Since the implementation of TCAB at Medina Memorial Healthcare System, voluntary nurse turnover has improved markedly. Before TCAB, the average turnover rate was seven nurses per year. Over the course of 30 months of applying TCAB principles, only three nurses left, bringing the voluntary nurse turnover rate for 2011 down to 1.5 percent. The hospital attributes this difference to the collective involvement of frontline nurses in the improvement process and the effort by the nursing staff to engage newly hired nurses in TCAB. The chief nursing officer overseeing Medina’s TCAB unit...
It is well established that hourly rounding on hospital units can decrease call-light use, 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 scores on the HCAHPS question regarding prompt response to call button, employed this best practice of purposeful hourly rounding. In purposeful hourly rounding, 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...
The Gettysburg Hospital TCAB team applied a tried and true improvement tool, the Plan/Do/Study/Act (PDSA) process, to a problem identified on the TCAB unit. The team was spending too much time looking for equipment and supplies—“hunting and gathering.” They noticed a lack of organization and clutter that was impeding efficient care. To address this need to organize space, supplies, and equipment, the team went through the PDSA steps and used the principles of lean process referred to as the “5Ss: Making your space work for you.” The 5Ss stand for “sort...
It is estimated that 80,000 central venous catheter-associated nosocomial bloodstream infections occur annually in the United States.These infections have been shown in many instances to increase morbidity, length of hospital stay, and costs associated with hospital stay. In an effort to reduce these consequences, the TCAB team at Erie County Medical Center developed an innovation approach. Through education surrounding the negative effects of infection and the link to proper IV use, they increased IV tube labeling from 65 percent to 100 percent and thus reduced potential for infection on...
Many Increasing Throughput hospitals have learned that solving the problem of emergency department (ED) crowding requires getting the entire hospital involved.
Mount Clemens Hospital, a non-profit suburban hospital in Mount Clemens, MI, that sees about 56,000 ED patients each year, decided to tackle crowding head-on by challenging its principal driver: boarding. Boarding patients is a coping mechanism EDs use when beds are not available in inpatient units, but it can lead to delays in necessary treatment as well as patients leaving without being seen.
The...
To increase physician usew and documentation of interpreter services, St. Mary’s Hospital in Madison, WI, added a physician Best Practice Alert into Epic, the electronic medical record system the hospital uses, to highlight the need for an interpreter, inform physicians of how to access an interpreter, and inform physicians of a newly created space in Epic that allows them to document interpreter services easily. The Best Practice Alert is automatically triggered at registration for any patient who states a preference for receiving health care in a language other than English....
Mercy Hospital Anderson’s Patient Family Council facilitates the TCAB team’s understanding of the patient experience, improved care, and increased patient satisfaction. The council meets once a month for a roundtable discussion covering areas for improvement, successes, and patient satisfaction scores, among other topics. With approximately 20 members, the council continues to grow. Current members are past patients, family members of current patients, volunteers, hospital leadership, and staff from various hospital departments. Through the awareness and feedback received...
At first, staff at Carson City Hospital in Michigan were incredulous when quality department staff told them their scores on compliance with ideal care measures were lower than the standard the 77-bed acute care hospital had set.
“Our nurses didn’t really understand what core measures were really, really all about, or what it takes to actually get in compliance with those measures,” said Joan Sweet, vice president and chief quality/risk officer at Carson City Hospital.
The hospital was searching for a way to re-educate and re-energize staff members about the...
The 2012 AF4Q National Meeting was held in New Orleans, Louisiana form May 16-18. At the event the many successes of the Transforming Care at the Bedside or TCAB initiative was shared with the meeting attendees at a kiosk sharing this presentation. View the slidedeck here!
When the Minnesota Hospital Association (MHA) applied to join the Partnership for Patients (P4P) Hospital Engagement Network, it realized it would need to change the culture both at the leadership and front line staff levels to bring about the network’s required results.
Hospital Engagement Networks (HEN) work to develop learning collaboratives for hospitals and provide a wide array of initiatives and activities to improve...