Decreasing Noise to Increase Our HCAHPS

Transcription

1 Decreasing Noise to Increase Our HCAHPS Joanne Muzzey, RN MS Director of Patient Advocacy and Planetree Karin Block, RN Relationship-Based Care Coordinator

2 Agenda Introductions Awareness activity Elmhurst Memorial Healthcare overview Kaizen event Rest and relaxation hour Outcomes Lessons learned Next steps

3 Elmhurst Memorial Hospital Suburban Community Based Hospital established in beds 66% private rooms Model of Care Relationship-Based Care Shared Governance Planetree Affiliation 2007

4 Elmhurst Memorial Hospital Today Transitioned to a new replacement Hospital on June 25, private rooms

5 Awareness for Change HCAHPS first released for EMH Quiet at Night 47.2% 1% of HealthStream database One unit as low as 17.1% Planetree Progress Assessment Feedback

6 Initial Interventions Work Life Council Silenced portable phones Planetree Steering Committee Healing Environment Team Organization awareness Unit Councils Unit specific noise Practice Council Sleep Standard

7 Reasons for Organization Wide Approach Minimal improvement in HCAHPS Feedback from our Patient Family Advisory Council Initial efforts were not coordinated and ineffective A culture change was needed

8 Assessment Kaizen event held on June 30, 2009 Multi disciplinary focus included staff members from all areas, volunteers and members of Patient Family Advisory Council Organizational noise assessment Data collected Decibel readings Observation of workflow

9 Assessment 46 tasks were identified and categorized Environment and equipment Processes People

10 Accomplishments from Kaizen Quiet at Night Standard Elevator use Standard Standardized call light system and telephone ring tone volumes across all units Keypads silenced Tube stations padded Cushioned tops of laundry hampers IV pole inventory Rest & Relaxation Time

11 Rest and Relaxation time objective Create an environment conducive to healing by offering our patients one hour in the afternoon to rest without interruptions 80% of the time, through the coordination of patient care and support services.

12 Rest and Relaxation Planning Multidisciplinary task force developed 31 areas/departments represented Senior leadership support Staff-level team leaders Members: clinical/nonclinical Emergency Department Cardiovascular unit Critical care unit Progressive care unit Oncology unit Medical unit Surgical unit Food Service Family Birthing Center Housekeeping Respiratory care Transitional care unit Pediatrics Ambulatory surgery unit Central Admissions Area Diagnostics Physical Therapy

13 Planning: Initial meeting Senior leader message Awareness activity Overview of project Everyday Creativity Defined the scope Set timeline for implementation Initial discussion of unit hours

14 Planning: Everyday Creativity Reframe the problem into an opportunity Change the group s perspective Seek the next right answer Create passion

15 Planning: LEAN process Defined scope In scope: inpatients Out of scope: new admissions, outpatients (ED, Ambulatory Surgery), Transitional Care Center, behavioral health unit, stat and emergency care Decision making activities

16 Picture Frame Scope of Project New Admission Behavioral Health Unit Inpatient Nursing Units Bedside handoff process Verbal/written report tools In-patient areas Admitted patients(including OBSV and SPO s) Content of report Outpatient to inpatient areas Transitional Care Center Stat and Emergency Care Outpatient Areas: ED & Ambulatory Surgery

17 Planning: Timeline 6 months from Kaizen to Implementation Kaizen June 30, 2009 Initial task force meeting November 23, 2009 Rest and relaxation hour February 1, 2010 phase one Hours by department/floor 1 2p.m. Third floor: medical, oncology, Family Birthing Center, Pediatrics 2 3 p.m. Second floor: cardiovascular, progressive care, critical care 4 5 p.m. Fourth floor: surgical

18 Implementation Phases Phase one Inform patient and family Rounding to prep patients Close patients doors as desired Dim hallway lighting Lower voices Phase two Decrease/eliminate environmental noise at the unit level Phase three Coordinate patient s schedule to support rest time 80% of the time

19 Outcomes Decibel reading Unit observation Hall lights dimmed Patient doors closed Staff activity Patient interviews Are you aware of rest and relaxation time? Was the environment suitable to allow you to rest?

20 Decibel Readings Unit Before After Change 3N CVC PCU % reduction 32% reduction 33% reduction

21 Timeline Initial HCAHPS Report Council projects Rest and Relaxation hour New Campus opens Steering Committee initiatives Kaizen New Campus training 75.9%

22 Quietness of area around room at night September % September % March % September % March % September % December % March % December % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% New campus

23 New Hospital Quiet by Design Sound absorbing materials Room darkening shades Decentralized work stations Onstage / Off stage work and patient flow

24 New Hospital Quiet by Culture Uncluttered Quiet equipment Staff awareness and ownership of the environment

25 Implementing R&R in our new environment Individualized to patient preference Patient Centered Scheduling Multidisciplinary approach

26 Lessons Learned Need a department champion Feedback is essential Share department best practices Keep the momentum Monthly check in meetings

27 New Hospital Decibel Scores Average Sound Levels (db) New Hospital October 2011 New Hospital September 2013 Unit Daytime Levels (6:00 am 10:00 pm) Night-time Levels (10:00 pm 6:00 am) Medical 5SW* % increase % increase Surgical 4W Oncology 4SE Cardiovascular 3SW % increase % increase % increase % increase % increase % increase Progressive Care Unit % increase % increase Family Birthing Post Partum NA 52.0 NA 46.4 Average % increase % increase

28 Next Steps for EMH Awareness Patient Experience Team Relationship-Based Care Kaizen Always events expectations

29 Questions?