erin brown, rncontinuous improvement 92% 89% communication about patient information 91% 86%...
TRANSCRIPT
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Digestive Health Clinic, LLC
Idaho Endoscopy Center, LLC
Erin Brown, RN Director of Nursing Services
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Digestive Health Clinic (DHC) • State-of-the-art physician-owned outpatient healthcare
facility
• Provides for the comprehensive care of diseases of the digestive system and liver for adult patients
• Performs endoscopic procedures (EGD and colonoscopy) in the Idaho Endoscopy Center (IEC), an AAAHC accredited free-standing ambulatory surgery center (ASC)
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DHC’s Medical Staff • DHC’s seven physicians and two nurse
practitioners evaluate and treat patients in the outpatient clinic area.
• Our physicians practice in the ASC and other outpatient/inpatient hospital facilities in the valley.
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Idaho Endoscopy Center Structure • 4 pre-op rooms, 4 procedure
rooms, 5 recovery rooms, and 5 step-down stations
• Full time staff: 11 RNs, 1 LPN, 7 CMAs
• Part time/prn staff: 3 RNs
• One Endoscopy Manager
• Only our physicians practice in the IEC
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Response Rate
98%
• 49 out of 50 surveys were completed
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Survey Results
Organizational Learning—Continuous Improvement
92% 89%
Communication About Patient Information
91% 86%
Management Support for Patient Safety
89% 81%
Teamwork 86% 81%
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Survey Results
Staff Training 78% 79%
Response to Mistakes 82%
78%
Communication Openness 85%
73%
Staffing, Work Pressure, and Pace
76% 55%
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Reactions & Follow Up • Shared results in a staff meeting
Managers were surprised about some of the results because staff do not always speak up during meetings
• During the survey period, our endoscopy center was going through a staff transition
• Decided to focus on Communication Openness
Staffing, Work Pressure and Pace
Staff Training
Response to Mistakes
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Communication Openness • 73% positive for DHC vs 85% for pilot ASCs
We feel comfortable asking questions when something doesn’t seem right.
93%
84%
When we see someone with more authority doing something unsafe for patients, we speak up.
87%
82%
Our ideas and suggestions are valued in this facility.
75%
52%
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Change Implemented • Assigned recovery nurses to specific rooms
each day to help improve face-to-face communication with physicians, facilitate continuity of care, and validate staff concerns
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Staffing, Work Pressure & Pace • 55% positive for DHC vs 76% for pilot ASCs
We have enough staff to handle the workload.
83%
64%
There is enough time between procedures to properly prepare for the next one.
86%
76%
We feel rushed when taking care of patients. (negatively worded)
58%
26%
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Change Implemented • Trained certified medical assistants to remove
patient IVs prior to discharge when there is a shortage of nursing staff
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Staff Training • 79% positive for DHC vs 78% for pilot ASCs
Staff who are new to this facility receive adequate orientation.
80% 85%
Staff feel pressured to do tasks they haven’t been trained to do. (negatively worded)
72% 71%
We get the on-the-job training we need in this facility.
84% 91%
Staff get the refresher training they need.
79% 68%
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Response to Mistakes • 78% positive for DHC vs 82% for pilot ASCs
Staff are treated fairly when they make mistakes.
81%
89%
Learning, rather than blame, is emphasized when mistakes are made.
78%
70%
Staff are told about patient safety problems that happen in this facility.
86%
74%
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Change Implemented • Staff Training: Provided additional drills and staff
training to develop more confidence in performing tasks
• Response to Mistakes: Continued treating mistakes as learning opportunities
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Going Forward • Continue to collaborate with
other departments on workflow improvements
• Initiate staff competencies evaluations more frequently
• Perform periodic company-wide re-surveys
• Continue to share survey results
• Strengthen Patient Safety Sustainability Plan