Minutes Team Meeting October 5, 2011

Minutes from Team Meeting October 5, 2011

Those present: Julie Mojica, Fran Lindell, Pat Stein, Joyce Peterson, Con Marks, Gail Hall, Lois Bilesky, Natalie Nordin, Shirley Kiesman, Marie Laporte, Debbie Page-Newton, Marla Penner, Elaine Nagy, Laura Kolesar

CALL TO ORDER

1. Dr. Kendiss Olafson & Brenda Kline: VAP: Collection guideline review. • Kendiss presented some information about declining VAP rates and protocols that are in place to try to prevent VAP’s. She outlined the importance of keeping track of VAP rates. • The guidelines are on the wiki. It is important to code VAP based solely on these criteria and not on what the doctors write in the chart. • We need to clarify the significance of yeast in the sputum and also when a pt has a previous aspiration and how this could skew the results of VAP’s

2. Device Use Study: Laura Kolesar : Introduction to the purpose and goals of the study. • This study only applies to critical care, plan to start Jan 1, 2012. • The options are in the tmp study section on the laptops, data collectors are encouraged to try collecting this data as a pilot in order to familiarized themselves with the study and to see what obstacles they may encounter finding the information. • Instructions are on the wiki • Times are approximate • Art lines will be removed from the study • Need to still modify some items, changes will be posted on the wiki. • Workload concerns • A suggestion was made to have a memo sent to all ICU managers and physicians to inform them of the study and that we need their cooperation in ensuring the charting of lines, etc.

3. Discussion about comparison of data between sites. (Laura Kolesar). This is very time consuming and most often is unnecessary.

• This topic was discussed at the Steering committee meeting on October 3. The consensus was that if the data collector cannot finish the profile without comparing data, then this should be done. For example, to clarify VAP criteria on pts that were transferred, or to find out the organisms. • Times and dates of transfer can be obtained by referring to the transfer tracker in the tmp files on the Regional Server. • It is not essential that comorbid lists match exactly. • Diagnosis will vary anyway because of differing health issues after transfers.

4. IPax: Has been loaded onto the laptops. Plan to try to get all diagnostic imaging counts directly from this computer source instead of counting them. We will keep you posted if this can be done.

5. Dan Roberts: Transfer Ready Times for Medicine: • Dr Roberts presented data that showed how having the transfer ready times has been helpful in the past. • He also showed that there is a huge problem with pts that are staying in city hospitals way beyond the time that they actually require medical care. • He showed that this overstay correlates with many factors such as age, co-morbids, etc. • The problem is very costly ($25 million) as wasted bed days and requires action to try to improve this issue. • Dr Roberts will be directing the medical staff to indicate in all charts when a pt is medically ready for transfer. This is the time that the data collectors will put as transfer ready. • This time and date should not be revised even if the pt deteriorates. It is important that the first date that the pt was medically stable is indicated. • Not all profiles will have a transfer ready time. For example if a pt moves off one ward to another, they may not be medically stable or ready to transfer, so in this case, that profile would not have a transfer ready date or time. • Tentative start date November 1, 2011.

6. Dr. Rizwan Manji: Seizures Post Cardiac Surgery. • Dr Manji presented a scenario where an increased seizure rate was found during a change in medication protocol. (antifibrinolytic therapy intraop). Utilizing data from the database, the physicians were able to monitor the increased incidence of seizures and determine the cause to be a specific dosage change in this medication. • Seizures during the post op period can greatly complicate a pt’s recovery and result in longer hospital stays. • Dr. Manji utilizes the database for many studies and would like to see some other items collected (LVEF and blood groups).

CLOSING Minutes of Team Meeting October 5, 2011