Aligning efforts and establishing partnerships across systems is becoming a necessary fact for health care providers and organizations as both look to achieve the Triple Aim of improved health outcomes, improved health care quality and reduced costs. This type of effort is what is underway in New Mexico.
In August 2011, the Albuquerque Coalition for Healthcare Quality, the local Aligning Forces for Quality (AF4Q) Alliance, launched its Regional Transforming Care at the Bedside (TCAB) initiative across New Mexico. In April 2012, HealthInsight New Mexico, New Mexico’s Quality...
Sometimes perfect compliance on a quality measure is only as far away as a store-bought shower caddy and a bit of MacGyver ingenuity. That’s how an Erie County Medical Center unit lifted nurse compliance with its IV-tube labeling measure out of the 20 percent to 30 percent range to 100 percent.
The demands on physicians, nurses, and staff in medical surgical units can be intense. Juggling complex patient needs, making the rounds, following documentation requirements, and managing staff turnover in a fast paced environment can leave little time for meaningful patient interaction or evaluating and improving patient satisfaction.
The AF4Q National TCAB teams convened July 25-27 in San Francisco for their final meeting. Among the 121 attendees were the hospital team participants, the six AF4Q TCAB Regional Clinical Leaders, as well as AF4Q alliance representatives from 11 communities. Each hospital team completed a “graduation” video that highlighted their successes and the impact the program had on their units. Speakers also included the Foundation’s Anne Weiss; Sue Hassmiller, RWJF senior advisor for nursing; Joyce Batcheller of Seton Family of Hospitals, along with three staff nurse...
At Southern Maine Medical Center (SMMC), a time savings of 15 to 17 minutes every shift means more quality time for patients. “Huddles,” a mechanism for communicating critical information about patient care needs, once lasted approximately 22 minutes on the SMMC TCAB unit. After the TCAB team implemented an innovation designed to address this, huddle times have decreased to five to seven minutes. The nursing staff accomplished this decrease by providing staff a standardized format for what information should be relayed and the emphasizing the importance of staying on topic...
Sinai-Grace Hospital TCAB Team focused on the patient discharge process to improve HCAHPS scores and lower the cost associated with items patient leave at the hospital. Often hospitals must spend a great deal of time searching for belongings patients leave behind and sometimes are responsible for replacing items such as dentures and glasses. The TCAB team took a unique approach in tailoring a popular and well-vetted innovation, the “four-eyed assessment,” and applying it to discharge. For each discharge, two staff members—thus four eyes—visit the patient to ensure...
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...