Business Administration, Management, and Operations Commons^™

Strengthening Safety Culture By Leveraging The Daily Management System, Suneela Nayak, Mark Parker, Erin Graydon Baker, Amy Sparks, Ruth Hanselman, Stephen Tyzik, Sydney Green

Operations Transformation

STRENGTHENING SAFETY CULTURE BY LEVERAGING THE DAILY MANAGEMENT SYSTEM

There is abundant evidence that links a strong culture of safety with improved patient and staff experience. However, there has been no clear avenue identified as to how to achieve this metric.

A team in a large academic tertiary teaching hospital set about leveraging their daily managing system (DMS) to attain improvement in their institution’s safety. The goals of this quality improvement project were to use DMS to identify and report safety concerns and increase frontline team knowledge and comfort with reporting safety concerns during Gemba walks.

A root cause analysis …

Coordination Of Inpatient And Outpatient Care For Neurology Patients Undergoing Epilepsy Monitoring, Sara Schrock, Michelle Beane, Kathryn Cope, Mark Parker, Suneela Nayak, Ruth Hanselman, Stephen Tyzik, Amy Sparks, Brendan Lilley

Operations Transformation

ORGANIZING A SYSTEM TO CONSOLIDATE EPILEPSY REFERRALS TO AN OUTPATIENT NEUROLOGY PRACTICE

An outpatient neurology practice was experiencing delayed or lost referrals for epilepsy monitoring. This delay was leading many patients to suffer unnecessary and unmanaged seizures and, in some cases, frequent trips to the emergency department.

As a result, a team consisting of the neurology practice and neuro-navigators used baseline metrics to demonstrate the current state of the problem and conducted a root cause analysis that outlined several causes. A number of countermeasures were initiated with the goal of decreasing referral misses.

Post the initiation of two KPIs, a …

Mmc Fall With Injury Prevention Project, M. Wiggins, Joanne Chapman, Laurie Wilson, Rhonda Babine, Jennifer Laflamme, Melissa Vanmeter, Erica Weightman, Natalie Talbot, Kristine Hykras, Marie Hodge, Angela Smith

MaineHealth Maine Medical Center

Problem/Impact Statement:

Patients falls with injury remains an elusive problem at MMC. Over the past 8 quarter, (2016 and 2017) MMC has outperformed 3 of the last 8 Quarters of data. The average rate for the past 8 quarters is .57/1000 patient days with the mean benchmark of .54/per 1000 patient days. MH has determined a focus goal for all the MH hospitals to be below .70/MH 100 patient days as a goal for falls with injury. MMC having the largest volume must be below NDNQI mean to drive this change as the .70 is the average of all MH …

Improving Type And Screen Specimen Collection Prior To Elective Surgery, Nordx Blood Bank Staff, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

To avoid delays in the availability of compatible blood for elective surgery patients requiring transfusion, a type and screen specimen should be completed at least 24 hours prior to surgery. Baseline metrics in an acute care inpatient blood bank demonstrated a significant number of cases with no type or screen completed.

The objective of this KPI was to prevent any delays in providing compatible blood products to scheduled surgical patients. Several internal and external system issues were identified as a result of a root cause analysis and a number of actions were initiated.

Outcomes have been positive. Data collection post …

Delirium Reduction Strategies For The Critically Ill, June Chaves, Sam Canonico, Will Cheney, Tammy Corey, Gil Fraser, Alex Kowalewski, Jen Low, Cardiac Intensive Care Unit, Haley Pelletier, Cathy Palleschi, Stephen Tyzik, Suneela Nayak, Ruth Hanselman

MaineHealth Maine Medical Center

Delirium, an acute and fluctuating disturbance of consciousness and cognition, is a common manifestation of acute brain dysfunction in critically ill patients. Patients with delirium have longer hospital stays and a lower 6-month survival rate than do patients without delirium. Preliminary research suggests that delirium may be associated with cognitive impairment that persists months to years after discharge.

In a large acute care hospital, the cardiac intensive care staff became interested in mitigating their unit’s high delirium rate of ventilated patients. At baseline, many members of the healthcare team did not believe that delirium could be prevented and the predominant …

Improving Cardiology Patient Flow In Nuclear Medicine, Kelly Haar, Hannah Sullivan, Kathryn Laverdiere, Nuclear Medicine Department, Haley Pelletier, Stephen Tyzik, Suneela Nayak, Ruth Hanselman

MaineHealth Maine Medical Center

At baseline, a nuclear medicine department found it difficult to complete cardiac stress tests within scheduled times. Using the performance improvement process, a nuclear medicine department looked to improve patient experience related to wait times for this test.

Two goals were identified and a root cause analysis was initiated. After identifying some process issues, two KPIs were developed to address them.

A root cause analysis identified some processing issues and two KPIs were instituted to address them.

As a result, one outcome was to hire an additional physician assistant to address the barrier of inadequate cardiology coverage. Next steps include …