(精选)Using simple interventions to make significant improvement in Acute Kidney Injury outcomes教学课件.pptVIP

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2018-03-21 发布于天津
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(精选)Using simple interventions to make significant improvement in Acute Kidney Injury outcomes教学课件.ppt

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‘STOP AKI’ PROJECT- Driver Diagram Project: “STOP AKI” – Acute Kidney Injury Mortality Monthly Leadership Report: 8th March 2014 Sponsor: Mr Richard Ward (interim Medical Director) IA: Dr Peter Chamberlain, THF/IHI QIF pchamberlain@ihi.org TEAM MUSIQ SCORE: 108 (Max 168) UHA Core Team Dr T Chandrasekar(Neph Cons/Lead) Dr Asheesh Sharma (neph cons/ lead) Alistair Leinster (directorate manager) Lucinda Tennant (Business Intelligence) Heather Sullivan (Junior doctor) Salim Hammad (Junior doctor) James Master (Junior doctor) Clair Reeder (medical Student) What are we trying to accomplish? Reduce the 30 day mortality in AKI and LOS in AKI across the trust by 30% from 2010/13 baseline over a period of 12 months from October 2013 Why is it Important to work on now? UHA Mortality AKI non-renal wards 3x that of renal wards (29% vs 9%) Length of stay for AKI 7x that of trust average AKI represents 1.3% UHA discharges but 21% of UHA deaths One of 4 key mortality work streams for UHA. UHA under mortality scrutiny Recent critical incidents highlight the urgency Business Case: Reduction of AKI LOS non-nephrology wards AKI LOS of nephrology ward represents a sum of ￡1.21m /year to the trust in cost/bed days. Baseline measures affirmed. Process measures commenced. Testing has commenced. Process mapping complete. Next Steps: To reach score of 3.0 Monthly streaming of all measures Increase in testing @ front line with patients Anecdotal evidence of improvement Barriers and Specific needs from Sponsor: It is clear that the core team do not have dedicated time for this project. This is a major challenge for the trust if it believes in increasing capacity and capability for quality improvement. The team have identified key cultural barriers within junior doctors to change in respect of mortality work streams Changes Currently Testing/tested AKI Risk Trigger Campaign AKI diagnosis alert tool AKI Bundle efficacy Staff awareness strategies Medication chart alert Pati