Cepheid — Cepheid Webinar, June 25, 2009
50 slides from Cepheid's conference presentation, Jun 25, 2009
Slide 1: Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In
Denise L. Uettwiller-Geiger, Ph.D., DLM(ASCP) Director of Laboratories/Clinical Chemist, John T. Mather Memorial Hospital Port Jefferson, New York Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In
Slide 2: Presentation Overview
Presentation Overview • Enumerate the many advantages of a MRSA surveillance program in terms that speak to executives’ priorities; • Describe the criteria by which executives value a capital investment; • Share metrics and other documentation that establish the value and cost-effectiveness of Mathe
Slide 3: Securing Organizational Buy-In
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In
Slide 4: Active Surveillance for MRSA Cost-Benefit
ACTIVE SURVEILLANCE FOR MRSA Cost-Benefit Molecular Testing (PCR) Costs Savings • Screened high risk patients • 248 bed hospital 2008: 88/mo = 1,050/yr • 82,373 patient days/91% occupancy • PCR Assay ~ $63 per test • 0.90/1,000 = 74.3 infections (2007) • Cost 2008: $66,150 • 0.59/1,000 = 48.0 infect
Slide 5: Balancing Healthcare Costs
Balancing Healthcare Costs Making the financial case at JT Mather: Surveillance Surveillanc e Pro$66,150 gram Cost of Infection $920,000 Saving: $854,350
Slide 6: Bottom Line Results Since 2008
JOHN T. MATHER MEMORIAL HOSPITAL LABORATORY Bottom Line Results Since 2008: Implementation of an Active MRSA Surveillance Program Improved services by bringing Molecular testing in-house Increased Awareness of HAIs Achieved Best Practices in: Cost Reduction Decrease Infection Rate - 35 % - 34
Slide 7: Zero MRSA in ICU
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In Zero MRSA In ICU
Slide 8: Patient Admissions and Patient Care Days
JOHN T. MATHER MEMORIAL HOSPITAL Patient Admissions Number of Patient Care Days 2007 2008 For the 2007-2008 period, there were 138 patient care days saved and 230 more admissions, generating additional revenue of $1,150,000.
Slide 9: J.T. Mather Memorial Hospital
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In J.T. Mather is a 248 bed, not-for-profit hospital located in Port Jefferson, New York, situated on the north shore of Long Island, in Suffolk County (population 1.4 million). Since its establishment in 1929 a
Slide 10: Voyage To Excellence
Voyage To Excellence J. T. Mather Memorial Hospital. Our Mission to be the best community hospital in New York State.
Slide 11: Only Long Island community hospital with real-time molecular MRSA testing
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In John T. Mather Memorial Hospital – gained another first when it became the only community hospital on Long Island to perform real-time molecular testing for MRSA surveillance.
Slide 12: Long Island Health Network, Catholic Health Services
Mather Hospital Long Island Health Network Catholic Health Services
Slide 13: Securing Organizational Buy-In
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In
Slide 14: Health Care Dilemma
Health Care Dilemma Fewer$$ Fewer Long LongED EDWait Wait BedShortage Bed Shortage Rapid Testing is Telemetry EDDiversion ED Diversion TelemetryBackup Backup Essential PatientRisk Patient Risk Imperfect ImperfectInformation InformationFlow Flow Inappropriate InappropriateAdmissions Admissions
Slide 15: What keeps senior executives up at night?
What keeps senior executives up at night? • Hospitals’ insatiable needs for access to capital • Comparative Quality • Cost Containment • Critical staff shortage • Need to keep medical staff happy • Managed Care • Health Care Reform • Financial Survival of Hospital
Slide 16: Securing Organizational Buy-In
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In
Slide 17: How to obtain buy in from C-Suites?
How to obtain buy in from C-Suites? (Senior Administration and Finance) • Meetings • Provide articles • Make the financial case • Enumerate advantages of a MRSA surveillance program • Provide education • Everyone must be equal stakeholders
Slide 18: Meetings
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In MEETINGS
Slide 19: Update on MRSA
Update on MRSA Presentation to Long Range Planning Committee March 5, 2007
Slide 20: Agenda
AGENDA Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In 1. Definitions a. Infection versus Colonization b. Current Terminology 2. Presentation and Genetics of MRSA a. HA-MRSA versus CA-MRSA b. Genetics of Resistance c. PVL Toxin: A Special Threat from CA-MR
Slide 21: Hospital Acquired Infections Statistics
Hospital Acquired Infections Statistics The estimated number of people developing a serious MRSA infection (i.e., invasive) in 2005 was about 94,360 with 18,650 deaths. About 70% of these HAIs are resistant to at least one drug. Every year an estimated 1.7 million Americans develop a new infec
Slide 22: Securing Organizational Buy-In
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In www.SafePatientProject.org
Slide 23: What Level of Surveillance Do We Need?
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In WHAT LEVEL of SURVEILLANCE DO WE NEED? Key Questions • How can a MRSA surveillance program support the organization's strategic plan, vision, and priorities? • How will a MRSA surveillance program fulfill our
Slide 24: MRSA Active Surveillance Objectives
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In MRSA Active Surveillance J.T. Mather Objectives: Identify patients that are colonized (or infected) with MRSA Place colonized/infected patients into contact isolation Reduce patient-to-patient transmiss
Slide 25: Team to Evaluate MRSA Surveillance Program
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In Team to Evaluate MRSA Surveillance Program should include: Senior Hospital Leadership Clinical Laboratory Leadership Nursing Management/Staff Physicians Infectious Disease Professionals Pharmacists Purchasing
Slide 26: Hospital Wide MRSA Surveillance Approach
Hospital Wide MRSA Surveillance Approach Build Constituency from other Departments Senior Administration Laboratory Professionals Infection Control Specialists Physicians Nursing Administration Pharmacists ER Physicians Intensivists Finance Hospitalists Environmental Services
Slide 27: Provides the organization with direction for the future
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In Provides the organization with direction for the future.
Slide 28: Don't abandon your dreams
MRSA Surveillance Program Don’t abandon your dreams because of those who lack the vision.
Slide 29: Knowledge Preparedness
Knowledge Preparedness Knowing Goals Building a Sense of Ownership
Slide 30: Leading Change
Leading Change Action Oriented Communication Action a l io n di t a Tr Commitment Understanding Information
Slide 31: The Guiding Change Coalition
JOHN T. MATHER MEMORIAL HOSPITAL LABORATORY The Guiding Change Coalition Position Power Expertise Credibility Leadership
Slide 32: Change: Resist, Embrace or Create It
Change: You can resist it, You can Embrace it, Or you can create it.
Slide 33: Securing Organizational Buy-In
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In
Slide 34: Securing Organizational Buy-In
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In
Slide 35: Molecular Diagnostics
Molecular Diagnostics Direct method of MRSA detection Identification of MRSA through the detection of DNA sequences Dramatically improve turnaround time (TAT)
Slide 36: Benefits of Second-Generation PCR
JOHN T. MATHER MEMORIAL HOSPITAL LABORATORY Benefits of Second-Generation PCR FDA approved May be integrated into Core Laboratory Continuous and random access MRSA test result in < 2 hours (2 m set-up, 72 m run-time) All testing processes- sample preparation, real- time PCR amplification a
Slide 37: MRSA Next Generation Technology: Cepheid GeneXpert
MRSA Next Generation Technology Cepheid GeneXpert® 5. Insert cartridge and start assay
Slide 38: GeneXpert IV and GeneXpert XVI
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In GeneXpert IV GeneXpert XVI
Slide 39: Once executives are engaged, then what?
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In Once senior executives have a MRSA surveillance program on their radar, then what? Establish a team to gather information and perform the following analyses: Operational Financial
Slide 40: Correctly Calculating ROI, NPV, IRR
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In Correctly Calculating Return on Investment (ROI) Net Present Value (NPV) Internal Rate of Return (IRR)
Slide 41: Return on Investment
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In Return on Investment Gain from Investment – Cost of Investment ROI = Cost of Investment ROI is a performance measure used to evaluate the efficiency of an investment or to compare the efficiency of a number o
Slide 42: Establishing urgency, coalition, vision and communication
1. ESTABLISHING A SENSE OF URGENCY ~ Examining the market and competitive realities ~ Identifying and discussing crises, potential crises, or major opportunities 2. CREATING THE GUIDING COALITION ~ Putting together a group with enough power to lead the change ~ Getting the group to work together lik
Slide 43: Success: short-term wins, consolidating gains, anchoring change
6. GENERATING SHORT-TERM WINS ~ Planning for visible improvements in performance, or “wins” ~ Creating those wins ~ Visibly recognizing and rewarding people who made the wins possible 7. CONSOLIDATING GAINS AND PRODUCING MORE CHANGE ~ Using increased credibility to change all systems, structures, an
Slide 44: The Importance of Team Work and Collaboration
Team work can do it! THE IMPORTANCE OF TEAM WORK and COLLABORATION
Slide 45: Keys for Success: Lessons Learned
Keys for Success….... Lessons Learned Start screening with a pilot population Continuous assessment of the program Capture the informal opportunities Capture the formal opportunities Assemble a team Attend committee meetings Become a liaison Keep communication open Collaboration am
Slide 46: Active MRSA surveillance program opportunity
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In Our active MRSA surveillance program provides an unique opportunity for disciplines, specialties, laboratorians and technology to complement each other using a molecular method for rapid MRSA identification,
Slide 47: A Work in Progress
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In A WORK IN PROGRESS. . .
Slide 48: Together Implementing a Successful MRSA Surveillance Program
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In Together Laboratorians, Hospital Professionals and Executives Can Implement A Successful MRSA Surveillance Program
Slide 49: Securing Organizational Buy-In
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In
Slide 50: Thank You
Expanding MRSA Surveillance Beyond the High Risk Population: Securing Organizational Buy-In Thank You