Improving response to sepsis, reducing emergency department (ED) visits, standardizing communication in the operating room (OR) and streamlining patient alerts were among the winners of the 2023 VHA Shark Tank Competition at last week’s annual VHA Innovation Experience in Washington, DC. The competition was designed by the Veterans Health Administration to promote innovative programs developed by VA hospitals to support the largest health care system in the country.
More than 350 of the VA’s front-line employees submitted applications to the competition, with 15 finalists selected to present at the ninth annual event. Nine of the finalists were awarded the title of Diffusion of Excellence Promising Practice and invited to replicate their programs at other VA facilities across the country.
Although the VHA Shark Tank featured programs developed specifically to serve veterans, many offered solutions that could be leveraged to improve efficiencies and outcomes for the broader patient population. The following four standouts were among the winners:
1 | Surviving SEPsis90 Campaign
Sepsis accounts for one-third of hospital deaths. Only 38% of veterans with sepsis or septic shock received early management in 2022 compared with 58% of other patients. The Surviving Sepsis Campaign (SSC), which was developed at James J. Peters Department of Veterans Affairs Medical Center in New York City, provides guidance for care within the first six hours of sepsis.
SSC leverages clinical documentation templates to trigger a computerized sepsis order set pathway in the computerized patient record system. The order set defaults to immediate administration of antimicrobials and bundles blood culture and lab orders. It sends alerts to notify the care team of real-time sepsis recognition, which allows for treatment within the three- and six-hour management windows.
Implementation of the SSC program increased the SEP90 SAIL (statins for acutely injured lungs) score from 14% in FY22 to 67% in FY23.
2 | One View: Streamlining Health Care Operations with a Unified Dashboard for Multi-Facility View Alerts
One View, a unified dashboard that consolidates patient view alerts from multiple facilities onto a single display, offers a comprehensive view of actionable items without the hassle of multiple logins.
One View, developed at VISN-21: Sierra Pacific Network in 2022, alerts providers to veteran needs across multiple categories (e.g., abnormal lab results, imaging results, scheduled and completed consults). The dashboard's reporting capabilities empower health care organizations to make data-driven decisions, optimize processes and enhance patient care.
One View now has more than 100 active users. The dashboard displays view alerts from 13 facilities in near real time and is estimated to save about 30 hours of staff time per week.
3 | Surgical Intraoperative Handoff Initiative: Standardizing Surgical Technician Handoffs
Troy Bowling Campus in Lexington, Kentucky, developed the Surgical Intraoperative Handoff Initiative (SHRIMPS) to standardize critical information needed during surgical technician staff changes in the OR during surgical cases.
SHRIMPS utilizes a handoff tool and visual aid to remind surgical technicians of critical elements to perform during each handoff. Before implementation, handoffs occurred in 83% of cases, but only 42% of handoffs included communication with surgeons. The introduction of SHRIMPS resulted in 100% performance of handoffs — with 100% of targeted elements addressed — during surgical staff changes. Handoffs were achieved in an average of 77 seconds.
4 | Supporting Community Outpatient, Urgent Care and Telehealth Services
More than 1 million veterans 65 years and older visit VA EDs annually. In 2021, six VA hospitals piloted a program designed to reduce the number of ED visits by improving access to virtual care.
SCOUTS (Supporting Community Outpatient, Urgent care and Telehealth Services) is a post-ED care transition program for older veterans who are identified as high risk for functional decline, hospitalization, institutionalization, falls or repeat ED visits. After release from the ED, a caregiver performs a follow-up home visit, typically within 72 hours, to reassess the patient’s condition, establish care coordination and set up virtual care connections.
A year after the program launched, SCOUTS patients were less likely than other patients to be readmitted to an ED within the next 30 or 90 days (11.7% vs. 26.9% and 20% vs. 32.5%, respectfully). The program saved an estimated $4.5 million since inception.
Interested in Exploring Other Innovative Approaches to Health Care’s Biggest Challenges?
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