teamstepps team presentation...hospital information •hospital opened october 2013 •5 story...
TRANSCRIPT
November 10, 2016
TeamSTEPPS Team Presentation
Temecula Valley Hospital
Hospital Information
• Hospital opened October 2013
• 5 Story Building-140 Beds
– All Private Rooms
– 20 ICU Beds
– 120 MST Beds
– 21 Bed ED
• Expansion plans for a second patient tower for total of 320 beds
TVH Team
• Over 700 Employees
• 300 Physicians
• Over 150 Volunteers
Mission, Vision and Values
• Mission: To deliver exceptional and compassionate patient care
• Vision: To transform the healthcare experience
• Values: Compassion, Trust, Courage and Innovation
• Patient safety is Priority
– Just Culture
– Transparency
– Staff/patients, family encourage to identify and report safety concerns
Key Programs
• TJC accredited as Primary Stroke Center
• Chest Pain Accredited as STEMI Receiving Center
• Open Heart Program
Why we are Glad to be Here!
• Our Hospital’s Unique Challenges
– New Hospital
– New Staff/Physicians
– Rapid growth
– Creating and maintaining intentional culture based on safety
• Introduction to TeamSTEPPS• Periop Education 2015
• BOG presentation
Area for Improvement
• ED Throughput– 80% of patients admitted through ED
– ED throughput involves every department in hospital
– Baseline data showed there were admission delays from the ED to the hospital
• Patient and staff/provider dissatisfaction
• Potential safety issue
– How we decided our area of focus: • Issues with ED handoff from ED to nursing floors
– Not timely
– Incomplete patient information/communication
Intervention
• TeamSTEPPS tools/strategies – Handoff
– SBAR Communication
– Face to Face Communication
– Advocacy and Assertion
• Small Tests of Change – Developed Admit Checkoff List
– Includes what should be done for patient before leaving ED and Face to Face Handoff
– Transport by RN
• Low Hanging Fruit– Developed flowchart of options when ED nurse not available
to transport patient
How We Implemented the Changes
• Key Individuals– ED and Hospitalist MDs
– Jacquelyn Ramirez, Director of ED
– Jackie Simon, ED Staff RN
– Lori Ohringer, Director of Med/Surg/Tele
– Med/Surg/Tele Staff Nurses
– Amber Gollogly, Director of Clinical Programs, Education and Training
– Kate DiDonato, CNO
• Key Strategies– Identify Risk Points
– Involvement of frontline staff
– Setting clear expectations
– Education and reinforcement of communication
– Follow up and follow through for accountability
Process Changes
• Specific Changes – Re-defined process for communication between ED and
nursing units
– Expectation for SBAR communication
– Face To Face Handoff
– Reinforced expectation for teamwork in transporting
patient
• Minor adjustments– Follow up on process when it didn’t go well
– Based on real time feedback
– Audit of process
Audit Tool
Face to Face Hand-off Validation:
Signature is Acknowledgement of Face to Face handoff only
ED RN handing off patient Face to Face signature:
Signature:______________________Time:____________
RN Receiving Face to Face handoff on floor:
Signature:___________________Time:____________
Barriers & Strategies
• Barriers Identified– Time challenges and conflicting priorities
– Inconsistency in team membership (2 key members left organization)
– Work load
• Strategies– Communication and collaboration between directors
and team members: staff were the drivers
– Cross-monitoring and feedback
– New team members were needed and committee restructured
What we found out?
• The new process could actually work!
• Needed to reframe our thinking – not focus on– what’s been done in the past
– why it can’t be done
• Surprises – Early buy in and adoption of the new process
– Staff started coming up with what they could do to improve
the process for each other and how they could support
each other
How did it go?
• Staff feedback
• New employee comment
• Medication reconciliation improved
• Eliminated patients being brought to floor without staff
awareness
• Staff Satisfaction
• Teamwork
• Opportunity to validate patient condition upon arrival on unit
Patient Satisfaction scores
• Patient admitted to floor more promptly
Next STEPPS
• Patient Safety Hero
• Annual Culture of Safety Survey
• Speak up campaign
• Monthly safety report to Board of Governors and annual TeamSTEPPS training
• Incorporated TeamSTEPPS concepts into annual Culture of Safety/Patient Experience/Service Excellence training for all employees and volunteers
• Corporate appointed physician leader for TeamSTEPPS
The Value of Participating in the IE TeamSTEPPS Collaborative
– Relationships improved between ED and Nursing
impacting team performance
– Mutual trust developed
– Improved patient safety & staff teamwork
– TeamSTEPPS was the system that helped us pull
it all together!
Something BIG is happening in the IE!
• We are glad to be a part of it!
• Happy to collaborate and share lessons learned:
Amber Gollogly
(951) 331-2270