2.50
Hdl Handle:
http://hdl.handle.net/10755/344139
Category:
Abstract
Type:
Poster
Title:
Implementing a Region-Wide Service and Flow Improvement Initiative
Author(s):
Kigerl, Kathy
Lead Author STTI Affiliation:
Non-member
Author Details:
Kathy Kigerl, MN, RN, kathy.x.kigerl@kp.org
Abstract:
Evidence-based Practice Abstract Purpose: With over one million visits per year organizationally, our emergency departments represent a critical touch point within our integrated delivery model. Often arriving with a heightened sense of anxiety and pain, our patients and family members need clear communication and information about their care. The objective of our evidence based-project was to improve the care experience for patients treated within our fourteen emergency departments. Design: This was an evidence-based project focused on front-line staff and leader development, throughput, and quality improvements. Setting: Fourteen urban facilities (with a range of 12 to 78 bays) that see approximately 72,000 emergency department visits per month. Participants/Subjects: All visitors to fourteen emergency departments. Methods: The program utilized a collaborative structure with two waves, each group of emergency departments participating for twelve months. The operational leadership teams for each emergency department participated in monthly meetings (four in-person and eight conference calls). The meetings included data review, repot outs to share challenges and best practices, skills labs, and coaching. Coaches also conducted quarterly site visits to observe and validate practices and to provide real time coaching. The program consisted of four phases. The first phase focused on rounding on patients and direct reports and immediately bedding patients. The second phase included waiting room announcements, coaching staff, and care boards. During the third phase, the focus was on bedside shift report and utilizing a standardized communication process to patients. The fourth phase focused on the handoff process from the emergency department to inpatient. Evaluation tools included a monthly dashboard with key throughput and patient satisfaction metrics. The throughput data was based on events generated from an electronic health record. The patient satisfaction scores were derived from a mail survey based on a computerized random sample. Results/Outcomes: There were statistically significant improvements and standardization of workflow post implementation of the evidence-based practices at Wave 1 sites. The average duration from arrival to room and the standard deviation significantly improved from 35 minutes (SD=948) to 24 minutes (SD=40; t(945,315)=8.59, p < .001). We saw similar findings for length of stay for fast track patients and length of stay for admitted patients. On patient experience measures, the percent of patients that responded with a 9 or 10 on overall satisfaction in the emergency department (scale from 1-10) was above baseline performance for eight consecutive months (April 2013 – November 2013). Similarly, the percent of patients that responded “yes” to being informed about their length of treatment was above baseline for 12 consecutive months (December 2012 – November 2013). Results from Wave 1 indicate that effective training of the leadership team and ensuring practices are hardwired across staff will lead to improvements in front and back end flow, as well as patient perception of being informed about their care and their overall satisfaction. Implications: An organized service and flow initiative utilizing a collaborative approach with a combination of skills labs, coaching, didactic, and sharing best practices is an effective way to improve the patient experience across multiple sites.
Keywords:
Improve Care Experience; Patient Care
Repository Posting Date:
4-Feb-2015
Date of Publication:
4-Feb-2015
Conference Date:
2014
Conference Name:
2014 ENA Annual Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Indianapolis, Indiana, U.S.A.
Description:
2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titleImplementing a Region-Wide Service and Flow Improvement Initiativeen_GB
dc.contributor.authorKigerl, Kathyen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsKathy Kigerl, MN, RN, kathy.x.kigerl@kp.orgen_GB
dc.identifier.urihttp://hdl.handle.net/10755/344139-
dc.description.abstractEvidence-based Practice Abstract Purpose: With over one million visits per year organizationally, our emergency departments represent a critical touch point within our integrated delivery model. Often arriving with a heightened sense of anxiety and pain, our patients and family members need clear communication and information about their care. The objective of our evidence based-project was to improve the care experience for patients treated within our fourteen emergency departments. Design: This was an evidence-based project focused on front-line staff and leader development, throughput, and quality improvements. Setting: Fourteen urban facilities (with a range of 12 to 78 bays) that see approximately 72,000 emergency department visits per month. Participants/Subjects: All visitors to fourteen emergency departments. Methods: The program utilized a collaborative structure with two waves, each group of emergency departments participating for twelve months. The operational leadership teams for each emergency department participated in monthly meetings (four in-person and eight conference calls). The meetings included data review, repot outs to share challenges and best practices, skills labs, and coaching. Coaches also conducted quarterly site visits to observe and validate practices and to provide real time coaching. The program consisted of four phases. The first phase focused on rounding on patients and direct reports and immediately bedding patients. The second phase included waiting room announcements, coaching staff, and care boards. During the third phase, the focus was on bedside shift report and utilizing a standardized communication process to patients. The fourth phase focused on the handoff process from the emergency department to inpatient. Evaluation tools included a monthly dashboard with key throughput and patient satisfaction metrics. The throughput data was based on events generated from an electronic health record. The patient satisfaction scores were derived from a mail survey based on a computerized random sample. Results/Outcomes: There were statistically significant improvements and standardization of workflow post implementation of the evidence-based practices at Wave 1 sites. The average duration from arrival to room and the standard deviation significantly improved from 35 minutes (SD=948) to 24 minutes (SD=40; t(945,315)=8.59, p < .001). We saw similar findings for length of stay for fast track patients and length of stay for admitted patients. On patient experience measures, the percent of patients that responded with a 9 or 10 on overall satisfaction in the emergency department (scale from 1-10) was above baseline performance for eight consecutive months (April 2013 – November 2013). Similarly, the percent of patients that responded “yes” to being informed about their length of treatment was above baseline for 12 consecutive months (December 2012 – November 2013). Results from Wave 1 indicate that effective training of the leadership team and ensuring practices are hardwired across staff will lead to improvements in front and back end flow, as well as patient perception of being informed about their care and their overall satisfaction. Implications: An organized service and flow initiative utilizing a collaborative approach with a combination of skills labs, coaching, didactic, and sharing best practices is an effective way to improve the patient experience across multiple sites.en_GB
dc.subjectImprove Care Experienceen_GB
dc.subjectPatient Careen_GB
dc.date.available2015-02-04T11:27:11Z-
dc.date.issued2015-02-04-
dc.date.accessioned2015-02-04T11:27:11Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Annual Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationIndianapolis, Indiana, U.S.A.en_GB
dc.description2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_GB
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