Daily Management System: Improving quality and promoting patient safety: An Evidence-based Practice Initiative

Transcription

1 Daily Management System: Improving quality and promoting patient safety: An Evidence-based Practice Initiative Pauline M. Johnson, DNP, RN, FNP-BC Lennore Dennis-Yorke, RN, FNP-BC Kings County Hospital Center Brooklyn, New York

2 Disclosure There are no conflict of interest in relation to this presentation.

3 The goal of this presentation: To provide an overview on the role of Daily Management System (DMS) in promoting: High quality safe healthcare Patient and staff satisfaction Interdisciplinary team building Coaching & mentorship

4 DMS was implemented in New York City Health + Hospitals acute care facilities in Achieved much success in practice improvement since the implementation of DMS One such facility is Kings County Hospital Center.

5 King County Hospital Center, located in Central Brooklyn, is one of the oldest public hospitals in United States. Providing care for the Brooklyn, New York community since 1831 Current total capacity 627 acute care beds

6 Our mission: To provide high quality safe healthcare to a culturally diverse population, regardless of their ability to pay.

7 As a patient centered facility, KCHC strives to deliver the highest quality healthcare services with an emphasis on patient safety. In 2009, the hospital completed a $500 million major re-development project with the goal of improving care, and updating services.

8 DMS initiated 2014 aims to maintain continuous practice improvement of these updated services. An evidence-based practice initiative, subsystem of Breakthrough/Lean methodology. Applies to everything learned from root cause analysis and rapid improvement experiments. Uses visual boards for collection and display of real-time process-focused data.

9 Structuring of DMS: Understanding, Planning, Preparation, Implementation Toolkit DMS Area Board, Process Control Boards for data collection Implementation Team - Unit Leaders - Coach / Expert Steering Team - Executive & Sponsors - Higher Level Area Leaders Discipline Daily briefs Support for Improvement and Sustainment

10 Elements of Daily Management System Visual management boards Daily briefs- multidisciplinary Basic daily problem solving Monthly trend charts Monthly Pareto (Issues) charts Standard work for all processes Tiered briefs (leadership engagement) Executive rounds (stakeholders)

11 Team members meet or huddle for at most ten minutes each day to share information, reviews, and updates. Frontline team members are able to see their contributions to this process in real time. Team members engage in identifying and solving problems. Remove barriers to best patient care.

12 Weekly Tiered Briefs: Bring management team to DMS Board at regular intervals. Help management team understand the issues. Provide guidance and support. Promote team based problem solving, focused on improving patient experience. Problem solve to eliminate waste and improve process.

13 Why Daily Management System? Assumed Results of RIEs: Actual Results:

14 Why Daily Management System? Results of Continuous Improvement Activities (RIEs & DMS) (RIE) (DMS)

15 Data driven vs. Opinions and misconceptions Focuses on continuous practice Improvement Elimination of waste and inefficiencies Utilizes Breakthrough/Lean tools and concepts Transformational plan of care

16 Examples of successful DMS projects converted to process improvement: Telemetry Monitoring Weight assessment of patients with heart failure Foley catheter removal Wound care Verification of patients insurance information Length of stay issues Coaching and mentoring

17 Converts leaders from being reactive firefighters, attacking problems in crisis mode. To proactive leaders who manage and control priorities in order to continuously improve processes, True Continuous Improvement happens everyday at anytime, by anyone.

18 In Summary: Daily Management System Teamwork focused Practice improvement Action oriented Improves patient/family experience by improving processes Eliminate silos and waste Data driven Staff engagement Mentoring and Coaching

19 Thanks you! Questions??

20 References: Abanese, C. T., Aaby, D. R., & Platchek, T. S.(2014) Advanced Lean in Healthcare; create space America s Hospitals: Improving Quality and Safety: The Joint Commission s Annual Report 2015; Fletcher, S., Berg, A. Zimmerman, M., Wuste, K., & Behrens, J. (2009) Nurse-patient interaction and communication. A systematic literature review. Journal of Public Health. 17, Furman, C., Caplan, R. (2007) Applying Toyota Production System using a patient safety alert system to reduce error The Joint commission on quality and safety, 33: Garbow, P., & Goodman, P. (2014) The Lean Prescription: Powerful Medicine for Our Ailing Healthcare; Productivity Press Hafer, M. S., (2012) Simpler Healthcare; Create Space Institute of Medicine Report. Crossing the Quality Chasm. A new health system for the 21 st century. Academics Press: Johnson, P., M. (2013) Lean Methodology: An Evidence-based Practice Approach for healthcare improvement. The Nurse Practitioner. Lippincott Williams & Wilkins