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Patients and Families- The Center of Care
Sue Gullo, RN, MS 
Managing Director, IHI 
 
Nov 2004Feb 2005Oct 2005Jun 2006
PHASE IPHASE II
AscensionHealthcarestarts their effort withIHI - eightteamsSetonHealthcaretakes thelead
Focus:Reliability andBundle conceptSimulation drillsFinalDeliverablesBeginningsOf a ChangeConceptPackage for OB
•
High Reliability Team Training
•
Primary focus is bundlecompliance for the augmentationand induction bundles
•
Managing first stage of labor 
•
Common language andcommunication skills
High Reliability Teams
Focus on bundle compliance for the augmentation and inductionbundles; introduction of asecond stage of labor bundle
Managing second stage of labor 
Teamwork and communication
Measuring harm reduction
• Premier launchesPerinatal innovationCommunity with IHI•Ten teams – PIMSand Informaticscustomers•March Premier andAscension teammerge
Apr 2006
•
IHIIHIlauncheslaunchesPerinatalPerinatalIMPACTIMPACTComm.Comm.
•
5050TeamsTeams join joinFall 2006
•Premier holdsAdvisor Live callover 2,300 call in•IHI Web andAction 180 teamslearn bundleimplementation
Phase IEnd Phase IILaunce Phase II
Community sizeincreases to 26teamsWhite Paper/various articlesabout the project
History of the Perinatal Improvement Project
 
Reliable designReduce variation
1.Implement the (2) oxytocinbundles and vacuum bundle.2.Use ACOG/AWHONN guidelinesfor documentation.3.Standardize administration of high alert medications- oxytocin,magnesium sulfate, epidurals.4.Design care processimprovements based on triggertool analysis, event detection,sentinel event
EffectiveTeamworkPatient/familyCentered care
1.Effective communication- SBAR,2.Common language such as adoptingNICHD criteria for fetal monitoring3.Establish reliable techniques forhandoffs4.High risk identification andmanagement-such asmultidisciplinary huddles5.Standardize Team Response-drills,simulations6.Establish a just culture.
1.Engage patients & families aspartners in care2.Study patients/familiespreferences such asPatient/Family Focus Groups.3.Transparent care with timelycommunication respectful of patient’s preferences4.Include patients and familieson improvement teams
Primary DriversSecondaryDrivers
Le
 
adership/Sponsor
1.Leadership-help establish aim & goals2.Senior Administration-support, sponsor3.Physical plant and supplies4.Competent trained available staff 
I Perinatal Communityraft 6.12.09Improvereliability of documen-tation to100%MeasureandImprovePatientCenteredCare by25%Reduceharm to 5or less per100 livebirths
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