Medicine and Health Sciences Commons^™

Improving Patient Experience And Education By Leveraging Technology, Cathy Palleschi, Wendy Osgood, Mark Parker, Cecilia Inman, Alicia Russell, Eileen Shanahan, Erin Pappal

Operational Transformation

It is estimated that 65% of the population are visual learners. With that in mind, a team of cardiac nurses in a large academic tertiary hospital developed a quality improvement project to hopefully improve patient engagement as well the patients’ perception that the nurses explained things in a manner that they could understand.

Baseline patient survey scores for the question, “Nurses Explained Things In A Way That I Understand”, were under the 75^thpercentile for a period of 9 months. A root cause analysis was conducted and it demonstrated numerous reasons for this score.

Several countermeasures were instituted to …

Improving Patient Flow By Increasing Early Discharges On A Mother & Baby Unit, Faye Weir, Joy Moody, Kathleen Cyr, Cathy Palleschi, Stephen Tyzik, Joseph East, Heidi Morin, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operational Transformation

Discharging patients early in the day has many advantages amongst which is increased bed availability. However, the experience in a large academic tertiary medical center demonstrated that most discharges occurred early to mid afternoon. A care team on a mother /baby unit established a quality improvement project to increase the number of discharges by 11AM and streamline key discharge planning activities.

A root cause analysis identified multiple barriers to attaining he established goals. To address these barriers, a multi prong approach was instituted to include a discharge education KPI for all unit staff.

Data collection post countermeasure implementation demonstrated some …

Treating Substance Use Disorders: Enhancing Attendance At The Weekly Inpatient Medication Assisted Treatment Group, Devon Gillis, Jayne Weisberg, Dena Whitesell, Amy Mcauliffe, Amy Sparks, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

Operational Transformation

At a large academic tertiary medical center, an Integrated Medication Assisted Treatment (IMAT) program has been established for those medically stable inpatients with an addiction diagnosis. Over a four month period, this program had experienced a decline in attendance and a quality improvement project was initiated is to better understand the barriers to attendance and institute a process that would reverse the decline.

A goal was established to improve attendance by medically stable patients that have consented to participate to a minimum of 50%.

A root cause analysis outlined numerous causes for low attendance and several countermeasures were established to …

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

Operational 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 …

Implementing Strategies To Reduce Central Line-Associated Blood Stream Infections On An Inpatient Pediatric Unit, Sherryann St. Pierre, Nicole Manchester, Jessica Howe, Melanie Lord, Mark Parker, Suneela Nayak, Ruth Hanselman, Stephen Tyzik, Amy Sparks, Barbara Bush Children's Hospital

Operational Transformation

STRATEGIES TO REDUCE CENTRAL LINE ASSOCIATED BLOODSTREAM INFECTIONS

Every central line associated bloodstream infection (CLABSI) leads to poor outcomes, increased mortality and increased healthcare costs. A pediatric care team in an academic tertiary medical center set a goal to reduce the number of these infections on their unit.

The team’s research showed that daily bathing greatly decreases CLABSI. Their baseline metrics demonstrated an unacceptable level of those with central lines being bathed. A root cause analysis revealed that patient and family refusal was the leading cause for those who did not bathe.

A performance improvement plan was initiated that consisted …

Improving Revenue Capture And Patient Safety In An Icu Setting, Natasha Stankiewicz, Laura Lewis, Jonathan Archibald, Mark Parker, Suneela Nayak, Stephen Tyzik, Ruth Hanselman, Amy Sparks

Operational Transformation

IMPROVING REVENUE CAPTURE AND PATIENT SAEFTY IN AN INTENSIVE CARE SETTING

Materials management department is responsible for restocking chargeable supplies in an intensive care unit (ICU) at an academic tertiary medical center. Staff confusion as to what items were considered chargeable often led to low supply par levels resulting in delays of critical patient care.

Using baseline metrics, a team of caregivers created several performance improvement goals to increase nursing compliance with appropriate supply charging. The results of a root cause analysis spearheaded the development of a KPI that encompassed staff education, lost charge tracking and charge supply labeling.

Post …

Strategies To Improve Timeliness For Cleaning Inpatient Rooms Following Patient Discharge, Lora Dixon, Mark Parker, Ruth Hanselman, Suneela Nayak, Amy Sparks

Operational Transformation

STRATEGIES TO IMPROVE THE TIME FRAME FOR CLEANING INPATIENT ROOMS BY ENVIRONMENTAL SERVICES

In an inpatient rehab hospital, it was noted that Environmental Services (EVS) was delayed in cleaning rooms between patient discharges and admissions. This resulted in the frequent use of a “stat clean” order that allows only 50% of the normal cleaning time , forcing patients to wait and impacting patient flow.

A root cause analysis demonstrated lack of communication between the rehab hospital and the contracted cleaning services. A number of counter measures were initiated with the goal that cleaning would be started within 20 minutes of …

Strategies To Increase Early Discharges To Reduce Avoidable Patient Days And Improve Patient Flow, Cathy Palleschi, Cecilia Inman, Erica Weightman, James B. Powers, Stephen Tyzik, Joy Moody, Mark Parker, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operational Transformation

CREATING ALGORITHMS TO INCREASE THE NUMBERS OF HOSPITAL MORNING DISCHARGES RESULTING IN IMPROVED PATIENT FLOW

Discharging a percentage of patients early in the day helps to improve patient flow. This results in a reduction of Emergency Department congestion as well as peaks in patient numbers in the early to late afternoon on patient care units.

A cardiac unit in an academic tertiary medical center created a goal to increase the number of their discharges by 11 AM and to streamline key discharge planning activities. A root cause analysis was initiated and after identifying several barriers, two KPIs were developed using …

Consistently Using A Transportation Department For Patient Discharge To Sustain Nursing Staffing Levels, Victoria Boutin, Joseph East, Stephen Tyzik, Joy Moody, Mark Parker, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operational Transformation

IMPROVING PATIENT FLOW BY UTILIZING A HOSPITAL TRANSPORTATION DEPARTMENT FOR DISCHARGES

Using a transportation department for transporting patients for discharge is the industry standard. At a large urban hospital, inconsistent use of this department has resulted in frontline caregivers (RNs) having to pick up this function, resulting in potentially unsafe staffing levels on the floor.

The goal of this quality improvement project was to improve the percent of discharges with the transport department from ≤10% to 70% by the end is fiscal year 2018 in an academic tertiary medical center.

Baseline metrics demonstrated the current state and a root cause …