Hospital Care

It is well established that hourly rounding on hospital units can decrease call light usage, decrease the number of falls, improve patient satisfaction, improve team communication, and promote patient safety. The TCAB unit at Lovelace Westside Hospital, seeking to improve HCAHPS scores regarding prompt responses to call buttons, employed this best practice of purposeful hourly rounding, in which nurses enter a patient’s room every hour during the day and every two hours at night. In an effort to assess a patient’s current condition, nurses go through the “3 Ps”...

In 2009, national patient safety goals called for improvement in effective communication among caregivers and active involvement of patients in their own care. The TCAB team at Multicare Health System embraced this call to action by developing a bedside shift report. Through Plan/Do/Study/Act (PDSA) trials and support from hospital leaders, the team successfully developed a comprehensive bedside shift report that has been in place on the TCAB unit since January 2010 and spread to the entire hospital by September 2010. During the spread process, the TCAB unit staff served as consultants...

When staff surveys and feedback revealed a concern among nurses about patient assignments and the provision of safe patient care, the TCAB team at York Hospital set out to determine the number of patients one nurse can care for. This is a difficult task, as individual patients have varying care requirements. With staff input, the team developed and tested a patient acuity tool designed to predict how much nursing time each patient requires and based staffing assignments on the estimates. The tool incorporates specific care tasks, such as feeding patients, as well as factors affecting...

To decrease its 30-day readmission rates, Samaritan Albany General Hospital created a comprehensive patient education and post-hospital follow-up system for its heart failure patients. This multi-disciplinary approach to heart failure care and follow-up consisted of several strategies, including working toward standardizing congestive heart failure education materials within the entire health system, implementing the teach-back method, distributing “Heart Failure Care Kits” upon admission, and conducting follow-up phone calls after discharge. As a result, Samaritan Albany...

Mount Clemens Hospital of Mount Clemens, MI, is a non-profit, suburban hospital with 56,000 emergency department (ED) visits each year. The ED frequently was crowded with patients waiting for inpatient beds. The ED and hospital leadership created a process in which a designated person sends out the hospital census every morning, accompanied with any information on patients anticipated to need admission, throughout the facility. This process alerts the hospital of the urgency for beds in an organized manner and allows staff to better match their demand (ED patients needing beds) with...

HD Goodall Hospital in Sanford, ME, is a rural, non-profit hospital seeing about 22,000 patients a year. The emergency department (ED) staff has demonstrated outstanding innovation in implementing strategies that support the total picture of the patient. The staff at HD Goodall continues their system of bringing patients straight back to the rooms when beds are available. These patients are registered at the bedside and triaged in the room to expedite the intake process and decrease wait times. When beds are unavailable, a concierge in the waiting room greets people and begins the...

St. Mary’s Medical Center in Maine has had much success with its multidisciplinary discharge planning at the bedside. The TCAB unit aimed to strengthen team vitality and increase patient satisfaction by involving the entire care team as well as the patient in rounds and discharge planning. They collaborated with the chief hospitalist to develop a method for involving the patient and family in discharge planning. The care team includes the charge nurse, patient’s nurse, physician, case management, social worker, physical therapist or occupational therapist, and pastoral care...

Implementing medication safety zones has been shown to reduce medication errors and adverse drug events, thus increasing patient safety. The TCAB unit at Spectrum Health System–Gerber Memorial Hospital noted these findings and, using the Plan/Do/Study/Act cycle, created a “no interruption zone” in front of the medication preparation area. Nurses reported a calmer environment with fewer interruptions but suggested including the entire medication room due to logistics, physical environment, and continued interruptions from conversation outside of zoned areas. Through the...

In 2009, national patient safety goals called for improvement in effective communication among caregivers and active involvement of patients in their own care. The TCAB team at Multicare Health System embraced this call to action by developing a bedside shift report. Through Plan/Do/Study/Act (PDSA) trials and support from hospital leaders, the team successfully developed a comprehensive bedside shift report that has been in place on the TCAB unit since January 2010 and spread to the entire hospital by September 2010. During the spread process, the TCAB unit staff served as consultants...

Mercy Hospital Anderson’s Patient Family Council has heightened the TCAB team’s understanding of the patient experience, improved care, and increased patient satisfaction. The council meets once a month to engage in a roundtable discussion covering topics including issues of concern, recognition, TCAB successes, and patient satisfaction scores, among others. There are currently about 20 members, five of whom are either past patients or family members of patients. The remaining members consist of volunteers, leadership, and housekeeping. Membership has been increasing, most...