VAP - CRBSI Call to Action - Safer Healthcare Now!

Can you prevent VAP and reduce your CRBSI rates by 50 per cent?Join the National Breakthrough Series Collaborative and we will show you how!A Call to ActionIn partnership with Safer Healthcare Now! (SHN), theCanadian ICU Collaborative is inviting teams from acrossthe country to participate in a new National BreakthroughSeries Collaborative to prevent ventilator associatedpneumonia (VAP) and reduce catheter-related bloodstreaminfections (CRBSI).Enrolled teams will be invited to the first Collaborative LearningSession in Toronto, Ontario on January 15-16, 2009 and will besupported by expert Faculty until December 2009, as they testand implement the latest knowledge available.The ChallengeHealthcare does not always reliably transfer evidence intopractice and processes frequently fail despite the bestintentions of a dedicated and highly skilled workforce. Oursystem, which intends to heal, too often does just the opposite,leading to unintended harm and unnecessary deaths.In addition, Accreditation Canada and provincial jurisdictionssuch as the Ontario Ministry of Health and Long Term Careare committed to improving patient safety through theidentification of VAP and CRBSI as standards of practice orreporting requirements.Every system is perfectly designed to deliver exactly theresults it gets. Better outcomes are not simply a matter ofeffort – they are a matter of design. If we want improvedpatient care and safety then we must change the design ofthe system.The SolutionParticipation in this Collaborative can contribute to theachievement of SHN goals and provincial / organizationalreporting requirements. The VAP-CRBSI Collaborative has thestructure, topic expertise and proven methods and tools tocreate lasting improvement.The Collaborative brings together teams that share acommitment to making significant and rapid changes toachieve results.Benefits of participating• Learn and apply methodology to introduce rapid change• Attend highly interactive learning sessions• Interact with peers and expert Faculty across Canadato test and implement the latest knowledge available• Learn measurement techniques to monitor yourprogress and identify reliable methods for trackingperformance measures• Develop processes to support improvement efforts,applicable to other contexts• Prevent VAP and reduce incidence of CRBSIResultsThe Canadian ICU Collaborative has engaged over 90teams from 50 organizations across Canada in the last sixyears. These teams are getting results! For example:• In Alberta, the Calgary Health Region, VAP rates havesteadily declined. The team’s success in lowering VAPhas resulted in overall improvements in healthoutcomes and resource utilization within the criticalcare units.• South Shore District Health Authority inBridgewater, NS and Valley Regional Hospital inKentville, NS reported 14 months and nine monthswithout an infection, respectively.• Grand River Hospital from Kitchener, ON initiallyincreased their days between VAP infections fromeight to 18 days and recently reported 10 months(November 2006 to August 2007) without an infection.• Kelowna General Hospital (KGH), BC achieved morethan 80 per cent overall compliance with each VAPprevention strategy and reduced VAP rates by 25 percent. KGH recently reported 12 months without a VAP(August 2007 to August 2008). This initiative improvedpatient care, increased access to ICU critical carebeds, and provided significant cost savings to theorganization.• The BC Children's Hospital (BCCH) improved insertionand maintenance practices resulting in a 70 per centdecrease in CRBSI’s over 10 months in 2005. BCCHrecently celebrated 13 months without a CRBSI andare currently at a cumulative CRBSI rate of 0.45 per1,000 line days.• Sir Mortimer B. Davis Jewish General Hospital (JGH)in Montreal, QC implemented insertion andmaintenance bundles and over a 12-month period,achieved 100 per cent compliance with the insertionbundle and had an increasing compliance with themaintenance bundle. This resulted in a zero CRBSIrate for a five-month period.• After introduction of insertion and maintenancebundles, London Health Sciences Centre, ONreduced CR-BSI rates to below two cases per 1,000line days. Education and implementation of VAPbundle resulted in sustained improvement in rates tobelow three infections per 1,000 ventilation days.This Collaborative is financially supported by:

Page 2Teams can expect:• Three face-to-faceLearning Sessions• Evidence-based changesthat are ready to test andimplement• Coaching fromexperienced Faculty onapplication of thosechanges• Education and training ontools for improvement andmeasurement• Advice on targetedstrategies to overcomeresistance and addressbarriers• Feedback on your progressevery month• Monthly conference callsspecific to VAP/CRBSItopics and challenges yourteam is facing• A website for storing andsharing your documentswith others• A comprehensiveImprovement Guide withexamples, checklists, toolsand much more!“Many improvements havebeen made since the lastsurvey, including participationin the critical care CanadianCollaborative and SaferHealthcare Now! This hascontributed to a culture ofsafety, promoted cohesivenessamong members of the nursingteam, created collaborationand monitoring of indicatorsand the development andmaintenance of a scorecard forthe ICU.”- Accreditation Canada report forone hospital“We now have support to goahead and address the issuesbecause someone else is facingthe same. (Being part of theCollaborative) has got rid ofsome of the skepticism.”- Critical Care Physician“We may report results bydifferent sites, but we areworking together. Let me tellyou, this is very exciting tome. Great progress …”- ManagerShould your team join the Collaborative?Teams that join the Collaborative share the followingcharacteristics:• Senior leadership support• Willing to rapidly test and implement localsolutions• Prefer structure and focused deadlines• Actively shares learning with other teams• Ability and financial resources for a partial teamto travel to three face-to-face learning sessionsTeams will work together intensely for 12 months andshare their results and data with other Collaborativeparticipants.CostThere is no cost to enroll and no fees for Learning Sessionsand ongoing support. Conference calls and Faculty supportare provided free of charge for participants. Travel,accommodation and implementation costs are at theexpense of participating centres.Key DatesNovember 18, 20November 28, 2008December 2008One-hour Informational Calls—Watch the SHN Community ofPractice (CoP) for detailsEnrollment DeadlinePre-Work Calls with EnrolledTeamsJanuary 15-16, 2009 Learning Session 1 (Toronto, ON)April 27-28, 2009(tentative)October 2009December 2009How to Join!Can you prevent VAP and reduce your CRBSI rates by 50 per cent?Join the National Breakthrough Series Collaborative and we will show you how!Learning Session 2 (Toronto, ON)— in conjunction with the CanadianForum on Patient Safety andQuality Improvement: A LearningSeries for HealthcarePractitioners and LeadersLearning Session 3 (location TBD)Collaborative completeIf you are interested in learning more about the VAP-CRBSICollaborative, complete an online Expression of Interest.Once the Expression of Interest is received, teams willreceive an Enrolment Package that provides moredetails about Collaborative expectations and outlinespreparation activities for the first Learning Session,including a pre-work call with Faculty and an enrolmentquestionnaire.Contact a member of the Planning and Support team ifyou have further questions.VAP-CRBSI FacultyMs. Paule Bernier P.Dt., MScSir MB Davis Jewish General HospitalMcGill UniversityDr. Paul BoiteauDepartment Head, Critical Care Medicine,Calgary Health Region; Professor ofMedicine, University of CalgaryDr. David CreeryHead, Paediatric Intensive CareChildren's Hospital of Eastern Ontario,OttawaMs. Rosmin Esmail, BSc, MScMr. Gordon Krahn BSc, RRTQuality and Research Coordinator, BCChildren’s HospitalDr. Denny LaportaChief, Adult Critical Care; Director,Respiratory Therapy, Sir MB Davis JewishGeneral Hospital, McGill UniversityMs. Debbie Lynch, RN, ICPEastern Health, St John'sDr. John MuscedereAssistant Professor of Medicine, QueensUniversity; Intensivist, Kingston GeneralHospitalMs. Tracie Northway, RN, MSNQuality & Safety Leader, Critical CareProgram, BC Children's HospitalMs. Kim Rafuse, RN, BN, DOHN, ICPAnnapolis Valley District Health AuthorityDr. Peter SkippenDivision Head & Medical Director,Pediatric ICU, BC Children’s HospitalPlanning and Support TeamDr. Claudio MartinChair, VAP and CRBSI Collaborative Professor,Schulich School of Medicine and Dentistry,University of Western Ontario; AttendingPhysician, London Health Sciences Centredrcm@rogers.com519.685.8090Cynthia MajewskiExecutive Director, Quality HealthcareNetwork and Ontario Node Leader, SaferHealthcare Now!cynthia.majewski@qhn.ca416.351.3761Clara BallantineSafety and Improvement Advisor, OntarioNode, Safer Healthcare Now!clara.ballantine@qhn.ca613.736.9142Bruce HarriesImprovement Associates Ltd.bharries@telus.net780.437.5861Leanne CouvesImprovement Associates Ltd.lcouves@telus.net780.446.9940Ardis EliasonImprovement Associates Ltd.aeliason@telus.net780.298.7875