Adult Service and Operational Excellence

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1 Adult Service and Operational Excellence Presented By Joelle Jensen, RN, MSN, NEA-BC Senior Associate Director Clinical Services Medical Surgical Services Nursing Division Terri Brennan, MD Colloton Associate Professor Clinical Director, Division of Cardiovascular Medicine Jane Moss Brenda Winkle Rachel Hottel Angela Freese

2 Ideal Adult Inpatient Arrival Experience Presented to Management Staff Meeting May 27, 2010 PRES

3 Ideal Arrival Experience Team Co-leaders Team members Support team Co-Leaders Theresa Brennan, MD Int. Med Cardiology Joelle Jensen, Senior Assoc Director Nursing Team Members Christi Greene, RN Emergency Treatment Center Karen Lynch, RN 4JPE Deniece Carlson, RN 4JPW Michelle Daufeldt, RN 4JCW Jenny (Gates) Becker, RN CVICU Annie Bethke, RN 4RC Katie Knox, RN 3BT Brenda Winkle, RN CRU Wendy Beranek, RN HCCC Clinic Cathy Anson, RN Admission/Transfer Center Kelly McLaughlin, NClinician UIHVC Clinic Marsha Solares, NA 4JPW Theresa Loutsch, NUC 6RCE Kelley Terhark, NUC RSCU Angela Freese, NUC 3RCP Kelley Hough, NUC 4JCW Team Members Dick Harrison, Admin. Assistant MSS/ISS/BHS Cynthia Fairchild, Admin. Assistant Patient Account Representative Marcy Clark, Nurse Manager RSCU Rhonda Evans, Nurse Manager ALBMT Cheryl Bombei, Nurse Manager MICU Jennifer Long, Nurse Manager 4RC Pat Bott, Nurse Manager Emergency Treatment Center Fred Arnold, Nurse Manager Integrated Call Center Larry Espy, Asst. Manager Guest Services Karen Stenger, Advanced Prac. Nurse ISS Rachel Hottel, Advanced Prac. Nurse Perioperative Division Brian Daniel, MD Hospitalist Mike Miller, MD Emergency Treatment Center Steve Hata, MD SICU Christine Waller, MD GME House Staff II Carl Christensen, Volunteer Volunteer/Community Support Roles Linda Abbott Advanced Practice Nurse Chad Allen Clerical Marla Graf, Clerk III HCCC Clinic Kim Chamberlin Senior Nursing Associate Director Norma Panther, Clerk IV HCCC Clinic Cathy Willoughby Senior Nursing Associate Director Judy Snyder, Clerk IV DOSA Toni Mueller Senior Nursing Associate Director Barb Fishman, Program Assistant Patient Account Representative Tom Persoon Operational Improvement Jane Moss, Office Coordinator Eleni Jensen, Office Coordinator Sharon Artman, Project Assistant Integrated Call Center Information Desk Concierge Services Randy Fry, Director Randall Aitchison Diana Lundell Operational Improvement Patient Satisfaction Strategic Communications PRES

4 Thanks to our presenters Jane Moss (Office Coordinator: Integrated Call Center) Brenda Winkle (Staff Nurse, Behavioral Health) Angela Freese (Unit Clerk: 3RCP) Rachel Hottel (Advanced Practice Nurse, OR) PRES

5 Agenda Frame the problem Outline the six elements of the ideal arrival experience Describe the infrastructure needed to create the experience PRES

6 Framing the problem Reviewed patient satisfaction comments Interviewed 99 recently admitted patients 50% DID NOT EXPECT to be admitted Conclusion: Assume EVERY admission is a surprise to the person being admitted But. WE should NEVER be surprised by an admission We should always be expecting another guest PRES

7 Framing the problem If Disney Ran Your Hospital: Hospitalization is an opportunity to experience healing. The healing experience begins as soon as the patient walks through the door PRES

8 Framing the Problem If Disney Ran Your Hospital: 3 levels of satisfaction Competence (tasks) an expectation Courtesy an expectation, leaves patient satisfied if met Compassion patient is extremely satisfied if this is evident, becomes a loyal supporter Patients tell positive stories about their experience Compassion is skills of the heart! In order to excel, we need to be constantly demonstrating our compassion! PRES

9 Six Elements of the Ideal Arrival Experience 1. Every entrance is a front door 2. When the decision to admit is made, communicate with patient and family 3. The room is always ready! 4. The caregivers are always ready! 5. Friendly, warm, compassionate greeting at inpatient area 6. Communication (again) PRES

10 1. Every entrance is a front door Warm, friendly greeting at all entry points Physical environment and atmosphere What do you see, hear, and smell? The people patients meet Are we caregivers or clinicians? Do we heal or do tasks? The route taken to a unit must be obvious Benefit of greeters Stage-setting: Cleveland Clinic Redcoats Mayo greeter: I have the best job in the hospital seeking out people I can help. PRES

11 2. When the decision to admit is made, communicate with patient and family Empathy We re sorry you re sick Reason for admission What will happen next the who, what, where, when, and how If family is present, where will they go If family is not present, how is information communicated to them, and by whom? PRES

12 3. The room is always ready! Pathway to the room is clean, uncluttered, and calming Patients arrive at a clean, stocked, working, quiet and calming environment Room exists for the patient healing experience, not for our tasks Cleaning the room is part of the discharge process Do our current processes and organizational structure support this? PRES

13 4. The Caregivers are always ready! Caregivers communicate with each other in advance of patient arrival Clinical information Psychosocial information (family and friends) This demonstrates Admissions are not a surprise to us! We re all on the same team! PRES

14 5. Friendly, warm, compassionate greeting at inpatient area Recognizes that the admission is disruptive for the patient and family Empathy: We re sorry you re sick Includes physical and atmospheric elements Sights, smells, and sounds Greet patient in healing environment Purpose-oriented: The purpose is healing PRES

15 6. Communication (again) Orient patient and family to the space White boards Equipment Family accommodations Communicate estimated discharge date Plant the seed for the discharge process Hope is healing! PRES

16 People, Process, Setting: the elements to make this happen Setting Physical environment Way finding Security Place to secure belongings Motor vehicle security PRES

17 People, Process, Setting: the elements to make this happen Communication consistently to entire team Wait time Reduced because the room is always ready Redirect attention from the wait when we can t eliminate it PRES

18 People, Process, Setting: the elements to make this happen Roles in the healing experience The lead role in the healing experience is the patient and family Caregivers and others with patient contact play supporting roles PRES

19 People, Process, Setting: the elements to make this happen When you re somewhere, be there! Behavioral elements of supporting roles The patient is always the focus Making eye contact Language that is patient appropriate Caregiver posture MD sitting vs standing Having time for the purpose, not just the tasks The purpose is healing PRES

20 People, Process, Setting: the elements to make this happen Selecting and training cast members in the supporting roles Today: we focus our teaching on tasks Future: we need to focus some teaching energy on the purpose We need to teach them to be caregivers The tasks are just tools Cast members learn from actions as well as words PRES

21 People, Process, Setting: the elements to make this happen Cast members in the environment Being nice to ourselves complimenting our fellow team members Listen, listen, listen! Anticipate needs We ve done this before, we know what comes next Offer assistance PRES

22 People, Process, Setting: the elements to make this happen We all become parts of our patients history! Your every day is our big event Be memorable in a positive way! Every interaction point is an opportunity to make an impact and an impression PRES

23 Compassionate care begins with how we admit people! What I do you cannot do; but what you do, I cannot do. The needs are great, and none of us, including me, ever do great things. But we can all do small things, with great love, and together we can do something wonderful. - Mother Teresa PRES

24 Top 6 Ideas Train everyone for the Purpose Warm welcome Compassion Healing Place greeters at every entrance Coordinate signage Train everyone in team communication skills Clearly define standard process for room preparation Continuous training to sustain excellence PRES

25 Our Recommendations Establish Purpose training program New employees Mandatory annual refresher Accountability for everyone Establish greeter program Preliminary data: 12% of guests needed assistance with directions Conduct kaizen to improve placing a patient in their bed Includes room and caregiver readiness Metrics available from bed management system Initial focus on one unit or service line PRES

26 Questions PRES

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