Reducing preventable harm to patients has been the primary focus of the healthcare risk management and quality professionals at AEIX from the start. Partnering with member hospitals to develop innovative patient safety initiatives and implement quality improvement measures has resulted in improved clinical outcomes while significantly reducing liability risk.
Along with the expertise of the AEIX risk consultants, AEIX patient safety improvement collaboratives provide our members with the resources and support they need to overcome barriers and deliver tangible quality improvement for their patients and their organizations.
Our recent projects include:
Premier AEIX Perinatal Improvement Collaborative
The Premier AEIX Perinatal Collaborative is a 24-month initiative designed to support and augment AEIX hospitals’ current perinatal safety goals and regulatory requirements, not to add additional goals to staff who are already low in resources. The goal of the project is to improve outcomes, efficiency of care, and the patient/family experience through alignment with national, evidence-based practice standards, as well as other national, state and regional perinatal safety initiatives. The project is scheduled to launch June 1, 2019 and conclude May 31, 2021, with a 10-hospital cohort of AEIX member hospitals, funded by AEIX.
The project will begin with an onsite Perinatal High Reliability Assessment. Using the findings from that assessment, a customized roadmap to improvement will be developed by Premier Perinatal Collaborative Performance Partners and the hospital teams themselves, so the improvement plan is relevant to that hospital’s goals and culture. The Premier team will provide monthly improvement coaching, and the teams will receive quarterly quality dashboard reports. These reports will provide a comprehensive analysis of the organization’s key perinatal and neonatal data sets, including comparative peer benchmarking quality and outcome reports. This dashboard provides collaborative members with cutting edge information, resources and analytics to support their efforts to reduce perinatal mortality and morbidity as well as to comply with regulatory reporting requirements.
The collaborative will host four educational events per year, providing actionable and scalable information which can be readily applied to clinical improvement plans. Members of the collaborative will have access to the Premier Connect Perinatal Safety Community, an online platform to support networking, knowledge sharing, and dissemination of evidence-based guidelines. A follow-up onsite Perinatal High Reliability Assessment will take place toward the end of the second year, to identify improvements and recalibrate ongoing organizational patient safety goals.
Vaginal Delivery Safety Checklist Collaborative
With partial support from an AEIX risk management grant, AEIX member Texas Health Resources developed a Vaginal Delivery Safety (VaDS) Checklist as part of a cutting-edge quality program. The Checklist has been shown to result in more frequent and earlier identification of the risk of three obstetrical emergencies: shoulder dystocia; postpartum hemorrhage; and neonatal resuscitation. While the tool was not designed to prevent the occurrence of such emergencies, improved situational awareness in the identification of potential risks and enhanced teamwork when responding to emergencies have the potential to result in improved outcomes.
The “Vaginal Delivery Safety Checklist: Teaming Up for Safe Deliveries” AEIX quality improvement collaborative launched in January 2017 with fourteen hospitals in five states. AEIX sponsored this improvement project to spread the use of the checklist developed by THR as a best practice across the AEIX membership. Along with support in the implementation of the checklist, this AEIX quality improvement project provided frequent web-based education to improve management of common obstetrical emergencies, promote earlier identification of at-risk patients and signs of clinical deterioration; and provide resources to support the teams’ OB improvement endeavors.
The AEIX consulting team collaborated with Premier Performance Partners to perform onsite targeted OB readiness assessments and simulation training focusing on team skills training based on TeamSTEPPS principles. This improvement concluded in August 2018. Hospitals interested in implementing the checklist or receiving onsite risk and/or readiness assessments, or simulation training in clinical or team skills, can contact Rebecca Price, CPPS, CPHQ, AEIX Claims and Quality Improvement Project Manager, at (858) 334-9504 or Rebecca_Price@Premierinc.com.
Perinatal Safety Initiative
The Premier Perinatal Safety Initiative (PPSI), 2008 – 2014, was launched to: 1) create high reliability in labor and delivery processes; 2) improve compliance with specific evidence-based interventions; (3) eliminate the incidence of preventable perinatal harm; and (4) reduce malpractice claims and payouts. AEIX created the project and funded the work for the first two years. In 2010, the project was awarded an AHRQ Patient Safety and Medical Liability Grant to continue through 2013. The improvement collaborative provided the hospitals with a baseline and follow-up High Reliability Perinatal Safety Assessment, consisting of a two-day onsite assessment with a report identifying risk exposures with recommendations for improvement and benchmarking of safety and reliability processes.
The hospital teams were provided with education and resources to improve the safety and reliability of their perinatal units, including clinical bundles, standardized communication and teamwork training, and EFM training using NICHD terminology. The participating AEIX member hospitals reduced total adverse events impacting mothers and neonates by 14.4 percent, outperforming a set of comparison hospitals. They also lowered birth trauma incidents by 15.7 percent, maternal and neonatal deaths by 20 percent, and maternal harm by 20 percent. More detailed information regarding the interventions and outcomes of the PPSI can be found in the PPSI Whitepaper published May, 2014.
AEIX provides consulting services to assist hospitals in evaluating and benchmarking the perinatal services program and can help develop and manage perinatal quality improvement programs. Every hospital that offers obstetrical services could benefit from the risk assessment and benchmarking available through the AEIX High Reliability Perinatal Safety Assessment. Contact Rebecca Price, AEIX Claims and Quality Improvement Project Manager, at (858) 334-9504 or Rebecca_Price@Premierinc.com.
Emergency Department Safety Initiative
The Emergency Department Safety Initiative (EDSI), 2010 – 2013, was a collaborative designed to improve treatment outcomes through the use of evidence-based diagnostic protocols in the ED while also lowering financial risk exposure. The initiative focused on management of two high-risk clinical conditions in the ED: chest pain and abdominal pain. Hospitals that collaborated in the initiative were provided with collaboration resources and education, and experienced a significant reduction in claims frequency arising from the ED. Download our July 2015 whitepaper.