Transcript WHAT THEY DID

How unit-based teams are getting results
Examples of operational success
June 24, 2013
Storytelling helps with early cancer detection
FEATURED TEAM
Primary Care, North Lancaster Medical Office
(Northwest)
WHAT THEY DID
To increase the number of members completing the
home test for colorectal cancer, this team:
• Identified members between the ages of 50 and 75
eligible for colorectal cancer screening
• Scripted a story about how physicians in the clinic had
tested positive—but because the disease was
detected early, they got treatment in time and are
doing well
• Tracked distribution of the kits and followed up with
members who hadn’t returned them
Visit LMPartnership.org for ideas and tools for your team.
RESULTS
Return rate for take-home fecal immunochemical
tests (FIT) kits
Communication among teams improves
mammogram rates
FEATURED TEAM
Adult Medicine, Shady Grove Medical Center
(Mid-Atlantic States)
WHAT THEY DID
This UBT in Rockville, Md., worked with Primary Care
and Radiology to resolve scheduling conflicts that caused
patients to be turned away from same-day mammogram
appointments. The team:
• Worked with Radiology on a process for sharing
schedule information so the best days and times for
same-day mammograms can be identified
• Set clear boundaries. For example, the Adult Medicine
unit agreed not to send patients for mammograms
after 3:45 p.m., when one radiology technician is
trying to close out the day’s appointments without
incurring overtime
Visit LMPartnership.org for ideas and tools for your team.
RESULTS
Mammogram screening rate
Getting to zero pressure ulcers
FEATURED TEAM
Respiratory Care, San Jose Medical Center
(Northern California)
WHAT THEY DID
To reduce reportable hospital-acquired pressure ulcers
(HAPUs), the team set a goal of sustaining at least a 90
percent completion rate for patient skin assessments .
They did this by:
• Conducting four skin integrity assessments per patient
during each 12-hour shift
RESULTS
• Documenting observations in patient charts
Reportable HAPUs
• Electronically tracking assessments on a weekly basis
• Auditing assessments on a monthly basis
• Posting results with names of corresponding respiratory
therapists
• Providing counseling and encouragement for those not
meeting the goal
Visit LMPartnership.org for ideas and tools for your team.
Transforming transport
FEATURED TEAM
Adult Medicine, Capitol Hill Medical Center
(Mid-Atlantic States)
WHAT THEY DID
To reduce staff time spent transporting patients by
wheelchair from the unit to the lab, pharmacy, hospital
entrance or public transit stop, the team:
• Tracked transport times by staff members
• Obtained new, wider wheelchairs to accommodate
more patients
RESULTS
• Coordinated transport times with other departments
Patient transport times (minutes)
• Created and staffed a dedicated transporter position
Visit LMPartnership.org for ideas and tools for your team.
Lab gets quicker on the draw
FEATURED TEAM
Infectious Disease/Oncology UBT
(Northern California)
WHAT THEY DID
To shorten wait times for blood draws, this Gilroy
Medical Offices UBT:
• Shifted staff schedules so the lab opens earlier
• Staggered lunch breaks to spread out the loss of staff
on the floor
• Educated physicians to improve the clarity of lab
orders and reduce duplicative orders
• Cross-trained staff members so everyone can register
patients and process specimens as well as draw blood.
If eight or more patients are waiting to have blood
drawn, the team goes into “all hands on deck” mode.
Visit LMPartnership.org for ideas and tools for your team.
RESULTS
Average daily wait time (minutes)
Standing together to prevent patient falls
FEATURED TEAM
Ortho/Neuro Surgical UBT
(Southern California)
WHAT THEY DID
To radically reduce the number of patients who fall, the
team at Fontana Medical Center conducted several tests
of change including:
• Calendar posts to make problems known to all when
they occur, whether day shift or night shift
• Daily huddles include a patient safety briefing to air
concerns or potential problems
• Blame-free debriefings after a fall to discuss what
happened and how to prevent it
• Quick response to bed alarms indicating that a patient
has gotten up
Visit LMPartnership.org for ideas and tools for your team.
RESULTS
Patient falls decreased by nearly 40 percent
Medication reconciliation keeps patients safe
FEATURED TEAM
Infectious Disease/Oncology UBT
(Georgia)
WHAT THEY DID
To reduce duplicate medications listed in patient records,
members of this team at the Cumberland Medical Office
Building in Atlanta started by manually cleaning up patient
charts. Then they instituted a new process for checking
medications:
• Licensed practical nurses and medical assistants ask
patients to bring their medications to office visits
• MAs and LPNs review patient medications and note on
member’s chart which ones the patient is or is not taking
• Providers confirm medications with the member and
remove the duplicate oncology medication from the
patient’s record
• MA prints out the patient’s medications and gives the list
to the nurse practitioner who, with the clinical
pharmacist, reviews it and removes expired medications
Visit LMPartnership.org for ideas and tools for your team.
RESULTS
Percent of duplicate medications per
office visit
Assigning ownership of surgical instruments
saves thousands
FEATURED TEAM
Head and Neck Surgery
(Colorado)
WHAT THEY DID
To reduce the number of surgical instruments lost
before and after surgeries, nurses in this Franklin
Medical Office UBT in Colorado now “own” a set
instruments.
Team members are responsible for counting the
instruments at the beginning and the end of the day,
similar to reconciling a cash box in a retail
environment.
Visit LMPartnership.org for ideas and tools for your team.
RESULTS
The number of lost or broken instruments
Team improves nutrition service while cutting waste
FEATURED TEAM
Food and Nutrition department
(Northern California)
WHAT THEY DID
This San Jose Medical Center team identified ways to
prevent costly food waste, where unused formula,
supplements and food end up in the garbage. Small tests
of change included:
• Conducting a “wasted meal study” to learn how much
money was being lost to unused meals ($16,000 a
year)
• Improving communication with unit assistants about
patients’ eating patterns and discharge data
• Paying closer attention to expiration dates on
supplements and adjusting the ordering accordingly
Visit LMPartnership.org for ideas and tools for your team.
RESULTS
Monthly food expenses cut by 10 percent
UBT helps new members navigate KP
FEATURED TEAM
Adult Primary Care, Falls Church
(Mid-Atlantic States)
WHAT THEY DID
To improve member retention and help Kaiser
Permanente grow, members of this UBT:
• Involved Spanish-speaking staff in welcoming 3,200
new Spanish-speaking members
• Used the New Member Identifier tool in KP
HealthConnect™ so staff can help orient new
members, or those who haven’t been in for a while
• Called new members to set up appointments, help
refill prescriptions and address other needs
• Sent welcome letters and a road map on how to get
started as a Kaiser Permanente member and patient
• Passed out a new member kit with contact numbers
Visit LMPartnership.org for ideas and tools for your team.
RESULTS
Favorable patient satisfaction scores
Wait times down, courtesy scores up
FEATURED TEAM
Laboratory
(Northwest)
WHAT THEY DID
To cut wait times that could sometimes exceed 45
minutes, the Mt. Scott Medical Office lab moved to a
one-on-one model in which:
• A technician stays with each patient from check-in
to blood draw
• The technician returns to the check-in desk to take
the next patient
• More team members are freed up to reduce the
queue, rather than having a dedicated member
working the computer
Visit LMPartnership.org for ideas and tools for your team.
RESULTS
Improved patient satisfaction and an
unexpected jump in technician courtesy scores