patient advisor rounding vidant medical center
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Patient Advisor Rounding Vidant Medical Center. Kim Blanton Patient & Family Advisor Melissa Thomason Patient & Family Advisor. What you will learn today. What are Advisor Rounds? Why are they important? How do you do Advisor Rounds? Tools to support successful rounding - PowerPoint PPT PresentationTRANSCRIPT
Patient Advisor Rounding Vidant Medical Center
Kim BlantonPatient & Family Advisor
Melissa Thomason Patient & Family Advisor
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What you will learn today
What are Advisor Rounds? Why are they important? How do you do Advisor Rounds? Tools to support successful rounding Impact of Advisor Rounding Lessons learned
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System of Care
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A Day in the Life of Vidant Health
196 acute care admissions
136 surgeries 118 critical care
patient 822 ED visits 1,377 outpatient visits 2,000 VMG practice
visits
7 medical air transports
21 babies born 184 patients with
central lines 78 patients on
ventilators 144 patients with
urinary catheters
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Patients & Families as Team Members & Leaders
“Put Patients and Families on the Improvement Team” is noted as the leverage point
with the greatest potential to drive the long-term transformation of the entire system.”
IHI Seven Leadership Leverage Points to Drive Organizational Improvement
2008 IHI innovation series
System Wide Advisor Structure
Vidant BertieHospitalAdvisoryCouncil
Vidant ChowanHospitalAdvisoryCouncil
Vidant MedicalCenter
AdvisoryCouncil
Vidant DuplinHospitalAdvisory Council
VidantEdgecombe
HospitalAdvisory Council
Vidant Roanoke-Chowan HospitalAdvisory Council
AlbermarleHospital Advisory Council
The Outer Banks
HospitalAdvisory Council
Vidant BeaufortHospitalAdvisory Council(To be
Developed)
Vidant Pungo
HospitalAdvisory CouncilTo be
developed
VidantEmployee
HealthAdvisoryCouncil
VidantHome Health And Hospice
Advisory Council
Vidant MedicalGroup
AdvisoryCouncils
Vidant SurgiCenter
Advisory Council
Vidant MedicalCenter
Service Line AdvisoryCouncils
VIDANT HEALTHPATIENT-FAMILY EXPERIENCE TEAM
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Vidant Medical Center
Vidant Medical Center Advisor Structure
Vidant Health’s commitment is to have advisors at decision-making tables and to view care through the eyes of the patient.
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Patient and Family Advisors
Any role or activity that enables patients and families
to have direct input on policies, programs, and
practices affecting health care.
What do VMC Patient Advisors do?
Patient & Family
Advisors
Education
Literature Review
Safety
Rounding
Facility Design
Quality & Performance Improvement
Teams
System Input
Patient Communication &
Transparency
Storytelling
*Unit Rounds*Return to Care
Rounds*Safety Liaisons
Safety SummitSafety Boot
CampRCAs
FMEAs
FallsUTISkin
CLABSIVAP
MyChartCare Coordination
Board Presentations“Experiences in Care” Videos ConferencesNew Nurse Orientation
Provider Education
Patient EducationStaff Education
REAL DEAL training
Children’s EDCancer Center
Children’s HospitalHeart Institute
Hiring CommitteesStrategic PlanningVendor Selection
WHY Should Advisors do Rounds?
A real-time pulse check Strengthens partnerships Some patients are more comfortable
sharing concerns with a “former patient” Introduces a fresh perspective Front line workers see PFCC in ACTION Drives results. Yields better outcomes.
Vidant Medical Center Safety Liaisons
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Patient & Family Advisors who have completed risk assessments, HIPPA training and role orientation.
Patients give consent in advance.
Liaisons focus on safety and use a rounding tool.
Findings are documented and staff and advisors conduct debriefs with safety manager.
Pre – Safety Round Patient Consent Form
Safety Liaison Rounds:What we learned…
…. about Advisor Rounding Advisor Selection Important Builds Relationships Some patients more comfortable sharing with Patient
Advisors than with Staff
…. about our Care System Identified transition snags from acute to rehab Room nightlight preventive maintenance process
missing Discharge instructions in bright envelope; being used
throughout the system Patient-family engagement in bedside shift report, hourly
rounds and communication boards
Return to Care Rounds
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Advisors rounded with leaders from Office of
Patient & Family Experience
Used separate rounding tools and compared results
after each room
Hospital – wide results compiled by Office of
Patient & Family Experience
Service Line Rounds
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“ That’s what made a believer out of me….”
Diane HatfieldEast Carolina Heart Institute
Quality Chair
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Cardiac Intensive Care Unit
CICU
Cardiac Intermediate Unit
CIU
Cardiovascular Intermediate Unit
CVIU
Unit RoundsCVIU and CVICCVIU and CVIC
Cardiovascular Intensive Care Unit
CVIC
HOW do we do Unit Rounds?
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Meet with Unit Manager Review Unit Scores Identify Unit’s Needs (based on scores, manager’s needs & advisor’s input) Round with Managers Discuss Advisor Rounding Alone Report Findings to Unit Manager Act on Findings
A Success Story: CVICU
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From CVICU Rounds:
1. “Patient does not understand purpose behind the only new med she has received since admission”2. “No staff member has ever removed the “Commonly Used Meds” sheet from the boom for any reason.”
Unit Needs:Med CommunicationNurse Communication
Act on Findings
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1. TEAM strategy session
2. Small tests of change
3. Round to assess effectiveness
4. Make Improvements
5. Continue Rounding
One piece of the puzzle:
RESULTS:CVICU Med Communication
score rose from sub 10% to 98% within a year.
A Success Story: CIU
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“Wife stayed with husband for entire admission of 40+ days and was overwhelmed by the care she received as a family member. Nurses offered her extra meal plates at every meal time and checked on her regularly.”
Act on Findings
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1. Advisor and Wife immediately recognized nurse on duty
2. Advisor reported findings to Unit Manager at end of Rounds
3. Unit Manager and Advisor gave Wife Employee Recognition form
4. Form copies added to personnel files
5. Nurses received Staff Reward Points
1 West, Rounds - September 19, 2013, Patient Advisor Feedback
FOCUS: Pain Management and Quietness (Restfulness)
Patient 1:
Positive Feedback: Patient felt well-informed and well taken care of.
Needs Work: Patient’s largest complaint concerned restfulness. She felt as though staff members were in and out of her room all night long. Patient finally requested that staff please limit the times they come in during the night, and they made an effort to coordinate her care. She did add though that nurses/care partners are still coming in and making her get out of bed to weigh at 4am
Patient 2:
Positive Feedback: Pain is being managed well. Patient and husband both love that they always feel well prepared for what’s coming next. Staff makes it a point to tell them both what to expect ahead of time.
Needs Work: Communication Board not updated for current shift. (as of 4pm)
Patient 3:
Positive Feedback: Says that she’s had a perfect experience. Could not think of one thing that needed work.
Needs Work:
Patient 4:
Positive Feedback:
Needs Work: Patient was in horrible pain while in the ED the night before. She felt like no one was listening to her and ended up taking her own IV out. She offered no positive feedback. She did say that 1West staff is doing a better job of managing her pain but seemed completely unsettled by the ED experience.
Round, Round, Round …
VMC Outcomes 58% reduction in hospital acquired infections
(HAI) since 2008 95% optimal care on core measures (up 17
percentage points since 2007) 90th percentile inpatient experience Tripled number of patient-family advisors in
less than two years Hardwired hourly rounding, bedside shift
report and communication boards Nearly 90% of staff report organization
demonstrates commitment to patient-family centered care
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Advisor Rounding: Impact Strengthened Partnerships Advisor impact no longer dependent on
presence of Patient Experience Team leaders Boosted Patient Morale Boosted front-line staff support Made managers more open to Advisor input Increased Advisor satisfaction Improved scores & outcomes
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Lessons Learned
Not every manager is open to Advisor Rounding. Start small.
Not every Advisor will want to Round. Advisor selection matters.
Rounding requires mutual respect and open communication between Advisors and Managers.
Build on existing work. Don’t reinvent the wheel. Keep it simple!
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What can I do today?
Leader Rounds + Experienced Advisors
ADVISOR ROUNDING
“I love to round with advisors. It is the best thing a manager can do for her unit.”
Elaine ClarkManager, Women’s & Children’s
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Kim BlantonPatient-Family Advisor, Vidant Medical Center
Melissa ThomasonPatient-Family Advisor, Vidant Medical Center
for more information contact