Medicine and Health Sciences Commons^™

The Challenge: No Harm Index Relay Race, Hannah Taylor, Kate Campbell

Nursing

The Challenge: No Harm Index Relay Race is an evidence-based learning program developed to provide a group of learners the opportunity to solve a series of skill-related puzzles and complete tasks related to the National Database of Nursing Quality Indicators

Sustaining Care Team Engagement Using A Hierarchy Of Needs Framework, Katherine Skroski, Sam Canonico, Hailey Frager, Mary Beeaker, Natalia Johnson, Rebecca A. Brookes

Operational Transformation

Cardiology Intensive Care & Cardiovascular Interventional (CICU & R9 West) teams provide superb care to critically ill cardiac patients at Maine Medical Center. Covid Pandemic revealed the importance of physical and mental health wellbeing, as well as care team engagement in order to continue to provide outstanding care to patients. CICU/R9 West Leadership looked for ways to improve team engagement and ensure that care team members’ needs are met and sustained.

Leveraging Vascular Access Team To Increase Safety And Access To Care, Deb Linscott, Cecilia Inman, Mandy Rodney, Vascular Access Team

Operational Transformation

Using a pager platform to receive vascular access consults related to peripheral intravenous catheter (PIV)/central line care and maintenance needs has resulted in significant time and delays in treatment lost by bedside nursing and vascular access staff. The goal of this project is to develop a nursing consult order set to replace the paging process to improve transparency and communication among team members, reduce delays in IV therapy administration, and improve efficiency.

Measuring Monetary And Non-Monetary Roi At Mmc Opex, Suneela Nayak, Natalia Johnson, Rebecca A. Brookes, Jill Shiroki

Operational Transformation

Operational Excellence (OpEx) is a data driven approach to department based continuous improvement, minimizing costs, increasing efficiencies, engaging staff in a shared quality agenda and assuming a proactive approach to maintaining facilities. The OpEx platform assists in strengthening efficiency and patient safety at Maine Medical Center (MMC) by demonstrating alignment of goals across the entire organization. A recent publication by BMC Health services “… found that the ROI concept in healthcare QI aligned with the concepts of value and benefit, both monetary and non-monetary.”2. Currently, OpEx does not have a system in place to track these values. We are looking …

Reducing Postpartum Hemorrhage Rates At Maine Medical Center, Meaghan Smith, Colette Dumais, Tracey E. Mcmillan, Carrie Comeau, Mandy Wallace, Jenelle Boulanger, Jodi-Lynne Vaughn, Kelly Ouellette, Natalia Johnson, Suneela Nayak, Rebecca Brookes

Operational Transformation

In the United States, approximately 700 women die each year from pregnancy related deaths and the most frequent cause of preventable maternal mortality is obstetric hemorrhage. The postpartum hemorrhage (PPH) rate at Maine Medical Center (MMC) is three times the national average. At our facility we care for the most complex patients in the State and we must decrease our rate to accurately reflect our expertise, knowledge and skills.

Improving Pubmed For The Novice At The Expense Of The Expert: Surveying Librarians 3 Years Post-New Pubmed, Tim Kenny Mls, Heather Kemp Mlis

Maine Medical Center

Background: In 2019 PubMed, the publically accessible search interface for the MEDLINE database underwent a user interface update and overhaul. MEDLINE is the primary component of PubMed, a literature database developed and maintained by the NLM National Center for Biotechnology Information (NCBI)” (National Library of Medicine, 2022).

Methods: Using a brief web-based survey, comprised of both closed-ended and open-ended questions, health science library professionals provided feedback on the new PubMed.

Improving Employee Engagement Scores With Strategically Focused Improvement Coaching, Suneela Nayak, Natalia Johnson, Rebecca Brookes, Jessica Ladd, Meghan Flaherty, Mark Parker

Operational Transformation

Every three years, Maine Medical Center releases a Strategic Plan outlining high level priorities. This guides decision making, resource allocation and invited a call to action for engaged participation from providers and staff. Operational Excellence at MMC is leveraging a stable Daily Management System to strengthen strategy deployment by coaching teams and leaders to link local improvement initiatives with high level strategic priorities.

Leveraging The Operational Excellence Platform For Improvement: Strengthening Culture Of Safety, Rebecca Brookes, Suneela Nayak, Natalia Johnson, Risk And Patient Safety

Operational Transformation

Senior leaders drive the culture change by demonstrating their own commitment to safety and providing the resources to achieve results. Their consistent and sustained messages about safety help advance a culture of safety ¹. Even with many efforts to improve patient safety, harm events continue to occur, challenging us to innovate additional ways to safeguard patients in our care. The Operational Excellence (OpEx) platform for improvement at Maine Medical Center (MMC) is well positioned to strengthen the Culture of Safety at Maine Medical Center (MMC) by leveraging the mechanism of established Daily Gemba Walks. During each Gemba Walk, leaders …

Code Blue: Back To Basics, Melissa N. Allen Msn, Rn, Hannah Taylor Msn, Rnc-Mnn, Jennifer Smith Bsn, Rn

Southern Maine Health Care

Introduction: High-quality cardiopulmonary resuscitation (CPR) improves a patient’s chance of survival. High-quality CPR started immediately after cardiac arrest combined with early defibrillation can double or triple the chances of survival.

In 2021 Joint Commission (JC) provided new and revised in-hospital resuscitation standards due to suboptimal patient outcomes related to poor resuscitation performance.

Using Hierarchy Of Needs To Build Care Team Engagement, Cathy Palleschi, Katherine Skroski, Sam Canonico, Hailey Frager, Mary Beeaker, Suneela Nayak, Natalia Johnson, Rebecca Brookes

Operational Transformation

Cardiology Intensive Care & Cardiovascular Interventional Care teams provide superb care to critically ill cardiac patients at Maine Medical Center. Covid Pandemic revealed the importance of caregiver physical and mental health wellbeing, as well as engagement in order to continue to provide outstanding care to patients. Leadership devised innovative ways to improve team engagement and ensure that care team members' needs are met.

How Help Provided The Pathway To Become Age-Friendly, Chesley Ferris, Anna Pleet, Emily Carter

Maine Medical Center

In assessing how the 4Ms framework applies to the Hospital Elder Life Program, we were able to target specific ways to deliver more Age-Friendly care to those enrolled in the program.

Equipping Health Professions Educators To Better Address Medical Misinformation, Brian G. Southwell, Andrea Anderson, Anne Berry, Kamilah Weems, Lisa Howley, Cristina Pelin, Maya Vasser, Michael Cassara, Marie C. Petrizzo, Samara Ginzburg, Renee Mcleod-Sordjan, Joseph Weiner, Lexie Morales, Mark Saunders, Emiri Uchiyama, Laura Fothergill, Deborah Sherman, Rebecca L. Toonkel, Alison M. Vargovich, Nicholas M. Fusco, Kelly Foltz-Ramos, Jessica Kruger, William Prescott Jr, Jennifer Hayman, Shelley Cohen Konrad, Linda H. Chaudron, Christine Mallar, Grace Price, Brendan Prast, Julia Safarik, Leah Mallory, Aashna Sunderrajan, Sara Serritella, Nicole L. Pierce, Olabisi Falana, Eve Bloomgarden, Shika Jain, Lisa Mordell, Vineet Arora

Maine Medical Center

As part of a cooperative agreement with the US Centers for Disease Control and Prevention (Federal Award Identification Number [FAIN]: NU50CK000586), the Association of American Medical Colleges (AAMC) began a strategic initiative in 2022 both to increase confidence in COVID-19 vaccines and to address medical misinformation and mistrust through education in health professions contexts. Specifically, the AAMC solicited proposals for integrating competency-based, interprofessional strategies to mitigate health misinformation into new or existing curricula. Five Health Professions Education Curricular Innovations subgrantees received support from the AAMC in 2022 and reflected on the implementation of their ideas in a series of meetings …

Team Engagement & Obstetrics Transformation Committee, Colette Dumais, Faye Weir, Lynn Willey, Kristen Heanssler, Brittany Babb, Suneela Nayak, Natalia Johnson, Rebecca Brookes, Obstetrics Transformation Committee,Maine Medical Center

Operational Transformation

Gallup defines employee engagement as the involvement and enthusiasm of employees in their work and workplace. Employee engagement helps to measure and manage employees' perspectives on the crucial elements of workplace culture. Based on over 50 years of employee engagement research, engagement employees produce better outcomes (better patient care) than other employees. Based on the unit survey, team members, with the support of local leaders, formed the Transformation Committee. This Committee was developed as a shared governance, team led model to address process improvement needs and create a culture of active engagement in problem solving.

The Rapid Increase Of Digital Resources And Research Used At The Maine Medical Center Library And The Nation: Since The Beginning Of The Covid 19 Pandemic, Maegan L. Halica

Maine Medical Center

Health science resources have increasingly become accessible to researchers, health care professionals, and health scientists. With the current technology available in the healthcare settings affiliated with all MaineHealth, authors of various publications can share their knowledge with others across the globe. The COVID 19 pandemic created a situation that not only increased the need for technological communication and accessibility at a rapid pace, but the situation also created an alternative outlet for those in a medical library to utilize needed information pertaining to their position through the crisis of the pandemic.

Finding The Right Scope: Dermoscopy For Primary Care, Peggy Cyr, Elizabeth Seiverling

Maine Medical Center

Background

• Primary care physicians (PCPs) frequently address skin concerns and perform clinical skin examinations1

• For PCPs, the use of dermoscopy has been shown to increase the sensitivity for skin cancer diagnosis compared to unassisted examinations2,3

• Prior to this study, no formal consensus existed on the fundamental knowledge and skills that PCPs should have with respect to dermoscopy

Objectives

• To develop an expert opinion consensus statement on 2 proficiency standards for PCPs using dermoscopy

Impact Of Dermoscopy Training For Pcps On Nnb To Detect Melanoma, Madeline Prentiss, Kathryn Stevens, Henry Stoddard, Peggy Cyr, Laura Houk, Hadjh Ahrns, Elizabeth Seiverling

Maine Medical Center

The goal of this project was to analyze the impact of dermoscopy training on the number of melanocytic nevi needed to biopsy (NNB) to detect a melanoma in the primary care setting .

Pediatric Dermatology Econsult Program With Dermoscopy: Sub Analysis Of Infantile Hemangiomas, Peggy R. Cyr, Madeline Prentiss, Hadjh Ahrns, Abby Markham, Elizabeth V Seiverling

Maine Medical Center

Here we present an analysis of pediatric dermatology eConsults with emphasis on dermoscopy utilization and the impact on eConsult on infantile hemangiomas (IH) management.

Mapping Melanoma Risk And Locating High-Need Regions For Dermoscopy And Skin Biopsy Training, Calla Hladky, Madeline Prentiss, Henry Stoddard, Kathryn Stevens, Elizabeth Seiverling, Peg Cyr

Maine Medical Center

Background- Dermoscopy and skin biopsy trainings have been shown to help improve PCPs’ knowledge of and confidence in detecting skin cancer. The goal of this project was to determine where to focus training efforts in order to maximize our impact and reach regions that face the highest burden of melanoma in the state.

The Dangers Of Aces, Olivia Carey, Thea Forrest, Adna Abdi

Maine Medical Center

ACEs stands for Adverse Childhood Experiences, included (but not limited to) physical, emotional, and sexual abuse, substance abuse, neglect, dysfunctional families, and mental illness'. ACEs impacts childhood development and increases chances of future health implications.

Leveraging Improvement Capacity For Organization Strategy Deployment, Suneela Nayak, Natalia Johnson, Rebecca A. Brookes, Andrew Levine

Operational Transformation

Every three years, Maine Health releases a Strategic Plan that outlines the organization’s strategic priorities and guides decision making and resource allocation through promoting our mission, vision, and values. Operational Excellence at Maine Medical Center aims to create a culture of continuous improvement that promotes quality and value in our healthcare system in alignment with our strategic priorities. Through our improvement efforts within the hospital, we want to ensure we are disseminating and promoting the goals set forth by the Strategic Plan in our daily management system.

Pandemic Pearl: Innovations In Virtual Improvement Coaching, Suneela Nayak, Natalia Johnson, Rebecca Brookes, Andrew Levine

Operational Transformation

The success of local performance improvement efforts depends on the engagement of clinical care teams in a culture of continuous improvement. At the onset of the COVID-19 pandemic, many teams at Maine Medical Center (and across the globe), transitioned to remote work to stop the spread of the virus. While some are returning to office, a significant amount of work is still being done remotely. For continued success, we need to understand how we can best coach clinical care teams in a hybrid or remote environment.

Supporting An Advanced Practice Provider (App) Residency Program, Dina Mckelvy

Maine Medical Center

No abstract provided.

Resilience Of Regional Hospital Nursing Staff Working During The Covid-19 Pandemic Measured By The Connor-Davidson Resilience Scale., Jill Petzel

Maine Medical Center

As the COVID-19 pandemic stretches on, the importance of resilience is increasing as it protects against PTSD while aiding an individual in selecting healthy coping strategies. In a study of 657 healthcare workers in New York City in April 2020, more than half of healthcare workers screened positive for acute stress (PTSD symptoms), almost half screened positive for depression, and one third screened positive for anxiety; many also reported symptoms of insomnia (Schecter et al., 2020).

Resilience is important in nursing because it ensures a viable, healthy workforce for the future. Resilience has been described as the ability to ‘bounce …

Preventing Falls-Interventions In Geriatric Psychiatry Patients: An Overview Of Current Literature, Samantha Beckwith

Maine Medical Center

PREVENTING FALLS-INTERVENTIONS IN GERIATRIC PSYCHIATRY PATIENTS: AN OVERVIEW OF CURRENT LITERATURE

Samantha Beckwith, BSN, RN, PMH-BC, P6

Background: The Inpatient Psychiatry unit at Maine Medical Center (P6) is a 21-bed unit specializing in geriatric and medical psychiatry. The majority of patients have a primary diagnosis of Dementia with Behavioral Disturbance. The unit features 12 double occupancy rooms and one single occupancy room, as well as a large activity room. Patients participate in a therapeutic milieu in which they are encouraged to interact with other patients in common areas and ambulate around the unit. The average number of patients is 19.6 …

Lean Daily Management: Keeping Quality And Safety At The Forefront During The Covid-19 Pandemic, Suneela Nayak, Ruth Hanselman, Natalia Johnson, Sydney Green

Operational Transformation

This storyboard describes how our Operational Excellence Platform pivoted to keep quality at the forefront of the Covid-19 response. Applying the Framework for Safe Effective and Reliable Care, we implemented the following innovations:

• Daily quality huddles became virtual, with 70-100 frontline leaders sharing alerts, announcements and celebrations
• Traditional Gemba Walks transformed into daily Executive Gemba Rounds visiting all care teams and focusing on patient and workforce safety.
• Patient and Workforce safety concerns were resolved real time and those requiring coordinated response were triaged to the Hospital Incident Command System (HICS) for accelerated action.

Innovative communication strategies were adopted to clarify …

Collaborative Strategies To Reduce Incomplete Operating Room Instruments Trays, Richard Neusch, Nicole Wagner, Colby Fike, Suneela Nayak

Operational Transformation

In an academic tertiary medical care center, the OR was receiving incomplete instrument trays. This issue became increasingly problematic in wasted staff time and cost to the institution.

Using a tracking system to generate a missing instrument report, baseline metrics were established. Reviewing each report, an interdepartmental team comprised of members of the OR and sterile processing departments, initiated a number of countermeasures.

Since the start of these countermeasures, there has been a reduction in the receipt of incomplete OR trays. Next steps include creating a tag process by which the OR instrument trays from one case would be kept …

Joint Annual Wellness Visit Scheduling, Rob Chamberlin, Jennifer Bliss, Andrea Lai, Paula Dougherty, Deb Swett, Logan Merrithew, Pam Stevens, Scott Williams

Maine Medical Center

Problem/Impact Statement: The pharmacists in Scarborough & Westbrook Primary Care conduct Medicare Annual Wellness Visits (AWVs) with a physician. The pharmacist and physician see the patient individually. The practices achieved and sustained FY18 Joint AWV volume goals through a new process to reschedule physician-only AWVs to Joints AWVs with a pharmacist. This leads to reschedule rework and reduced time practice staff have for patient care.

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 …

Development Of Mechanical Ventilator Educational Brochure For Patients/Families, Cathy Palleschi, Wendy Osgood, Mark Parker

Operational Transformation

Patients on mechanical ventilation often have no memory of events while being ventilated. In addition, families during this time, are often overwhelmed and unable to retain information provided to them by caregivers.

In attempt to address these issues, a team of care providers in an tertiary academic hospital established a goal to create a mechanical educational brochure with the goal to reduce associated anxiety and improve overall understanding of information provided.

As part of a clinical transformation project, a root cause analysis was conducted and a number of countermeasures were initiated. Some of these included a survey to capture feedback …

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 …