Responsiveness of Hospital Staff. Julie Kennedy BSN, RN
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1 Responsiveness of Hospital Staff Julie Kennedy BSN, RN Nashville, TN May 14-15, 2013
2 Past Present Future Responsiveness in healthcare s past Responsiveness now IP Hourly Rounding Study with top reasons for call lights (AJN, 2006) ED Hourly Rounding Study (JEM, 2010) Technology Value Based Purchasing Responsiveness expectations of our future
3 Outcomes of This Session WHY WHAT HOW During Your Hospital Stay How Often Did You Get Help as Soon as You Wanted it?
4 Execution Framework Evidence-Based Leadership SM Foundation STUDER GROUP : Objective Evaluation System Leader Development Must Haves Performance Gap Standardization Accelerators Aligned Goals Aligned Behavior Aligned Process Develop LEM goals for Responsiveness domain Weight units based on current results. Don t be afraid of weights! Add HCAHPS results to evaluations Educate leaders how to: Engage staff Share the WHY Validate and Inspire behaviors Critical Conversations Huddles Nurse Leader Rounds Hourly Rounding Post Visit Clinical calls KWKT- Narrate care Whiteboards Reward and recognize or coach/counsel as appropriate to reinforce behaviors and achievement of results Processes that are consistent and standardized Process Improvement PDCA Lean Six Sigma Baldrige Framework Software
5 Responsiveness: Correlates to Quality
6 Responsiveness: Correlates with Readmissions
7 Talk Money To Me CMS Quality-Based Payment Initiatives Will Put More Than 7% of Payment at Risk
8 Talk Money To Me ~ FY 2014 Core Measures (45% Weight) 1.25% Base operating DRG payments HCAHPS Composites (30% Weight) Readmissions (2%) 376 bed hospital 630M Inpt revenue 45% Medicare Outcomes (25% Weight) $3,543,750 $3,000,000 Source: OPPS VBP Final rule Note: Implementation FY 2014
9 Value Based Purchasing FY 2015 HCAHPS Composites (30% Weight) 1.50% Base operating DRG payments $ Outcomes (30% Weight) Core Measures (20% Weight) Efficiency (20% Weight)
10 Diagnose: Nurse Leader Rounding Ancillary Rounding Bedside Shift Report Its all about the questions. What did you have to use your call light for this shift? What about last night? When you put your call light on who answers it? Visualize when in the room call light in place and assess patient knowledge of using it Chapter 8-10
11 Diagnose: Call Light Audits
12 Time is Money $36,660/yr 700 calls/wk= 46 hrs One Call Light = 4 Minutes of Care Giver Time
13 Diagnose: Individual Call Light Audits Assess for inequality of call light use by nurse or team in relation to others Collect evidence on why call lights are being used and what patients are requesting Offer coaching for nurse and nurse assistants who are less efficient and practice less safely and proactively than peers
14 Treatment Interventions During Your Hospital Stay How Often Did You Get Help as Soon as You Wanted it? Responsiveness of Hospital Staff Treatment: No Passing Zone
15 Treatment: No Passing Zone YOUR CALL LIGHT IS IMPORTANT!! I am recognized for keeping my patients safe by answering call lights quickly and efficiently Section 3
16 Treatment Interventions During Your Hospital Stay How Often Did You Get Help as Soon as You Wanted it? Responsiveness of Hospital Staff Treatment: No Passing Zone Prevention: Hourly Rounding
17 Prevention: Hourly Rounding Use opening key words (AIDET ) Accomplish scheduled tasks TOP REASONS FOR CALL LIGHTS Address 3Ps (IP) Address PPD (ED) Address additional comfort needs Conduct environmental assessment Ask Is there anything else I can do for you before I go? I have time. Tell each patient when you will be back Document the round
18 Prevention: Hourly Rounding
19 During Your Hospital Stay How Often Did You Get Help as Soon as You Wanted it? Tactic / Intervention Diagnosis: Treatment: Responsiveness to call lights Prevention of call lights Nurse Leader Rounding Ancillary Leader Rounding Bedside Shift Report Call Light Audits Call Light Audits / Individual Call Light Audits No Pass Zone Hourly Rounding with Eight Behaviors
20 Change Before You Have To! Jack Welch For more information, contact me at
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