here in a hospital nothing like that program i was a
exacerbates the other side of the disease when patients having more
trouble breathing andy green lines that are being
mentioned says you can see where having dean bedtime standards and he’s a very
short and fragrance exaggerations along with uh… hostile
witnesses that entrance date fee for the future of this nobody can
make this is the rivers and this is a very severe disease and want to see you that the other interventions relented timeframe between households and headed for the long run
for the patient and family surrounded half of the reasons they’re
and she’s going to talk about the cause and houses out a set out on the senate has not
silenced it likes to identify teaching packaged issue catch either secular state fish and i didn’t
see on the side and the way that we can set it aside and
is needed i had to have your village here to identify problems that you did you
see on t_v_ that he gave me admissions we came up with automated highway system
vacation factors go better factors system that is in hospital backers arledge contributors the admissions
letting adhesion factors they found a sentence and realization of primary care
physicians hamlet on occasions often lack the education to fully understand and managed to
disease looking at a better factors rebounding
such as poor communication between buyers as well as i have a chance to
this whole guidelines sisson factors include things such as
flat integrated electronic health record system uh… fragmented care quick transition
to care environment behind so actors and you
seem to me and she found the day’s top in guatemala education as
well as poor discharge planning so that’s that was using contact method
as you see here he and missus are different from the
first and has been really looked at specific details of the case because that is used to identify
cause-and-effect relationships and as you know every black boxes here
on the left side goes out of hospitals which include
functional sets quite like inefficient use of resources immune cells that might negatively
impacted by sufi thirty day of the admissions anderson areas and i was a tremendous
charities that provides a lot so i just want to see my example and he’s not
dealing with this methodology was and i think one of the lack of
competency letter seeking an impact situations
ability to solve monsoon alliance up wanting to maintain and on missile
importance insensitive treatment plan there’s too many we encountered
functional sentencing awesomely uh… and out and result in addition to being rate
limited to the hospital so don’t identify at the root cause
specifically that he made missions haha so i want to discuss the solutions to
address those problems on the right side of the screen you see
interested i didn’t in this is what do you assume compared
to balance it impacts and i are considered recommendations and responses
from the last will be a massive resources requires
employment those interventions so these are not as easy recommends implementing
those interventions that have the highest impact in other words those up on the top to
bottom so that you had to diagram is that mentions are undergoing
greenirene include hospital factors such as how i just want to have been sent in
simple miedzian home on singing provided a consensus insuring
compositions a huge issue people guidelines in binary system factors
including creating cvd additional order set pat using better and i’m not trying to help record it anti-community and using the lean six
sigma team that is truly in place in the hospital throughout the implementation
of our recommendations so intense because our home in time that
is that it can be used to identify specific cost-effective decisions that
is also very useful for identifying uh… potential points intervention
services greenbacks is are damages i guess i should issue and the pre inside
enough though you had a nice not that’s it i have no money sitting before so i
was lucky few how those solutions not sent to the problems that we were able
to identify premises losing anything that anyone who
is behind you decide to advocate lavasoft monsooning i have to be addressed i hadn’t seen in
hunting problems better communication comedians through a documentary brotherhood asses and in a community nazi-like practices can improve brazenly
six sigma team throughout implementation of our regulations and
finally do you think your orders can be improved by creating this if you need additional
recessing ensuring that position this year to the growth guidelines serrano himself seem more details on
intervention so we realize how difficult it would be
your financially and logistically to start all these recommendations the same
time and that’s why we have to remember that
he sounded three distinct phases that you can see the woman sits in the
process is actually involved all three phases or thought about why that’s important in
the next life specifically somehow we first recommend
having a discharge advocate also recommend following the gold series
outlines an invasion force that’s used recently
image condition along with early insists it’s in the
process losartan so process and wonder and finally they sorry we also suggests integrating the
electronic health record so for example she discusses thusly
insisting process now the decision is actually watson across all three phases and also
as the combination of both the design implementation primitive inventions idaho immune system it in the process in place and successfully working on things that
just a reminder interest below who haven’t specifically focus on the
security discharge process and really help us to design and implement the
recommendations that we’re talking about over the next several minutes will be by doing this there are also invited deficiencies and
recommendations and also improved efficiency a prospect
list of the entire system through an analysis of the first one we
first recommend having one full-time nurse both altogether discharge advocate fundamental mission already insulting the honor of the time
of discharge recommend that you have to focus on
education communication and discharge planning vocations and
patients medical team recommends the done by utilizing a
discharge checklist which can be found in the image that we put that we could
have just a few always strapless our course several
different items but as you go into what is my blue jacket would make sure that
every patient knows how to properly use all their medicines the navigation knows and this out of the
revolves rosalind that’s because of that he was with some
of the lace index through that i’ve been invited haitians at high risk free
admission this important in the event that we have this time is limited
emotionally focus on the nation’s need help the most so this place and that is that right it stands for them to say it’s really a
mission the number of emily’s energy artisans
within the last six months laziness proposed national slower but
they don’t shout by patients as to the rest of the agreement it as i said daddy you can look at this stage to
cancellation deciding which haitians and you know what was about time so surveys one we also recommend
following the goals you review guidelines char national evidence-based guidelines
for seo image certain parts of these guidelines such as smoking cessation into influenza vaccines of improvements
resort mortality emboli law the total number of religions
all together we suggest is that i’m seeing good and the discharge checklist and the acting within the responsible
for making sure that he completed i would assume shirt leverages a feel of
the most out of state status referendum making mission or sex abuse re-education
comes in with the status of cities observation to those who successfully into that
fourteen it goes out of the moment all sides in
town won the primary care providers one of the doctors as well as the rest were
careless a social workers and one for nurses to the scene and get together will be the most out of space current
guidelines and really devising come up with the
national research that can be used inside asia comes in with us your baby’s
observation over there on the issue of your assessment so it
was pretty limited but just park illinois or said something
about study in both bedrooms original tolley mobility across the entire consultation as well the number of images altogether and that’s why we’re here today reach a set of it worked for the resulted diagnoses
that also workers to be as well similarities to unless arguments are in
the process of inhomogeneous and simply using what’s known as the
whole body system to the subway system is a good amount races in the aim is to
send a perceived to be patience so so so what happens is that they still
have this little hand-held dot com dot lights up their home and there’s a component that patient
interface with the slides no vital signs can also be measured and listening to me send back to decide how to get at the hospital who can answer to this area anxiety for
the mission should be necessary possessor thus eliminate some friends with vital
signs also provided some of the educational
booking as well yahoo ratings is the total cost for this
would be covered from for medicare patients through us and as a community scare
transitions yes right so it is a kind of show you what the salute lifetime around
here is the patient interfaces coalition the rest of the device they come out of the cities like ouaga
shirt off now as you can see here it was awesome
weather to the patient was on the fingered but it will be sent back to you this machine with the oxygen saturation
measured with vincent to discharge after he would
be responsible for delivering the state a and as i don’t know if he died at the
patient is in near out something else source documents and together or the
smile glaxo as a nation myself uh… ambassador for
our skydiving and all i assume you medicines that’s right well no i don’t really have so that a
salvage title will tell us why wife and i was just take a store once a
day or three-man today so i said earlier we’re going to take it all so in that
case i will question this will be sent back to the stars out
that he would of course to come along with this within call me to instruct me on the property my
medicine to both of them for many of the image of the hospital possible today know that i will turn over to casey will
talk about these that high-rate salvation recommends that its
yet into the allocation health record second harkin d i’m trying to do with the recommended
today is the i’ll hop information partnership organising program is a
federally funded program that allows committees and statewide
identities shielded indications information on a single network without
having to overhauls individually justice vintage clinic or hospital so this two million and a providers
hospitals and clinics in the area that we lost providers qualifications rather
tired take care so the benefits of exercise and act like
i said mountains are already choices costly and also increases communications
lessons i guess in here improves coordination to keep the peace
which is extremely important work chronically ill patients especially at
the city so this time i a m just giving you an insatiable we think
is that there was a timeline to implement all of our intervention presidency has dramatically basis and
that means if they’re not as follows the route how we feel that is a very realistic timeline except
where the organization so you are interventions you may want to
make sure that we are catholic high winds sixteens which i think i think
that that’s efficient and we have global patient care we wanted to have a visual show you how
each prayer intentions i really following he sees it seems to
have a specifically addressed those and this will ensure that were not
providing the best i carry my relations and also on evidence-based practices so clemens a financial analysis and give
you some information what we’ve been out of here so what i said i want to be some
financial assumptions it doesn’t actually have an appendix
they would have had all of the calculations for all of this and so this is the briefers what they
had in the appendix so they started i had it often cases in
the early former nation medicare cios vps per year of the purposes of this is
the attachment s if you ever since the ingeniously mission in the national
average what’s your view great missionaries constant coverage here area
party schedule process our savings accelerated the manager and
submit them inside somewhere situations and i’m not
positive rhinestones in order to appears to be done so whatever esquire here at the point of
this is going to provide better care of patients and make sure that they are and preceding it that karen is you know their activity in the best possible but
we also one of the wind potential hudson cmf shipping vizio tv and radio admissions
policy so you can hear it written down
specifically restores your view reimbursements sup anniversary sybase or higher level
of grievances that they would reach that have seen the maximum penalty one
percent which would result in brash inside to
see a few questions exterior managing reinvent himself soon after we were not allowed as though you have a meeting region and
i found out they would get dana hardly a thousand dollars into the
third year damaging three percent maximum they would get me bridges at two hundred twenty thousand
dollars over a three-year period that’s a lot of
almost four hundred or anywhere that mars has tested so that we perceive he
does not taking into account the other actions they would receive should they
have access remissions receipt at m_i_a_ or nano so this is a financial overview and
that’s not to make sure that our intentions are feasible financially for
the organization with what they were dealing with currently so this is just
about our future use adam hochberg explicit whatever it was
his on of the cost for interest in these
interventions to reap the benefits are patients sardine income and assets having
research last year we had hoped the amount of cash are stevenage ratio there not to get a
sense it whereas our position is taken these interventions and really active and actively signifies that house leonidas had always had a recent makes and added to all of the senate to bahut
he points here officer saturday here at the top until israel becasue come from the does not possible turnout that nurse to take on these cases are
based on research to be done but i don’t think that abacha gets more than ten dollars per
patient fire seizure in my absence of sound the cost of medicare patients the civic
unity doubts it’s not really four thousand dollars now if you are right i think that’s
great because that would be covered so there is potential here that that
hostile action easier for medicare patients is typically alleghenies and researching whether and
how much in the prices insistence that we’ve seen begin accessing about two hundred eighty
four dollars per patient hurt you antibody or each other you generation and i don’t hear spots
merit shocking that yes how does it benefit program part of the
greater the receipt of that they can actually case and that is not working
all the clinics all hospitals and listen the physicians bodies anything so
there’s a crackpots back is a six f process to get a separate
removing chimney and they have the funds you copper
cossack he argues that will be assessed in the
hospital uh… wiped out by a man later on in the future generator pieces they’re also missing small he’s out of
twenty five dollars per position per year i was really isn’t that so and i was in charge the hostel itself
very on hot spots and it’s not so much cheaper than over on a huge tax
associate editor who insists after the battle attestation if you got
one million dollars per year community-wide so humans not specific to see if he has
not specific to the hospital as is he’ll i think they should be ecstatic on based on similar research that leave so slightly facts fire intentions across
a seven forty eight thousand hours again has its own were finished
competency honesty has abated stating that we’ve seen here i really think that the costs for the
benefit that newt gets means so in conclusion hiring a professional team has debate
feasible labor management space recommendations that we’re going through
this transition period the handout these patients and families for c_m_v_ also
our entire haitians to control over their health with using emerging device
an overall achieving the goal of reducing underneath you release me from
twenty five percent to twenty percent within a year hitters here in kenya
community hospital assets valued at about specifically
thinking steinbeck began last year pictures especially silent house without
excuse she has a lot of people in parts alive and that you know how everything
so it really really appreciate that and the sunday everyone so thank you art death and i didn’t mention it was their
sentences sound of course is a graduate student id number of school terry graduate students school nursing
casein held demonstrations of the american public health already good
students have been busy with other other celestial owners but reggie what questions do you figures finally refute work ne part accuracy and south carolina university
minnesota at the university of new england now here inside con because peso they’re closed
today seems to not to s_o_s_ try to do anything with this person again he’s like so you know something comments
are coaching we’re online yall riding bases on it was interesting that i really need
people have different answers on their coach different people along
the way celebrate job guys we’re proud of europe you talked a lot about developing this
were set for seo bb digit talking about how you actually get
over the last used there were certain we have a lot of orders that sort of absolutely pristine
condition robert never have a good news summer russian mansur was if which is uh… see marlon studies
were set for the nation’s and uh… we have to save money and make
life easier but then he has all of our patients would improve the patient
outcomes began stress out of the physicians and nurses nursing staff master of the way to make a difference i
think that’s we talk about his investigation that’s
going to have to do and solid seismic changes that yes are just and so in addition to balance it out of
the papers paid for performance in benchmarking as
providers that we’re going to be held to his standards of each other and dennis decide to um… i’m running
into each other’s pearson out pockets might even catch it this is also an ira
distributions but you’ve thrown healthy organization we need to do you
see to that till grady i think the theme here is the eulogy
developed a great product market the product and you’ve got a mark
that internally your providers and give them the reasons
why it’s in their patients’ best interest in their best interest practice the trip and it ended up red that question yes
answer japanese collins stuff something out gets its act together bassam singer
positions that’s reached out to them lesson learned from c_q_ process how on how he you in your injure well and until two months ago so the cause of
bethlehem manifesto so for many towns in the nursing home i
think this is wonderful i’m going to take this uh… other problems within my
practice currently as a nurse practitioner use this to dine and enjoy them because
the syndication factors being spent on a better as well as make a little system
work better so this i have no idea when i was going to
be learning in in in some really good so as a third-year resident in the
finest partner argument improvement project assistant lobbying greatly paper that i think more
importantly from practicing you know i have my own i think is improving like michael reagan
flowing you know sort of nurses dresses that i
think this will go to truly finally gave him a couple of
all that answers will probably do it but i think
this is a good studies on arrival and inside those citations manager reviewers refueled whatever
medium supervisor u without he said it probably won’t matter here you always ritter car somewhere because are yours a and celebrated west asked about and you have to talk about this means
that they actually asset there’s a lot of media does not air pollution and
holly apparently back at the very hot blue
collar new year’s factory workers uh… a lot of smoking math when he talked about that in madison’s lesson in how and where we
understand that manipulate and play media what we’ve got hospital we are high we are seeing what the hell asset plans explicit remotely pack on aren’t at a hospital i think we could
successfully at this the actual t_v_ talkies and wants to get it under control then week pictures currency flood ride that we were just facing on a one-year
timeline and so he said he went down the road we would probably do mornings more key actors uh… pet
programs to address those issues hitchhikers when your time and we transition to a restatement in
just a little early focus that we were here to to reduce thirty two missions
which then i was going to help the entire health system in transitions and
fears and and is intended to professional team
those were kind of a focus of working together while we were actually a lot
investigation dizziness the final for a second day sinn fein around sitting on
the other presentations that we were able to watch anybody’s uh… based on talking to people and aiding right quietly sit and talk about
here at which point one nine it happening very specific real organization talks in manassas aerial and agree on people that that’s uh… i think i don’t know if i had a
variation wanted getting anything else that they didn’t have anything it was the party and that his once this thing animation and i think that renewal and hope that
they found residents want people to come i wasn’t looking i a m criteria that you
would like to you all about azerbaijan you with that flooded there’s no question specifically on to take a look at it training dot
handles back and i think that this combat system has
to have that so far jackets eight nine nine cash that they’re going to using say we treated to stop at that it had been
found to have to put this in success it can be totally at what’s on pieces
they see because we know that there uh… submissions and we don’t have the resources and a half the lifestyles of the score somebody’s
and in fact there is anything specific many cities and really make that case
hugging some blood danticat nervously frequently equivalently confusing i
think i think it would be unique hot i think you know that she was as part of
that responsibilities announced that it was really a sarajevo
over the world and that will include stuff i didn’t
have my own train and so innovations from jack she
interviewed him disgust you know what is all about style
used think that’s uh… all that so that he
has done what we’re going an entire is staff extracting all right excursions you guys allotment uh… producer does go back to you then all this week urine and consider that i was dispute division descended attract lots
of all those things that vision truth what has occurred plus so we were in the case like him in
january and so we met i think once a week for a couple hours each each week and for the first mother how so that was like you know me in a group but
are only out of your own research he pitches identities and outside discussed osama closer in the last month we’ve andreia dot hahaha fellini’s investable
weeks and data relay sometimes we have heard buyers and sellers and i did shaz desk waiting on that which is that as a whole bunch together
you know go into the presentation critiquing each other and back with you
that was really wasn’t helpful family practice listening to the
hospital and presented to a group of their uh… wins include a message with
your christensen nursing heads over there so that uh… you’re going to revisit the issue two or three times so immediate based i
mean i will be denied feedback which i was a tweak this and at really great
experience everybody’s opinion really helped us yes many of these are coming

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