Smilow Cancer Hospital Town Hall | November 29, 2023

Transcript

• 00:00To get started, just want
• 00:02to say hello and welcome.
• 00:05I'm going to turn this over to
• 00:07Kevin Billingsley and Tracy Carafino
• 00:09in in just a minute, but just
• 00:12want to say I hope everyone had
• 00:13a great Thanksgiving
• 00:15holiday for me.
• 00:17It's always a little
• 00:18painful coming back
• 00:19to work after being away for four days, but
• 00:23the good news is that there
• 00:25are more holidays coming up and
• 00:27that's that's good and that we have
• 00:29a lot of good work to do here.
• 00:31So you know I hope people have
• 00:34a great December as it is about
• 00:36to be December
• 00:37hard as it is to believe and
• 00:41we'll look forward
• 00:42to seeing you again
• 00:42at the next town hall.
• 00:44But in the meantime let
• 00:46me turn it over to to Kevin and Tracy. I know
• 00:48they, they have a pretty
• 00:51busy agenda for today.
• 00:53I don't know which of
• 00:54you is taking this away.
• 00:56Well, Eric, thank you very much.
• 00:58I will jump in.
• 01:00I also want to echo Eric's comments.
• 01:03I hope everyone had a great Thanksgiving.
• 01:06And I certainly reflected on the
• 01:08gratitude I feel not only for my family,
• 01:12but for the good fortune of being able
• 01:15to work with all of my close colleagues
• 01:18here at Smilo in the Cancer Center.
• 01:21December is a busy month.
• 01:23We continue to press ahead
• 01:25with providing excellent care,
• 01:27doing great research and caring for patients.
• 01:32I think about the fact that
• 01:34although it's a holiday month,
• 01:35there are two major oncology meetings,
• 01:39the San Antonio Breast Cancer
• 01:40Symposium as well as ASH,
• 01:42the American Society of Hematology.
• 01:45Both meetings have prominent
• 01:47representation by Cancer Center
• 01:49faculty and Smilo clinicians.
• 01:51You'll be hearing more about that,
• 01:54lots to be proud of.
• 01:55We have a great line up today.
• 01:57I want to really welcome Tracy Carafino
• 02:03who is my DYAD partner these days and our
• 02:07nursing leader to our first DYAD partnership,
• 02:10Town Hall.
• 02:12Tracy, so great to have you.
• 02:13We're also fortunate to have Stephanie
• 02:17McGuire who's with Protective Services
• 02:20and a security Technology advisor.
• 02:23Stephanie is going to take a minute
• 02:26and just just shortly to update
• 02:28us on some new developments that
• 02:31we are putting in place to make
• 02:33care safer both for our patients,
• 02:36families as well As for our
• 02:38clinical teams here in the hospital.
• 02:41Very happy to be having Cory Champow
• 02:44back with us in this town hall.
• 02:47Cory needs no introduction to this audience.
• 02:49She's our System Director of
• 02:51Quality and Safety and she will
• 02:54be sharing some really exciting
• 02:56developments about the SAFER program.
• 02:58Our new safety event reporting platform,
• 03:01Scott Huntington and Michelle Kelvey Albert,
• 03:05are quality and safety leaders.
• 03:08We'll be updating our audience on our
• 03:10quality and safety goals for fiscal year 24.
• 03:13And of course, as always,
• 03:14we encourage participation in
• 03:17our Q&A session to follow.
• 03:20This is a town hall and we really
• 03:23welcome participation.
• 03:24So Stephanie,
• 03:26maybe why don't I kick it over to
• 03:30you for your update and then I will
• 03:33provide another announcement and
• 03:34then we'll turn it over to Tracy.
• 03:37Sure. Thank you, Kevin.
• 03:38So hello everyone.
• 03:39My name is Stephanie McGuire Abate
• 03:41and I am the Security Technology
• 03:43Manager for Yale New Haven Hospital
• 03:45and I work here in the East Pavilion
• 03:48in at the York Street campus.
• 03:50So I want to thank Sonia for
• 03:53inviting me to the meeting today.
• 03:54I know that she's been in correspondence
• 03:56with some of you at a high level
• 03:59regarding the pilot that we actually
• 04:01just officially scheduled for
• 04:03the week of December 11th for a
• 04:07concealed weapons detection unit.
• 04:09So just to provide you some background
• 04:12based on employee engagement
• 04:14results over the last couple of
• 04:16fiscal years along with you know
• 04:18what is happening in the community.
• 04:21MSAC, which is the Emergency Management,
• 04:23Safety and Security Council,
• 04:25which is a system council really
• 04:29wanted to take a hard look at
• 04:32several different initiatives,
• 04:33one of which is hardening our environment.
• 04:37If you remember back in 2020,
• 04:40I project LED 2 pilots for visitor
• 04:44pass management and this is kind
• 04:47of like the second leg of it.
• 04:48So four years later,
• 04:50we're still working on getting
• 04:52visitor management approved.
• 04:54And again this is the second layer of
• 04:56of kind of hardening that physical
• 04:58environment as you walk into our front doors.
• 05:00So the concealed weapons detection
• 05:03unit is actually AI technology.
• 05:07It's AI technology combined with some
• 05:10sensor technology to identify and and
• 05:14really parse out between threats and
• 05:18personal items like cell phones or coins,
• 05:23keys,
• 05:23tweezers versus the large threats.
• 05:30As part of this due diligence process,
• 05:32we looked at other area hospitals.
• 05:35Our partners in Hartford Health do have
• 05:38this technology at several of their
• 05:41system hospitals as well as we tapped
• 05:43into our professional organizations.
• 05:45So as IS and IHOS,
• 05:47which are two of the largest security,
• 05:49healthcare, security profession
• 05:52professional organizations we interviewed.
• 05:55There's, there's a vice president
• 05:57that we worked with that is a system
• 06:01leader of 23 hospitals in the Midwest.
• 06:04They also have this technology.
• 06:06So this is part of the due diligence process,
• 06:08right? We did,
• 06:09we did all of the background.
• 06:10We did our research.
• 06:12Now we have the opportunity
• 06:13to demo this unit.
• 06:15So why I'm on the call with you
• 06:17all is because the North Pavilion,
• 06:19the smile entrance was the entrance
• 06:22that was chosen to have this demo unit.
• 06:25So again I had mentioned we received
• 06:27approval for the week of December 11th,
• 06:29that is a Monday in a couple of weeks.
• 06:32It will arrive on Monday.
• 06:35We will set up in the morning about
• 06:38halfway through the day it will become
• 06:41operational and then Tuesday from 7:50,
• 06:44Wednesday from 7:50 and then Thursday
• 06:46another half a day because they
• 06:48then they have to safely secure it,
• 06:50pack it up and send it to the next
• 06:52location in another hospital or or
• 06:55setting to demo the the system.
• 06:57So again it is originally this
• 07:01was made for actually stadium use.
• 07:05So it has a very high throughput.
• 07:07So I know some of the questions
• 07:08with the core committee that we've
• 07:10been meeting with over the past
• 07:11eight weeks have asked is this going
• 07:13to delay patient care?
• 07:14Do folks need to,
• 07:16you know pad their time by
• 07:1810 or 15 minutes to get in?
• 07:20And and the answer that that we've received,
• 07:23you know based on on our,
• 07:25on our vendor feedback as well
• 07:27as the other folks in the area
• 07:29that have this technology is no,
• 07:30it's made for thousands of people
• 07:33to go through within an hour.
• 07:36So what we're going to do is we're
• 07:38going to have aside from the staffing
• 07:41complement that you already currently
• 07:42have in the lobby as far as security,
• 07:44we will be adding two extra
• 07:47security officers.
• 07:48So folks will come in,
• 07:49they'll enter through the front door,
• 07:51they'll be triaged through
• 07:53the machine if there are any.
• 07:55If there is anything that is found and
• 07:59there's these bounding boxes that show up,
• 08:02whether it's on a bag or on your person,
• 08:04they will be discreetly shuffled to
• 08:06the side and a senior patrol officer.
• 08:09So an armed presence will be asking
• 08:11that an individual to to empty
• 08:13their pockets or their bag or
• 08:15wherever that bounding box appear,
• 08:17that there's something of interest.
• 08:21We talked to marketing.
• 08:22They're going to be signage outside.
• 08:25So hopefully folks before they even
• 08:26walk in will read the signage that
• 08:29will say that we're piloting this,
• 08:30this type of technology.
• 08:32If you have anything,
• 08:33please go back and safely
• 08:36secure it in your vehicle.
• 08:38We will also be, we're working
• 08:40with marketing right now in FAQ,
• 08:41so there'll be FAQs available to hand out
• 08:45as well as something going on the intranet.
• 08:48A my chart blast was something that was
• 08:52being discussed and it right now it's in
• 08:54Rob Hutchinson's hands to approve that.
• 08:57So I'm soliciting feedback if there's
• 08:59any folks in this call that feel
• 09:01that that would be a good idea.
• 09:03So it wouldn't go out to everybody,
• 09:04but when you signed in,
• 09:05there would be a message present
• 09:07on your home screen saying you
• 09:09know between these days this
• 09:11is what will be occurring.
• 09:13Please be aware,
• 09:17so all the communication piece
• 09:18is currently being worked on.
• 09:19We also work with life safety facilities,
• 09:22right? Because in a lobby you
• 09:24need to maintain at least an 8
• 09:25foot egress to be able to get out.
• 09:27So we we we're strategically going
• 09:30to place this by the first set of
• 09:33double doors that you walk into by the
• 09:35waterfall wall and that kind of open
• 09:38space where the Christmas tree is.
• 09:39Now we will have a table with the
• 09:41kiosk with the security officers,
• 09:43so it's out of the way, right.
• 09:44So we're not obstructing people from going
• 09:47out or getting in line for guest services.
• 09:50We've worked with IT.
• 09:52We've worked with Smilo and as well
• 09:56as Children's Hospital leadership,
• 09:57right, because those folks are
• 10:00using the North Pavilion as well.
• 10:02Ann Diamond and Dean Caruso are the
• 10:04executive sponsors on this project.
• 10:06So Ann Diamond is the executive
• 10:07sponsor of M SEC.
• 10:08And then the Yale New Haven specific
• 10:10presence on this is Dean Caruso,
• 10:12who's my Vice President and he's been
• 10:15working with Michael Holmes on this as well.
• 10:16So in a nutshell,
• 10:18that is what we're planning for the
• 10:20week of December 11th and I just
• 10:21wanted to be able to provide you that
• 10:24information and give you guys the
• 10:26opportunity to ask any questions.
• 10:32Stephanie, thank you.
• 10:36I think for benefit of time,
• 10:41what I'm going to ask that we do is save
• 10:46questions till the Q&A period at the end.
• 10:49I am hoping that your schedule will
• 10:51allow you to hang on for a bit longer.
• 10:56I have, I have daycare pick up.
• 10:58So I have about, I have about 15 minutes.
• 11:02OK. Well, let's see if there are any
• 11:04quick questions in the chat or the
• 11:08Q&A. While we're looking.
• 11:10I would under score the
• 11:12fact that this is a pilot,
• 11:14this is I'm proud that Smilo has been
• 11:17chosen as kind of the launch site for this.
• 11:21And I think what you're hearing
• 11:24is that we are all listening.
• 11:30One of the things that is clearly a source
• 11:34of stress for our frontline clinical
• 11:37teams is concerns about their safety.
• 11:40And I think there are a number of things
• 11:43that we're doing to try to enhance that.
• 11:45And I am optimistic that this
• 11:51program will be both unobtrusive yet
• 11:54will enhance our sense of security
• 11:57and safety in the facility absolutely
• 12:01and that you're spot on, Kevin.
• 12:02And I think that's the balance
• 12:03that we need to strike.
• 12:04We are a destination hospital.
• 12:06We want to balance that welcoming
• 12:09environment with safety.
• 12:10And in some cases in order to do that
• 12:13there might be slight inconveniences,
• 12:15but I think the the ROI is there.
• 12:21You know, we need to ensure and
• 12:23unfortunately in this environment
• 12:24and you know we hear it on the
• 12:26news right every other day that
• 12:28there's some sort of threat level
• 12:30that has increased and in some area
• 12:32within the community or the world.
• 12:34And I think what we've learned is
• 12:36hospitals unfortunately are not
• 12:37exempt from some of this violence.
• 12:39I think we've been very lucky
• 12:42and I think this is right.
• 12:44Rather than being reactive,
• 12:45this is a way for us to be proactive
• 12:48and in order for us as this is,
• 12:51you know I'll share with you.
• 12:52I'm not going to share the gory details,
• 12:54but this is an expensive endeavor.
• 12:56So for us to really do the due
• 12:58diligence because not only is
• 12:59it the cost of the equipment,
• 13:01but it's also an increased
• 13:04staffing complement, you know,
• 13:07because we'd be doing this at at
• 13:08many entrances across not only St.
• 13:10Ray's and York Street but but
• 13:12across the system.
• 13:13So to add a couple extra FT ES
• 13:1624/7 to each entrance is big.
• 13:19And so again,
• 13:21we need to pilot it to see what it looks
• 13:23and feels like in our environment live.
• 13:26And you know,
• 13:28do we need two people?
• 13:29Can we scale it back to one?
• 13:30Do we realize that we may need 3?
• 13:32So we're looking at several things
• 13:35during this week long pilot,
• 13:40thanks so much for joining us. Yeah,
• 13:43no problem. And again,
• 13:43I know that I have to drop,
• 13:45but if you think of
• 13:47something later or tomorrow,
• 13:49please feel free to reach out.
• 13:50I have some literature that I can
• 13:52share and again formal communication
• 13:53will be going out early next week.
• 13:57We appreciate you spending time
• 13:58with our community this evening.
• 14:00No problem. Take care.
• 14:05So I am also delighted to share we
• 14:10have leadership transition in our
• 14:13medical leadership in in Smilo.
• 14:17As many of you know Scott Huntington
• 14:20has served in the past several
• 14:23years as the NP7 firm chief.
• 14:25Scott is of course increasingly busy on
• 14:29a virtually daily basis in his role in
• 14:32quality as well as his ongoing clinical
• 14:35practice and leadership on NP11.
• 14:38Doctor Terry Parker who is also well
• 14:41known to our community has agreed to
• 14:45take up the leadership reins on MP7.
• 14:48Again Terry is I think you all know
• 14:53is one of our he malignancies leaders.
• 14:55She's a myeloma expert,
• 14:57leads our myeloma team predominantly
• 15:00at North Haven.
• 15:01Terry has previously served in this
• 15:04role and I'm beyond delighted to have
• 15:07her coming back into a leadership
• 15:10role here on the York Street campus.
• 15:13So please join me in welcoming Doctor
• 15:16Parker back into a significant
• 15:19role here in at New Haven.
• 15:24So I think I'll kick it over to Tracy.
• 15:27Hi everyone. Good evening.
• 15:29I'm happy to be here and I get the fun
• 15:31part of announcing some awards that were
• 15:33given out to some of our clinical staff
• 15:35over the last couple weeks.
• 15:37Nancy Dorenzo received the Daisy
• 15:39Award, Nancy's from NPA and the
• 15:42Daisy Award is given to a nurse.
• 15:45There's a the Daisy Foundation,
• 15:46which is an international program
• 15:49to recognize and honor nurses,
• 15:51which was started in memory of
• 15:53Patrick Barnes who was his family
• 15:56was very grateful for the nursing
• 15:58care he received during his illness.
• 16:00And so they this award is given out
• 16:04to and it's based on nominations
• 16:06from either patients,
• 16:07families or Co workers and staff.
• 16:10So the NP18 did a phenomenal
• 16:12job of surprising.
• 16:14Nancy was quite surprised and they
• 16:16had a great celebration for her.
• 16:20Next we will go to Renee if you could.
• 16:25Yes, thank you. The we also last week,
• 16:28the week before celebrated the Pcas.
• 16:30It was PCA week and it was kicked off
• 16:33with awards and we were fortunate and
• 16:36smiler to have several Pcas honored.
• 16:39Nam Wang, MO received the Circle
• 16:42of Care nomination runner up for
• 16:45inpatient and April Lee was the
• 16:48inpatient Circle of Care winner.
• 16:50And April is APCA for many,
• 16:51many years on NP15.
• 16:53They were both recognized at a
• 16:56celebration event on that Monday.
• 16:59And then the outpatient arena also
• 17:03received our ambulatory services.
• 17:05Amanda Adante who works in the NP8
• 17:09infusion won the Circle of award
• 17:13for ambulatory at York Street.
• 17:15And so she's seen there with Carolyn
• 17:17Thompson who's one of the nurses who
• 17:20nominated her and presented the award.
• 17:22So we are extremely proud of all of
• 17:24these winners and representing SMILO
• 17:27throughout the organization for the
• 17:29exceptional work that they are doing.
• 17:33And then I wanted to just
• 17:35announce that there's some new
• 17:37nursing leaders within Smilo.
• 17:39Leonna Keys was promoted to APSM,
• 17:42she on NP12 and the ECC,
• 17:45Leon has been a nurse there and has
• 17:47been doing some interim work as the
• 17:50interim APSM on 4/7 until we actually
• 17:54recently also hired someone there.
• 17:56And then Danielle White took on the
• 17:58position of APSM for 14 and 15 at night,
• 18:02which it's really important work that
• 18:05we have leadership presence on the night
• 18:07staff for all of our inpatient units.
• 18:10And Danielle's been in the role about
• 18:11a month and doing a really great job.
• 18:17So Kevin, did you want to
• 18:18talk about this? Absolutely.
• 18:22You know, I wanted to just share
• 18:25kind of a a reminder to our audience
• 18:29about the fact that SMILO has grown
• 18:33over the past six months with the
• 18:36addition of the SMILO E unit on 4/7.
• 18:39It's been open since July and it is
• 18:43really exciting because this is an
• 18:46extension of all of our SMILO services
• 18:49into some additional beds and it provides.
• 18:53It's important to remember that this
• 18:56is exactly the same signature of care
• 18:58as all of our inpatient units and it's
• 19:02staffed medically by our hospitalists,
• 19:04AP, PS, physicians and nursing staff.
• 19:09There has been some at times
• 19:13confusion that has arisen when SMILO
• 19:15patients have been admitted to four,
• 19:18seven with the expectation that they
• 19:20would be transferred at some point in
• 19:23their hospital stay to the North pavilion.
• 19:27This on occasion will happen,
• 19:30but when patients are admitted to Smilo East,
• 19:33in the main,
• 19:34this is the unit that they will
• 19:36stay in for their entire admission.
• 19:38Again, emphasis being on the same staff,
• 19:42quality, standards, telemetry.
• 19:45It is really a different physical
• 19:49location but the same teams, same care.
• 19:53So I would encourage all of us to kind
• 19:56of set that framing and expectation with
• 19:59our patients and families and I think
• 20:01it will help some of these admissions
• 20:03go much more smoothly for folks.
• 20:06Tracy,
• 20:06please add anything to that from
• 20:08a nursing perspective.
• 20:09Yeah, no, I think that
• 20:10that's exactly spot on.
• 20:12We've seen some patients and
• 20:13families come in with the expectation
• 20:15that they're just they're holding
• 20:17waiting for a bed in Smilo.
• 20:19So we really want to push the message and
• 20:22have people understand that this is a.
• 20:24Fully a SMILO unit,
• 20:25our fifth unit and that patients
• 20:27that are going there unless there's
• 20:29treatment that they can't receive,
• 20:30we'll stay there for the for
• 20:32their hospital stay.
• 20:33And I think you know if we worked
• 20:36with the Ed and the ECC but for those
• 20:38all those ambulatory areas sending
• 20:40patients in just to reinforce that
• 20:42message would be really helpful.
• 20:49So I think at this point, I am going
• 20:52to kind of pass it on over to Corey
• 20:57who is going to update us on SAFER.
• 21:00Thank you for joining us, Corey. Oh,
• 21:02thanks Doctor Billingsley.
• 21:03So for those that don't know me,
• 21:06my name is Corey Champo.
• 21:07I'm the Executive Director of the
• 21:09System Quality and Safety Team and
• 21:11I'm really pleased to be here.
• 21:13I've been with the organization
• 21:16since January and I'm really
• 21:17excited about the program that I'm
• 21:19here to talk to you about today.
• 21:21So I thought it would be remiss
• 21:24of me to talk about the launch
• 21:27of a new program and without
• 21:30giving some background as to why.
• 21:33So why is it important that we make
• 21:36the switch from RL solutions to Safer?
• 21:39There was a report that came out in 2010,
• 21:41which it's hard to believe is
• 21:43over a decade ago,
• 21:44but talked about the core tenets
• 21:47of an effective reporting
• 21:49system that hospitals have.
• 21:51And it's really having an environment
• 21:54that supports reporting and makes it
• 21:57easier for the frontline user to utilize
• 22:00a portal that protects the privacy
• 22:02of both our staff and our patients.
• 22:05Making reporting accessible to a broad
• 22:09range of personnel inclusive of doctors,
• 22:12physicians, nurses, AP,
• 22:14PS residents, trainers,
• 22:16ancillary staff and team members.
• 22:20Being able to provide that closed loop
• 22:23communication and giving feedback
• 22:25through both summaries as well as
• 22:28dissemination of information in a
• 22:30very timely manner and making sure
• 22:32that we have the ability to put each
• 22:35and every event that is reported
• 22:37through a structured review process,
• 22:39classification of that event and
• 22:42really resolving that event at
• 22:45the department or by committee.
• 22:50So for those that are familiar
• 22:51with RL solutions, you know,
• 22:53I think we can check one of these off
• 22:56swiftly and it is a portal that protects
• 22:59the privacy of our staff and patients,
• 23:02but it leaves a lot to be desired
• 23:04in some of these other categories.
• 23:06And just like Stephanie spoke to hearing
• 23:09the voice of the teams through the
• 23:12employee engagement surveys and really
• 23:15focusing on the safety of our teams,
• 23:18we've heard the voice,
• 23:20the view of our leaders of every
• 23:22person that took the time to fill out
• 23:25the safety culture survey in 2022.
• 23:27We did a full survey in 2022.
• 23:30We pulsed that survey in 2023.
• 23:32A key theme that came out in 2022 was that
• 23:36we need a better way to capture events.
• 23:40It needs to be easier for our
• 23:42frontline teams to utilize that.
• 23:44So that is,
• 23:45believe it or not,
• 23:46it has taken us about 18 months to
• 23:49get to this point to talk about the
• 23:52software that we'll be launching
• 23:54very soon with the NRL solutions.
• 23:57We currently have about 27,000 events
• 24:00that are reported on an annual basis
• 24:02across our whole health system.
• 24:04So if you think of really #5 here
• 24:07that we would put each event through
• 24:10structured process review classification
• 24:12and the committee review required,
• 24:14we don't have a platform that
• 24:17can really support that.
• 24:19So what does the new program offer us for
• 24:23those that are familiar with Press Gainey,
• 24:24Press Gainey currently solicits survey
• 24:27feedback from our patients when
• 24:29they're discharged from our facility.
• 24:32So that same company has launched a
• 24:35high reliability platform and that
• 24:37may be a buzz word for some of you
• 24:40around the high reliability journey.
• 24:42This high reliability platform helps to
• 24:44support not just safety event management,
• 24:48but it starts to overlay some very
• 24:51important closely related categories.
• 24:53Some of those are workforce safety,
• 24:57so employee injury and management is also
• 24:59going to be housed in this platform.
• 25:02It's also going to help our patient
• 25:05relations teams when it comes
• 25:07to service feedback,
• 25:08complaints and grievances.
• 25:10And then finally it's going to
• 25:12help support our clinical teams
• 25:13through the peer review process.
• 25:15So we're pivoting from one
• 25:17platform to another,
• 25:18but we're getting a wide variety of
• 25:21services within this one platform.
• 25:23It's really going to help us as
• 25:26an organization have one single
• 25:29platform that will initiate, track,
• 25:31manage, analyze events at the unit,
• 25:34department,
• 25:35delivery,
• 25:36network and system level simultaneously.
• 25:40It's also going to help us hardwire
• 25:42some of those high reliability
• 25:43principles because when staff are
• 25:45entering events at the front lines,
• 25:47they're going to see some of those
• 25:49buzzwords around high reliability practices.
• 25:52And then when it comes to our leaders
• 25:54that are supporting the evaluation
• 25:56of the events in the background,
• 25:58the terminology and the the framework
• 26:00that we think about safety in is
• 26:03already built into this platform.
• 26:05So we're not going to have to have
• 26:08duplicative processes living outside
• 26:09of what is a protected platform.
• 26:15So when it when we talk about the
• 26:17frontline teams and really understanding
• 26:20the feedback we received in the
• 26:222022 and 2023 culture surveys,
• 26:26we've greatly reduced the burden
• 26:28on those entering events because
• 26:30why 27,000 feels sounds like a lot.
• 26:33Our goal is to really exponentially
• 26:35grow the both the volume and the
• 26:37quality of the reports we're
• 26:39getting from our frontline teams.
• 26:41Because our goal is not just to look at
• 26:44those significant and serious events of harm,
• 26:47but really start to get at the events
• 26:49that haven't reached the patient yet.
• 26:51You've heard of them as great catches
• 26:53because we can learn a lot from those events.
• 26:56This platform is going to make
• 26:59that entry process easier.
• 27:003 Mandatory questions when a a staff
• 27:04member is entering an event into SAFER.
• 27:08It's going to have an Epic integration
• 27:10so that if we submit an event
• 27:12directly from a patient's epic chart,
• 27:14it will auto populate the
• 27:16patient's demographics.
• 27:17It's also going to have an enhanced
• 27:20process for closed loop feedback to
• 27:22those who are recording the events.
• 27:25We'll be able to customize that
• 27:27behind the scenes,
• 27:27making sure that we give enough
• 27:30information for our colleagues to
• 27:32understand that we're looking in
• 27:34to the event that they've reported,
• 27:36but not so much to jeopardize
• 27:38the privacy of anybody.
• 27:40And finally,
• 27:41we'll be able to customize fields
• 27:43for specific areas such as falls
• 27:45or medication area areas to make
• 27:46sure that we're capturing the
• 27:48same information we were able to
• 27:50capture through RL Solutions.
• 27:54For those that are leaders on the call,
• 27:56both unit managers, department managers,
• 28:00as well as safety leaders,
• 28:02this is going to greatly reduce your
• 28:04need to go to multiple different venues
• 28:08to follow up on specific events.
• 28:11Specifically what comes to mind when
• 28:13you think of the SAFER platform
• 28:16is safety event management.
• 28:18But you're also going to be able to manage
• 28:20some of the employee injury related events,
• 28:22as well as those complaints and grievances
• 28:25that you're getting tasked with with
• 28:27from employee from patient relations.
• 28:29You'll be able to manage all of
• 28:31that with one single task list
• 28:34within the SAFER platform,
• 28:35being able to easily toggle between
• 28:39those different module modules.
• 28:41You'll also have access to real
• 28:43time performance data for your
• 28:45specific unit and department.
• 28:46What we heard loud and clear
• 28:48about RL solutions,
• 28:49it was hard to to understand
• 28:52where I'm reporting an event for.
• 28:54We've built this to mirror Epic departments.
• 28:57Most of us that are in the clinically facing
• 29:00roles understand when we would log into Epic,
• 29:03we have to select the right
• 29:05location to get our patients.
• 29:06This is no different.
• 29:08It's going to mirror those
• 29:09epic names so that as leaders,
• 29:11if you cover multiple areas,
• 29:13we'll be able to create custom
• 29:15dashboards like as an example here.
• 29:17So that you can not just see how
• 29:19many numbers of events you've had,
• 29:21but how we've classified those events,
• 29:24what some of the common themes
• 29:25of those events are.
• 29:26And there's some software,
• 29:28some AI software here that's going to
• 29:31help us drill into that information
• 29:33without us having to touch each
• 29:35and every event before we get some
• 29:37of that important information out
• 29:39of the the platform itself.
• 29:41So what does this mean for us?
• 29:43We actually launched this project
• 29:46back in July.
• 29:48The Epic mapping took months upon
• 29:50months to build out and make sure
• 29:53that we met with key stakeholders
• 29:55to get that correct.
• 29:57Over this last month we've
• 29:59been doing notifications.
• 30:00I'm hoping that many of you have
• 30:02seen the notification have had
• 30:05an opportunity to do the LMS
• 30:07trainings and very swiftly.
• 30:09Next Tuesday we are going live.
• 30:12You know I asked the team to kind
• 30:14of put together a list of the ways
• 30:15that we're going to help support this
• 30:17work both on the go live days and
• 30:19the days and weeks following go live
• 30:22and couple important things I want
• 30:25to just call out next Tuesday on go live.
• 30:28Every area will get Flyers to
• 30:30post with links for office hours.
• 30:33These are going to be open teams
• 30:36meetings that anybody can drop into
• 30:38from either your phone or computer.
• 30:41If you're having an issue
• 30:42with reporting an event,
• 30:43we will have those areas staffed both day
• 30:47and evening hours to help our front lines.
• 30:50If there are any barriers,
• 30:52our safety leads are going to be rounding
• 30:55throughout all the organizations in
• 30:57the ambulatory space as well to help,
• 31:00you know,
• 31:01encourage event reporting as well as
• 31:04any Q&A. They'll be, like I mentioned,
• 31:06the Flyers and announcements as well.
• 31:09But what's really important is
• 31:11that we get your feedback and that
• 31:13if there are areas we need to,
• 31:14you know, pivot quickly optimize,
• 31:18we'll be able to do that in the first
• 31:20couple of days with the vendor.
• 31:22And then after that we're going to be
• 31:24setting up a council to help support
• 31:27ongoing optimization and review.
• 31:28We had so much customization done
• 31:30with on RL solutions that you had to
• 31:32know the exact word that you were
• 31:34filtering for to really find the
• 31:36key events that you're looking for.
• 31:38We've kept this pretty out-of-the-box
• 31:40as much as we can because we also have
• 31:43the ability to start benchmarking our
• 31:45safety event types, common causes,
• 31:48key drivers,
• 31:49root causes against other organizations
• 31:52out there,
• 31:53all protected under a patient safety
• 31:56organization license that we have
• 31:58added on to the platform as well.
• 32:00So I think from you know the those
• 32:03that are close to safety science
• 32:04that feel that safety is near and
• 32:06dear to each and every one of us.
• 32:08We're very excited about the launch
• 32:11of this and I you know wasn't going
• 32:13to get into the down and dirty
• 32:15of how to file an event.
• 32:16For those that are familiar with filing
• 32:19events currently in RL solutions,
• 32:21there's both the link on the Internet
• 32:24page as well as the link within EPIC.
• 32:26Those links on Tuesday Morning
• 32:28Woke will automatically be pivoted
• 32:31to take you directly into SAFER.
• 32:33It is very intuitive and as I mentioned,
• 32:35only three hard stops to submit an event.
• 32:38One is if you want to submit
• 32:40your own information or you want
• 32:43to submit anonymously.
• 32:44The 2nd is if a patient was involved or not,
• 32:47and the third is just a free text
• 32:49box that you can use your own words
• 32:52to tell us about the event that AI
• 32:54is going to work through some of
• 32:56that in the background to populate
• 32:58fields that we need populated but
• 33:00trying to take the burden off of
• 33:02the the reporter end of things.
• 33:06So Doctor Billingsley,
• 33:07I don't know if we got any Q&A,
• 33:12anything from the panelists
• 33:13that I may have missed that
• 33:14you'd like me to talk about. You
• 33:19know Corey, I'll I think the
• 33:22first thing I'll say is just an A,
• 33:25a note of gratitude as I round and
• 33:29talk to our frontline clinical teams.
• 33:31One of the things that I hear
• 33:34over and over again is how deeply
• 33:37invested we all are in making our
• 33:39care safe and comfortable and a high
• 33:42quality experience for our patients.
• 33:44And our teams will file things but
• 33:49often sense that the information
• 33:52that they are providing is not
• 33:55actionable and they don't see results.
• 33:58And I see this as a much more
• 34:01direct pathway to achieve that.
• 34:03And I guess
• 34:06do you have any further comments on that?
• 34:08Do you do you think this is a a way that
• 34:12our frontline staff will actually be able
• 34:15to connect their report with changes or
• 34:20outcomes in the organization willingly?
• 34:24Such important points,
• 34:25because it's really twofold that we're
• 34:27hoping this platform will help us.
• 34:29One is being able to provide
• 34:31that feedback as a reporter.
• 34:34When you file an event
• 34:36within the SAFER platform,
• 34:38you will get feedback from your team
• 34:40as appropriate for that specific event.
• 34:43But second, you can actually go
• 34:45into the event that you filed and
• 34:48see where it is in the process.
• 34:50The second piece that the
• 34:52platform that SAFER is going to
• 34:54help us with is that AI piece.
• 34:56So we currently I'm sharing
• 34:58some of this data,
• 35:00so I'm I'm not that bright,
• 35:01it's not usually this close
• 35:03to the tip of my tongue,
• 35:04but we've had 43 serious safety events in
• 35:07the last 12 months across our health system.
• 35:10Those 43 events we have completed
• 35:13root cause analysis on.
• 35:14So for those 43 specific events,
• 35:17we can tell you what the,
• 35:18what contributed to that event,
• 35:20what some of the individual failures were,
• 35:24what our system failures were that
• 35:26allowed those individuals to make the
• 35:28decisions they made and what the root causes.
• 35:32But out of 27,000 events,
• 35:34we can only tell you that about a very,
• 35:37very small keyhole of events within that,
• 35:40that greater cluster.
• 35:41We need the event,
• 35:43we need the information out of those
• 35:4527,000 events to be proactive.
• 35:48So having a platform that has
• 35:50some AI embedded into it that
• 35:52can start to give us real time,
• 35:55common cause analysis.
• 35:56That means if we have a bucket of
• 35:5910,000 medication events this year,
• 36:01it's not just going to tell
• 36:02us was it an administration,
• 36:04was it an ordering error, error?
• 36:06It's going to.
• 36:07It can help start classifying the
• 36:09categories of medications that
• 36:10we're having the most issues with,
• 36:13units, locations, delivery networks,
• 36:16service lines.
• 36:17So it will help us get to the areas
• 36:20that we need to focus on proactively,
• 36:23also giving us much more information
• 36:26about those events that we
• 36:27don't often get to touch.
• 36:33Thank you again, Corey.
• 36:34You know, I think your presence
• 36:36here is really timely and I wanna,
• 36:39I wanna keep the theme going
• 36:42there. There's just one
• 36:43question in the chat. Will
• 36:46locations that were available in RL
• 36:48but are not in EPIC department
• 36:50still be available?
• 36:51Yes, that's a great question, Tracy.
• 36:53So thank you for whoever mentioned it.
• 36:56If it is a non clinical area and
• 36:58doesn't have an EPIC department,
• 37:00we went with the RL name as long
• 37:02as the leader was OK with that.
• 37:05If there needed to be some modifications
• 37:08or changes to that name within RL,
• 37:10we did make those changes.
• 37:13So perfect. Thank you.
• 37:15And then the last was can
• 37:16we build or run reports
• 37:18based on specific teams?
• 37:20Yes, you'll have a dashboard.
• 37:23We are so used to needing to,
• 37:25I don't I don't know if how many
• 37:27folks on this call even know
• 37:28how to build a report with NRL.
• 37:30It's so complicated that I think most of
• 37:32us put a JDAP request in for it, right.
• 37:34Leaders will have these dashboards that
• 37:37will give you line of sight whether
• 37:39you're covering oncology at Yale,
• 37:41New Haven Hospital or Westerly
• 37:44Hospital, right?
• 37:45So you'll be able to see across the
• 37:48health system for the areas you cover.
• 37:50Our executive leaders will have
• 37:52much more global spans of views with
• 37:55higher level information that'll be
• 37:56relevant to them in the dashboard.
• 37:58The dashboard has this really
• 38:00great interface,
• 38:01you just keep clicking and you can get
• 38:02into the individual events themselves.
• 38:04So really no need for report building.
• 38:07After this you'll you'll be able to
• 38:10customize that dashboard for your needs.
• 38:15Perfect. So continuing on with the theme,
• 38:18we have Doctor Scott Huntington and
• 38:21Michelle Kelvey Albert who will update
• 38:24us on our quality and safety goals
• 38:26for this coming year. Great, that was
• 38:29incredibly important talk from Corey and
• 38:32really excited about the safer platform.
• 38:34We're going to kind of review the 2023
• 38:36quality and safety events at Smilo
• 38:38and then talk about the plan for 2024.
• 38:41But first go to the next slide.
• 38:46This idea of this high reliability journey
• 38:50that really echoes from from Cory's work
• 38:52is exactly where we want to go with SMILO.
• 38:55And at the end of the day what does quality
• 38:57and safety look at Smilo in a few years is,
• 38:59is really that every voice whether it
• 39:01be clinical or non clinical matters.
• 39:03And not only that that we all feel
• 39:05responsible for the quality and safety
• 39:07of of basically of the care that
• 39:09we're providing for our patients.
• 39:10We move on to the next slide in terms
• 39:13of high reliability of organizations.
• 39:16You can think of very complex high risk
• 39:18industries outside of healthcare that
• 39:20have been studied whether it be air
• 39:22traffic control or nuclear power plants.
• 39:24And the themes that come from those
• 39:28high risk industries can be applied in
• 39:30healthcare and and that's really really
• 39:32the shift not only here at Yale but
• 39:34across many academic medical centers.
• 39:35These are the key principles of HR OS
• 39:38including preoccupation of with failure.
• 39:40The idea that all of us can look
• 39:42at our daily day processes,
• 39:44our work flows and really identify
• 39:47potential shortcomings and be
• 39:48proactive in trying to improve and
• 39:50reduce failure in the in the future.
• 39:53This idea of really being
• 39:55sensitive operations,
• 39:56which is really after first line staff and
• 39:58making sure that their voices are heard
• 40:00and that they're really involved with
• 40:03all aspects of quality and safety work.
• 40:05This reluctance to simplify interpretations,
• 40:07I think that safer platform
• 40:08will really help with that.
• 40:10The idea of getting to the root cause
• 40:13analysis of of events and really
• 40:15understanding the complexities that goes
• 40:17into a safety event is going to be key.
• 40:19At the same time,
• 40:21we should really question kind of
• 40:23simplistic dogma and and really identify
• 40:25that perhaps in some cases there
• 40:27could be complex solutions to our our
• 40:29problems in healthcare going forward.
• 40:31So this is a kind of approach that I
• 40:34think will move move us into the the
• 40:36modern era with quality of safety here,
• 40:38that's Milo.
• 40:39Commitment to resilience is all about
• 40:42identifying kind of a shared responsibility,
• 40:45shared goal and recognizing that
• 40:47teaming and multidisciplinary teams
• 40:49are really critical to healthcare
• 40:51and that really allows us to recover
• 40:53from you know near misses or or or
• 40:55failures and reduce those in the future.
• 40:57And then finally,
• 40:59deference to expertise is all about
• 41:01getting the experts in the room
• 41:03and really deferring to expertise
• 41:05over authority or title.
• 41:07And we really want to integrate and
• 41:09make sure that we have expertise
• 41:11alongside our POG and safety
• 41:12initiatives moving forward.
• 41:15So this is the quality
• 41:16safety team. I'm certainly the
• 41:18newest member here joined in
• 41:20March of this year after the
• 41:23recruitment of Karen, Andy Anderson.
• 41:25And I'm thrilled to be working
• 41:27with a really great group here,
• 41:29enthusiastic, absolutely focused
• 41:31on patient care led by Michelle,
• 41:33who will speak in just a little bit.
• 41:35Javier is the leader of our tumor
• 41:38register and has a really large footprint
• 41:41covering the tumor register really
• 41:43throughout Connecticut and does a great work.
• 41:46Tom Collins has years of experience
• 41:48here at Yale and really does a great
• 41:51job focusing on calling and safety in
• 41:54our Western Connecticut SMILO centers.
• 41:56Maria is a a nurse and really does
• 41:58a phenomenal job with our ambulatory
• 42:01calling and safety.
• 42:02We're very fortunate to have her
• 42:04many of our quality and safety
• 42:07events as well as kind of solutions
• 42:10really interface with Epic and NHR.
• 42:12So having our own Epic implementation
• 42:15specialist Donna Lapolt is really
• 42:17key to our success and and is a
• 42:19valued member Chloe Shovelin many
• 42:22of you know incredibly enthusiastic
• 42:24engineering background and does a
• 42:26phenomenal job with our inpatient
• 42:27quality safety and all this work
• 42:29really couldn't be coordinated and
• 42:31efficiently done without the expert
• 42:33program coordinator with care.
• 42:34So really great working with these
• 42:37folks and you'll you'll hear more
• 42:39of them about them in the future.
• 42:41Next slide.
• 42:43So in terms of some key highlights of 2023,
• 42:47we can move on.
• 42:48It really is all about identifying you
• 42:51know what's going on in the front lines,
• 42:54how do we integrate both clinical
• 42:56and non clinical staff into
• 42:58the quality and safety program.
• 42:59And one initiative that I think
• 43:01was very meaningful this last year
• 43:03was the development of the SMILO
• 43:04quality and safety console.
• 43:06And so this is a group multidisciplinary
• 43:08really covering across SMILO
• 43:09enterprise both clinical and non
• 43:11clinical mostly frontline staff
• 43:13where we can discuss what are kind
• 43:16of priorities and quality of safety,
• 43:18where there's our alignment,
• 43:20where we perhaps missing some some key
• 43:24information as we move things forward.
• 43:25Today we've had several meetings and
• 43:27we've focused on Smilo morbidity,
• 43:30mortality,
• 43:30aligning our goals with the system goals,
• 43:34focusing on professionalism and medical
• 43:35practice committee recognizing that we
• 43:37certainly need more data infrastructure
• 43:39and transparency and data sharing.
• 43:41So we really have some exciting
• 43:43I think metrics that we're
• 43:45building and dashboards that we're
• 43:46building based off of this work.
• 43:48And then finally and they having
• 43:49their input as we we plan out
• 43:51the next year in identifying our
• 43:53priorities move on to the next slide.
• 43:56So what are some key highlights of 2023,
• 43:59a lot of heavy work for the
• 44:01ASCO PC-4 program,
• 44:02the certified certification.
• 44:04This was a extensive pilot of a
• 44:06medical home that was developed by
• 44:08ASCO and two of our clinical sites
• 44:10both breast Clinic and Guildford
• 44:12were successful in the pilot
• 44:14program and are now certified.
• 44:16We've learned a lot from that pilot
• 44:18program and and and look forward
• 44:19to kind of expanding some of the
• 44:21the key findings from
• 44:23that pilot moving forward.
• 44:24The Commission on Cancer had a recent
• 44:27visit and Javier did a wonderful job
• 44:29coordinating that visit that went
• 44:31quite favorably as did Alex with the
• 44:33cellular therapy on fact accreditation.
• 44:37I look forward to coming back to
• 44:39future meetings looking at quality
• 44:40and safety dashboard and and really
• 44:42building measures so that we can
• 44:44make sure that the quality and safety
• 44:46work that we're doing really leads to
• 44:48patient outcomes and improved performance.
• 44:51Recognizing that to date we've had more data
• 44:55on inpatient rather than ambulatory side,
• 44:57We are really developing more measures
• 45:00in including patient surveys that
• 45:03will really allow both practice
• 45:04level and provider level data.
• 45:07So it's been a busy last six months
• 45:09and I want to shift over to Michelle
• 45:12kind of reviewing the 2023 data
• 45:14and moving on to 2024 Pi plan.
• 45:18Thanks Scott. So we'll start with
• 45:20going good evening everyone going
• 45:22over kind of our safety events.
• 45:24So when we look at our reported
• 45:27events from fiscal year 22,
• 45:29which is in blue to our fiscal year 23,
• 45:32which is in orange,
• 45:34if we look at our kind of combined
• 45:36ambulatory and inpatient,
• 45:38we can see that our reported events
• 45:41dropped slightly in fiscal year 23.
• 45:44Our ambulatory data includes not only
• 45:47our care centers but also our ambulatory
• 45:51sites here on the main campus in New Haven.
• 45:55So a slight dip in reporting
• 45:58events across the ambulatory,
• 45:59but we have seen an increase in our
• 46:05inpatient reported events from 22 to 23.
• 46:09When we look at our reported events
• 46:12and kind of our top categories,
• 46:15these were our top six categories as
• 46:17and again this is from RL Solutions,
• 46:20we have our provision of care.
• 46:23So again this is comparing 22 to
• 46:272322 in blue and 23 in orange.
• 46:29Our provision of care event category
• 46:32really is somewhat of a catch.
• 46:35All Some of the events that get
• 46:38reported under provisions of
• 46:40care delays inadequate handoffs,
• 46:44also lack of using policies and
• 46:50procedures as well as documentation.
• 46:53And then we have our medication events,
• 46:55lab, specimen falls,
• 46:58adverse drug and patient ID and
• 47:00those again tend to be our top
• 47:03categories For our reported events.
• 47:06We wanted just to mention you
• 47:09know our quality and safety,
• 47:10quality and safety coordinators,
• 47:12how events get classified.
• 47:14So across our health system we use the
• 47:17safety event classification HPI which
• 47:20stands for health performance improvement.
• 47:23And I'm not gonna spend a
• 47:24lot of time on this for the,
• 47:26so we can continue to move on in the slides.
• 47:29But when we look at this in classifications,
• 47:32we really are looking to stay
• 47:35in our near miss safety events.
• 47:37So this is where it does not reach
• 47:40the patient and potential errors
• 47:42are caught before harm.
• 47:44That's where we're hoping most of our
• 47:47safety events are in classification.
• 47:49We do have our precursor safety
• 47:51events where this does reach the
• 47:54patient causing minimum or no harm,
• 47:56minimal or no harm.
• 47:57And then at the top of the pyramid
• 47:59is our serious safety events,
• 48:01which reach the patient causing
• 48:02moderate to severe harm or death.
• 48:04So these are the categories that
• 48:07our safety coordinators use when
• 48:09they're classifying the events and
• 48:12there's some graduation within
• 48:14each of those classifications.
• 48:16So just to give you just a sense of
• 48:20where we are as far as kind of looking
• 48:24again from fiscal year 22 to 23,
• 48:28the part that I'd like to really 'cause,
• 48:31you know,
• 48:32really point out for your attention
• 48:35is kind of our minimal temporary harm,
• 48:37which is our PSE precursor safety event too.
• 48:42Remember this is the events that
• 48:45have reached the patient.
• 48:46We've increased quite a bit,
• 48:5150% in from F from 22 to 23.
• 48:56And with these types of events
• 48:58depending on the severity of it
• 49:00or the gaps that
• 49:01are identified, we may do a root cause
• 49:04analysis or an apparent cause analysis.
• 49:07So some definite opportunities that we
• 49:09need to keep our eye on in that area.
• 49:14I'm not going to spend any time on
• 49:16this cause Corey did a wonderful job
• 49:18in talking about our move to Safer and
• 49:20we look forward to the collaboration
• 49:22with Corey's team and appreciate
• 49:24your comment Corey that you're going
• 49:27to have an open teams for people to
• 49:30log in to help them navigate that.
• 49:34So I'm going to move on to our
• 49:37SMILO performance or Pi plan.
• 49:39Just for background,
• 49:41when we're looking at our fiscal
• 49:44year 24 SMILO Pi plan,
• 49:46this is completed annually.
• 49:48Our Pi plan really focuses on alignment
• 49:52with health system objectives,
• 49:54also quality and safety and nurse nursing
• 49:57indicators as well as any oncology
• 50:00certifications and those are some of
• 50:02the certifications that Scott mentioned.
• 50:05As far as our Commission on cancer or our
• 50:08ask of certification or fact certification,
• 50:11we really look at what are the
• 50:13things that we're going to be working
• 50:15on around certification and how
• 50:17do we build those resources and
• 50:19those projects into our Pi plan.
• 50:22And when we're looking at kind of
• 50:24our overview and alignments with
• 50:26the system and Yale, New Haven,
• 50:28we really for our Pi plan,
• 50:30we want to be able to create short
• 50:33and long term goals and objectives
• 50:35looking at those small wins to get
• 50:38folks and engaged in our projects,
• 50:41looking at how to operationalize
• 50:43our meetings,
• 50:43everything starts with the data.
• 50:45We need to look at our baseline data,
• 50:48understand where the trends are,
• 50:51where our opportunities challenges are,
• 50:53how do we share learning and look at
• 50:56our best practices and then promote
• 51:00staff involvement and participation.
• 51:02We need our multidisciplinary teams
• 51:04and we really need to make sure
• 51:06everyone understands why they're at
• 51:08the table and why we're working on
• 51:11the projects that we're working on
• 51:13and how they tie into our our our
• 51:16work with improving patient care.
• 51:20So when we look at our quality and
• 51:23safety performance plan priorities,
• 51:25you know this is we have kind of
• 51:29drilled this down to five priorities.
• 51:32This obviously is not all the work that
• 51:34we are doing across our SMILO enterprise.
• 51:38There are a lot of other projects,
• 51:40but for quality and safety,
• 51:41we really tried to focus on our
• 51:44top five that we would really
• 51:46spend our most time and resources.
• 51:49And so I'll just go over them
• 51:51really at a high level,
• 51:53our inpatient mortality.
• 51:54And so as we're looking at
• 51:56our inpatient mortality,
• 51:58we're looking at our reducing the
• 52:00number of patients that die in the in,
• 52:03in the inpatient units on you know
• 52:08comfort measures without hospitals,
• 52:10Hospice services.
• 52:11So how do we increase our Hospice?
• 52:15Utilize our utilization at the end of
• 52:18life as well as improving the end of
• 52:21life care in patients with high expected
• 52:25mortality for a patient experience.
• 52:28We have two goals this year,
• 52:301 focused in our inpatient units
• 52:33around improving overall responsiveness
• 52:36around call bells and toileting,
• 52:38targeted toileting and improving
• 52:41our hospital environment.
• 52:43And our hospital environment is
• 52:46around our collaboration with our
• 52:49EVs and our SMILO operations team.
• 52:53In looking at cleanliness,
• 52:54not just on our units but
• 52:57also in our reception areas,
• 52:59our first impressions really make a
• 53:01difference in our overall patient experience.
• 53:05And then in our ambulatory clinics,
• 53:08we are looking at communicating
• 53:11patient wait times.
• 53:12This is led by doctor Tara Samth
• 53:15and myself and other team members
• 53:18really looking at our increase in
• 53:21in negative comments in our Prescani
• 53:24patient satisfaction scores.
• 53:25So how do we work with our teams
• 53:30to be better Custer customer
• 53:33service representatives,
• 53:35making sure we're communicating
• 53:36If there are wait times,
• 53:38how do we maybe utilize our patient
• 53:42volunteers to help with being
• 53:44better customer service stewards?
• 53:47And then our next is our social determinants
• 53:50or social drivers of health screening.
• 53:53This was started in 2019,
• 53:57providing the screening in in our
• 54:01ambulatory clinics using an iPad.
• 54:03It was paused during COVID and we kind
• 54:07of reinvigorated this during our ASCO
• 54:10certification with our 22 pilot sites,
• 54:13excuse me.
• 54:14And this is something that we want to
• 54:18continue to roll out the screening
• 54:21across all of our ambulatory sites.
• 54:24Inpatient falls continue to be a
• 54:27significant safety concern and a
• 54:29priority on our inpatient side.
• 54:31And there's many initiatives that
• 54:34are happening right now across all
• 54:37of our inpatient units to reduce the
• 54:40number of inpatient falls including
• 54:43the utilizing the bed alarms,
• 54:45staff handoffs,
• 54:46increased communication not only
• 54:49with each other,
• 54:51but communication with our patients
• 54:53to understand the importance of the
• 54:56calling before you get out of bed.
• 55:00Understanding why our staff needs to
• 55:02be in the bathrooms and and staying
• 55:05with our patients at the greatest falls risk.
• 55:09And lastly,
• 55:10our culture assessment.
• 55:12So this is about creating a culture
• 55:16of inclusion and belonging.
• 55:19This is a survey that's going to be
• 55:23administered to all SMILO staff and
• 55:25the the results of these surveys
• 55:28will be reviewed by senior leadership
• 55:31and a an action plan will be in
• 55:36development that will be shared
• 55:38around the results of that survey.
• 55:41So I think that is my last slide.
• 55:44I know we went through that quickly
• 55:46but wanted to take some time that
• 55:48we would have for any questions.
• 55:50Oh,
• 55:50I had a minute to spare Kevin
• 55:52that that was pretty impressive.
• 55:54You have to admit
• 55:56good work Michelle and Scott.
• 56:05So I'm going to ask a quick question given
• 56:09the hours late or maybe this is quick and
• 56:14this is open to Corey, Scott or Michelle.
• 56:18And the question is where are we standing
• 56:22with some of our external benchmarks, like
• 56:29where are we sitting with things
• 56:32like Leapfrog and CMS star ratings?
• 56:39How should we be thinking about that? And
• 56:43is it is that a focus of our ongoing work?
• 56:47Corey, that's a lead for you. Yeah,
• 56:51I I thought this, this might
• 56:52be teed up for Corey first, but yeah,
• 56:55I'm happy to take this one.
• 56:57So I believe it or not,
• 56:58I have a slide that still open from
• 57:02the presentation 'cause I think
• 57:04some of you may have seen this.
• 57:07Let me see if I can get this in to present
• 57:09review quick enough to show you all.
• 57:16So we, you know it's like award season and
• 57:19I say this to many people pretty frequently.
• 57:23It depends on what time of the year and
• 57:26we could talk about updated reports
• 57:29in any of these reputational programs.
• 57:32And I think the most important thing
• 57:36to say is that we aren't chasing
• 57:40anyone reputation program.
• 57:42But can you see my screen, Kevin?
• 57:46We can. OK, great.
• 57:48So I'm just trying to look at
• 57:50my other screen over here.
• 57:52So if you think about the most
• 57:54recent release and this is Yoni
• 57:57Haven Hospital performance in the
• 58:00four big reputational programs,
• 58:03we came in this fall as a leapfrog C
• 58:07This was a decline from the B grade
• 58:10that we had previously had CMS out of
• 58:14the five star ratings for inpatient care,
• 58:17your New Haven hospital is
• 58:20a three star hospital.
• 58:22Those reports came out in July.
• 58:27U.S. news, U.S.
• 58:28news changed a lot of their methodology.
• 58:31You know,
• 58:32they're only listing the top 20
• 58:35hospitals as ranked hospitals and
• 58:38there's no longer numerical rankings.
• 58:40So you don't know if you're #1 or
• 58:42#20 unless you do the statistical
• 58:43analysis behind the scenes.
• 58:45We take the time to do that.
• 58:46We're #28,
• 58:47We're an unranked hospital and I don't
• 58:50have oncology off the top of my head.
• 58:52So again this is hospital wide and
• 58:55most importantly what I have to
• 58:57say about those three programs,
• 58:58they all use the same data sets,
• 59:00they all use CMS, Medicare data.
• 59:03So we're talking narrow population sample
• 59:0665 and over disease specific cohorts,
• 59:11archaic data two to five years old.
• 59:15The most important and I think
• 59:16the ranking we should pay the
• 59:18most attention to is the Viziant
• 59:20Quality and Accountability study.
• 59:22The Viziant Quality and Accountability
• 59:24study was released September 9th.
• 59:26It shows us our performance
• 59:27from June of 2020,
• 59:29I'm sorry July of 2022 through June of 2023.
• 59:33That's remarkable.
• 59:34That means September 9th we found
• 59:36out our annual performance in as
• 59:39recent dating data from July.
• 59:43Where do we rank there we are a three
• 59:45star out of five star hospitals,
• 59:48but we are #90 out of 116
• 59:51other academic medical centers.
• 59:54So if you look at Leapfrog CMS,
• 59:57both of those programs compare
• 59:59us to all 4270 plus acute care
• 01:00:02hospitals across the nation.
• 01:00:04That means we are getting compared in Yale,
• 01:00:06New Haven to hospitals the size of
• 01:00:09Greenwich and Westerly Hospital.
• 01:00:11U.S. news is more academic
• 01:00:14health hospital focused,
• 01:00:16so it's a little bit more
• 01:00:17of a similar peer group.
• 01:00:19Vizian is 100% academic medical
• 01:00:21centers that Yale New Haven
• 01:00:23Hospital is being compared to.
• 01:00:25So I think that's where we need to
• 01:00:27aim our true North because we can
• 01:00:29no longer pass that performance off
• 01:00:31on that's historical data that's not
• 01:00:33we've done so much improvement since then.
• 01:00:36We can no longer say that it's
• 01:00:38methodology we don't believe in because
• 01:00:40Vizient helps us risk adjust and
• 01:00:42they do have some methodologies they apply,
• 01:00:44but it is 100% all patients,
• 01:00:47all payers,
• 01:00:48all disease states that are put into Vizient.
• 01:00:51It is looking at 100% of the
• 01:00:53population at Yale New Haven Hospital
• 01:00:55for the last year and saying,
• 01:00:57you know what,
• 01:00:58we have opportunity for improvement.
• 01:01:00You're #90 out of 116,
• 01:01:02and I don't think any of us want
• 01:01:03to be in the bottom quartile of
• 01:01:05performance across the nation.
• 01:01:07So this is where we're standing Doctor
• 01:01:09Billingsley with our reputational
• 01:01:11programs and I'm going to continue
• 01:01:13to say we're doing work to support
• 01:01:15each and every one of these because
• 01:01:18the reputation matters to us as an
• 01:01:20organization and to our patients
• 01:01:21for where they received their care.
• 01:01:23But if we just focus on the patients
• 01:01:26today on the outcomes we're seeing
• 01:01:28today and we work towards improving
• 01:01:30that Vizient performance,
• 01:01:32the other reputational outcomes will follow.
• 01:01:35It is been demonstrated in health
• 01:01:37systems across the nation that if
• 01:01:40you utilize Vizient to look at real
• 01:01:42time data drive those improvements.
• 01:01:44The other their programs will follow.
• 01:01:50Cory, I think that is both an
• 01:01:53inspirational and hopeful note to close on.
• 01:01:58I don't see any open questions right now.
• 01:02:01And I just want to say thank you to all
• 01:02:04of our panelists again this evening and
• 01:02:07all of our teams who are doing the great
• 01:02:12work of our organization every day.
• 01:02:14You know, as Corey pointed out,
• 01:02:16the patient is at the center.
• 01:02:18You bring your best to the bedside
• 01:02:20every day and good things will happen.
• 01:02:22So thanks everyone.
• 01:02:23Have a great evening. Thank you.