North Carolina Surgical Care Improvement Project (NC SCIP) Collaborative Overview

Purpose:
To assist North Carolina hospitals in reliably implementing the components of the Surgical Care Improvement Project (SCIP).

Partnerships:
Partnerships are used to support all the aspects of the collaborative. Partners contribute resources and/or expertise unique to their organization. Year one of the collaborative was led by the NC Center for Hospital Quality and Patient Safety (Quality Center) in partnership with the Carolinas Center for Medical Excellence (CCME), NC Area Health Education Centers (AHEC), Southern Atlantic Healthcare Alliance (SAHA) and the NC Chapter of the American College of Surgeons (NC ACS). Partnerships are currently being determined for year two.

• Comprehensive tool kit to assist the hospital project team with managing the project.
• In-person learning sessions to educate and collaborate with others.
• Use of Performance Improvement Model – rapid cycles of change with identified pilot units/areas to develop a process that is individualized to a hospital’s current systems and processes.
• Project time lines to move the performance improvement process.
• Data collection to demonstrate improvements.
• Aggregate data to understand overall participant progress.
• Secure website to collect data and serve as a resource for all documents and tools.
• Periodic, individual telephone consults to assist the hospital teams in overcoming process barriers.
• Teleconferences to continue learning and drive process momentum. Opportunity to share with larger audiences.
• Physician endorsement to support quality improvement efforts.

• Use of additional performance improvement methods to improve performance reliability and efficiency.
  • Lean- to address optimal performance and elimination of waste in processes
  • Six Sigma- to identify and remove causes of defects and errors in processes
• Optional measurement of safety culture using a web-based administration of the AHRQ Hospital Survey on Patient Safety Culture.
• Education and training on tools to improve culture such as Just Culture and TeamStepps^TM.
• Incorporation of the WHO, Safe Surgery Saves Lives checklist to reduce surgical errors and improve patient safety.

Year One Summary:
During the first year of the collaborative which kicked off in August 2007, hospitals participated and networked through two regional, in-person learning sessions, regular coaching/consultant calls, ongoing list serv discussions, and three teleconferences to share best practices led by the sponsoring organizations and national experts. A resource rich website and data tool has enabled hospitals to accelerate their improvement. Collectively, NC SCIP Collaborative hospitals have experienced a 10% increase in the SIP Optimal Care Score (OC) and an 8% increase in the VTE OC as part of their monthly process improvement efforts.

Year Two Plan:
Planning and recruitment for year two of the collaborative is well underway. The year one celebration is scheduled for September 30^th, 2008 at the Friday Center in Chapel Hill. This event will mark the continuation for current participants and will serve as the kickoff for new hospitals.

In addition to the support and services delivered during the first year of the collaborative, year two will include a greater emphasis on teamwork and communication, just culture, and the implementation of lean healthcare methodology.

The fee to join the NC SCIP collaborative starting in September 2008 will be $500 per hospital. If your organization is interested in participating in year two, or if you would like more information, please contact Dr. Carol Koeble at 919.677.4211 or ckoeble@ncha.org by Aug 1, 2008.

Medication Reconciliation Collaborative Overview

Purpose: To assist hospitals to ensure a process for medication reconciliation for all patients at transition points (admission, transfer and discharge).

Partnerships have been formed and are used to support all the aspects of the collaborative. The partners will contribute resources and or expertise unique to their organization. The collaborative partners include The Carolinas Center for Medical Excellence (CCME), the Western North Carolina Health Network (WNCHN), the Mountain Area Health Education Center (MAHEC), and the North Carolina Center for Hospital Quality and Patient Safety.

An additional partnership has been formed to bring access to this collaborative to eastern North Carolina. North Carolina Center for Hospital Quality and Patient Safety and CCME has partnered with the Coastal Area Health Education Center (Coastal AHEC) and Coastal Carolinas Health Alliance (CCHA). This collaborative is scheduled to start at the end of January 2007.

Using a modified collaborative model, the strategy is to provide national medication safety expertise at an affordable cost and local state level. Collaborative components include:

• In-person learning sessions to educate and collaborate with others.
• Use of Performance Improvement Model – rapid cycles of change with identified pilot units/areas to develop a process that is individualized to a hospital’s current systems and processes.
• Project time lines to move the performance improvement process
• Data collection to demonstrate improvements.
• Aggregate data to understand overall participant progress.
• Secure web site to collect data and serve as a resource for all documents and tools.
• Individual telephone consults to assist the hospital teams in overcoming process barriers.
• Teleconferences to continue learning and drive process momentum, opportunity to share with larger audiences.

Tools include a comprehensive tool kit to assist the hospital project team with managing the project. The tool kit contents include:

• Introduction
• Assessment
• The Project: Project management strategies
• Performance Improvement
• Secure monthly on-line data collection
• Spreading and Formalizing the process
• Reference

These collaboratives last twelve-months and begin with an all day learning session. There are four teleconferences and scheduled consults for each hospital throughout the year. Confidential written mid-term and final reports, outlining the collaborative activity, are produced for each hospital.

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