Welcome to the OPQC NAS November Action Period Call

Transcription

1 Welcome to the OPQC NAS November Action Period Call Thank you for joining; our webinar will start shortly! In the mean time; please sign in the chat box the names of all webinar participants and full name of hospital affiliation.

2 Welcome! Neonatal Abstinence Syndrome Project Action Period Call Ohio Perinatal Quality Collaborative November 21, 2014

3 Please don t put us on HOLD! If you need to step away: Use the MUTE button on your phone or You can use *6 to place the call on MUTE and *6 to come off of MUTE

4 Agenda Time Topic Presenter 12:00 pm Welcome, Agenda Review, sign in Susan Ford 12:05 pm Data Overview October Results Scott Wexelblatt, MD 12:15 pm Community Resources Site 1 Site 2 Site 3 Discussion/Team Sharing 12:50 pm Next Steps PDSA Submissions Save the Date OCPIM Summit OPQC Learning Session Data Submission Reminder Monthly Progress Report Reminder Presenter 1 Presenter 2 Presenter 3 All Teams Susan Ford

5 Roll Call: Please sign in with your hospital affiliation and the names of your team members on the call in the Question box

6 NAS Participating Sites 2014 Promedica ProMedica Toledo Children s Bay Park Mercy Children s Hospital St. Rita s Medical Center Lima Memorial Health System Marion General Nationwide Upper Valley Dublin Methodist Dayton Children s Medical Center Mt. Carmel West Nationwide Doctor s Good Samaritan Hospital Dayton Springfield Regional Miami Valley Medical Center Southview Medical Center Soin Medical Center Fort Hamilton Kettering Cincinnati Children s Atrium Medical Center Good Samaritan Mercy Hospital Fairfield Hospital Mercy Anderson UH Cincinnati Bethesda North The Christ Hospital Hospital Mercy Health West Nationwide Riverside Methodist Nationwide Grant Mercy Regional Medical Cleveland Center Lorain Fairview Hospital Clinic Hillcrest Hospital Elyria Medical UH Rainbow Babies Center -UH MetroHealth & Children s Akron Children s Summa Mercy Medical Akron Children s Center Canton OhioHealth MedCentral Mansfield Aultman OSU Nationwide Children s Adena Regional Medical Center Southern Ohio Medical Center Nationwide Mt. Carmel St. Ann s Mt. Carmel East Licking Memorial Health System Genesis Healthcare System Trumbull Memorial Akron Children s St. Elizabeth Health Center/Mahoning Valley 1/2014 start Level 3 and Level 2 teams 4/2014 start Level 2 teams

7 Key Driver Diagram Project Name: OPQC Neonatal NAS Leader: Walsh GLOBAL AIM To reduce the number of moms and babies with narcotic exposure, and reduce the need for treatment of NAS. SMART AIM By increasing identification of and compassionate withdrawal treatment for full-term infants born with Neonatal Abstinence Syndrome (NAS), we will reduce length of stay by 20% across participating sites by June 30, KEY DRIVERS Prenatal Identification of Mom Implement Optimal Med Rx Program Improve recognition and nonjudgmental support for Narcotic addicted women and infants Attain high reliability in NAS scoring by nursing staff Optimize Non-Pharmacologic Rx Bundle Standardize NAS Treatment Protocol Connect with outpatient support and treatment program prior to discharge Partner with Families to Establish Safety Plan for Infant INTERVENTIONS All MD and RN staff to view Nurture the Mother- Nurture the Child Monthly education on addiction care Fulltime RN staff at Level 2 and 3 to complete D Apolito NAS scoring training video and achieve 90% reliability. Swaddling, low stimulation. Encourage kangaroo care Feed on demand- MBM if appropriate or lactose free, 22 cal formula Initiate Rx If NAS score > 8 twice. Stabilization/ Escalation Phase Wean when stable for 48 hrs by 10% daily. Establish agreement with outpatient program and/or Mental Health Utilize Early Intervention Services Collaborate with DHS/ CPS to ensure infant safety. Partner with other stakeholders to influence policy and primary prevention. Engage families in Safety Planning. Provide primary prevention materials to sites.

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17 Community Resources for Patients and Providers

18 Site 2 Presenter 2

19 Our Community Resources Project Cure Methadone Clinic. Will take pregnant women up to 29 weeks; their waiting list is usually 2-3 weeks. Nova House Residential treatment. (No children allowed.) Does not prescribe Methadone or Subutex; instead focuses on the Substance Abuse Process. Women s Recovery Residential treatment facility. Women allowed to have their children with them. Associated with TCN Outpatient Clinic (Behavior Health and Addiction Services) Cornerstone 3 sites in our area. Substance Abuse Rehabilitation. Outpatient setting Subutex Clinic. Will take pregnant women up to 29 weeks. Samaritan Behavioral Health Mental Health and Substance Abuse Outpatient Clinic..

20 Community Resource Benefits Patient Benefit The need for these agencies is great in our area. The need currently exceeds the availability. We have found patient involvement with these facilities often assists in increasing stability in their lives which can lead to a decrease in relapse. Hospital/Provider Benefit Increased support for our patients. Better care for the moms and their babies. We have seen higher rates of visitation from mothers who are actively involved in these support agencies.

21 Site 2 Presenter 2

22 Collaboration between the Women and Children s Unit and OB/GYN & Pediatric Offices Dedicated Women and Children s Social Worker Time is Spilt Beginning and end of each day and group time is in hospital The middle of every day is dedicated to appointment with patients in the OB/GYN or Pediatric office. Address Patient s Social Problems throughout her Pregnancy (addiction, homelessness, non-custody of children, food insecurity, miscarriage, fetal demises, anxiety, depression, post traumatic stress disorder, post partum depression, NAS, child care/parenting, mandated reporting)

23 How addictions issues are addressed The Modified 5 Ps Referral-to LISW Assessment Explanation of Hospital Policies 1.Hold on infant 2. Scoring 3. Cord Stats Patient Options 1. Inpatient 2. Clinics 3. Groups Addressing Social Needs Subutex Group Monthly Centering Meeting Weekly Meetings Random Drug Screens Outside attendance of AA/NA meetings Journals, Feelings/ Emotions, Gratitude Lists Life Skills Successes-27 Babies Born- Only 2-Pharmological Interventions

24 Community Partners that Benefit Patients Addiction Related Scioto Paint Valley ADAMH Board * SPVMH/211/Crisis Center * Ross County s Drug Task Force Recovery Council * Local AA/NA Groups * Children s Services * County Health Departments* Health Recovery Services* Stepping Stones* Pregnancy/Family Ross County Domestic Violence Commission Family and Children First Council Elizabeth s Hope * Life Centers County Health Departments* Help Me Grow* WIC* Love Inc. Church Groups *Available in Multiple Counties

25 SITE 3 PRESENTER 3

26 OCWTP's 8 Regional Training Centers

27 THE TRAINER/COACH POOL APPROXIMATELY 250 INDEPENDENT CONTRACTORS

28 Participant/Trainee Populations Served Through the OCWTP Case Workers Child Welfare Supervisors and Managers Foster Caregivers and Adoptive Parents

29 Training Delivery Methods Focused on Building Competency Workshops Learning Labs GAPS Coaching Awareness, knowledge, beginning application Focused content Application and skill development Practical application Application and skill development Learner driven Focused on filling skills and knowledge GAPS Brainstorming and problem solving 1:1 home or work site based Individualized plan for learner Skill enhancement, working toward mastery

30 Discussion and Questions What has been your experience partnering with Community Agencies? What barriers have you encountered in attempting to partner with Community Agencies? Questions for our presenters?

31 PDSA s PDSA Key Drivers Improved recognition and non-judgmental support for Narcotic addicted women and infants High reliability in NAS scoring Non-pharmacologic bundle Standardized NAS Treatment Protocol Connecting with outpatient support and treatment program prior to discharge Partner with families to establish safety plan for infant

32 Save the Date(s)!

33 OPQC Learning Session Save the Date: January 26, 2015 at the Columbus Marriott (Airport) PLEASE be certain to have your Social Worker attend with your team if possible! Opportunity to Steal Shamelessly & Share Seamlessly with other teams Update your team contact info if changes have occurred from last January

34 Next Steps Continue testing small tests of change (PDSA) Please submit NAS Data by November 30th. Remember to please submit and check No Eligible Babies for the Month if there were no NAS patients at your site. Monthly Progress Report will be sent to Key Contacts this week; due NOVEMBER 30 th

35 Happy Thanksgiving!! We are so thankful for each of YOU and your hard work and dedication to the mothers and babies you care for! Best wishes for a Happy Thanksgiving!

36 The OPQC NAS Project is funded by The Ohio Department of Medicaid