Patient and Family Engagement: Mount Carmel New Albany s Journey. Susan Schultz, MSN, RN, FACHE July 16, 2017

Transcription

1 Patient and Family Engagement: Mount Carmel New Albany s Journey Susan Schultz, MSN, RN, FACHE July 16, 2017

2 Mount Carmel New Albany Surgical Hospital Built in 2003 as New Albany Surgical Hospital (NASH) Orthopedic and neuromuscular specialty hospital founded by physicians Quality, patient experience, and colleaguephysician collaboration at center of care model and culture Became a part of Mount Carmel Health System in 2007

3 Mount Carmel New Albany Surgical Hospital, cont d Two-story facility 117,668 square feet Ten operating rooms 60 private inpatient rooms

4 PFE 1: Planning Checklist for Scheduled Admissions PfP Metric Language Prior to admission, hospital staff provides and discusses a planning checklist with every patient that has a schedule admission, allowing for questions or comments from the patient or family

5 PFE 1: Planning Checklist for Scheduled Admissions, 2

6 PFE 1:Planning Checklist for Scheduled Admissions, 3 CMS Your Discharge Planning Checklist: For patients and their caregivers preparing to leave a hospital, nursing home or other care setting Discharge Checklist (

7 PFE 1: Planning Checklist for Scheduled Admissions, cont d At MCNA, this planning process begins with a strong collaboration with surgeons and their practice managers Patient Education Binders Multidisciplinary team develops and updates content Surgeons provide input Reviewed and revised annually

8 MCNA Educational Binders

9 PFE 1: Planning Checklist for Scheduled Admissions, 4 Cerner Discharge Screen - Adapted to address checklist items Where care will be received after discharge Problems to watch for Medications Contact person if there are questions Medical equipment

10 PFE 1: Planning Checklist for Scheduled Admissions, 5 Cerner Discharge Screen- continued ADL Caregiver support Demonstration of special skills Psychosocial support Written discharge instructions Next appointment

11 PFE 2: Shift Change Huddles / Bedside Report PfP Metric Language Hospital conducts shift change huddles and bedside reporting with patients and family At MCNA, shift change huddles were hard-wired; bedside report was not Fall 2015: Set Bedside Handoff Report as a strategic priority Jan 2016: Education and Implementation

12 PFE 2: Shift Change Huddles / Bedside Report, 2 PROBLEM STATEMENT 68% OF 3000 reported sentinel events were caused by miscommunication of health care providers during handoff (American Medical Association, 2012) Failure to communicate understandably created misunderstandings in discharge care resulting in readmissions that could have been avoided (Evans et al, 2012) Handoff report has historically taken many different forms and lacks continuity and formal education (Street et al, 2011) an estimated 80 percent of all sentinel events are cause by miscommunication between caregivers at hand-off report The Joint Commission (Zhani, 2012)

13 PFE 2: Shift Change Huddles / Bedside Report, 3 OBJECTIVES Nurses will identify reasons and guidelines for implementation of bedside handoff of care on completion of required education. Nurses will demonstrate desired handoff procedure, identifying pertinent information using a standardized form of communication. Nurses will demonstrate engagement with patients at bedside during bedside report allowing patient participation in plan of care. Nurse Managers will inquire about bedside reporting and assess patients opinions during rounding.

14 PFE 2: Shift Change Huddles / Bedside Report, 4 PROCESS Knock and wash in Greet patient explain bedside report procedure Greet visitors ask patient if visitors may stay or if they prefer they step away Encourage patient to participate and to speak-up if something sounds incorrect Be sure patient is at center of report speak clearly and audibly Assure all invasive devices (IVs, tubes, lines) are intact and properly functioning Review I&O Review medications/treatments address pain medications and make a plan Assure environmental cleanliness and items (call light, water) are in reach Review white board and update for accuracy ENCOURAGE questions or concerns Remind patient to use call light for assistance especially if at risk for fall Inform patient that hourly rounding will occur throughout the day/night Wash out

15 PFE 2: Shift Change Huddles / Bedside Report, 5 IMPLEMENTATION AND MONITORING Go live date Stressed peer-to-peer accountability and integrity Leader audits Positive feedback; stories

16 PFE 2: Shift Change Huddles / Bedside Report, 6 BARRIERS Perception that report takes longer at the bedside Concern about sharing certain clinical information (alcohol and/or drug abuse; certain diagnoses) Change Nobody likes change except a wet baby Drift Natural tendency to revert back to past habits

17 Patient Experience Scores FY17 YTD

18 PFE 2: Shift Change Huddles / Bedside Report, 7 REFERENCES American Medical Association. (2012). Reducing the risk by designing a safer, shame-free health care environment. Retrieved from ( Evans, D., Grunawalt, J., McClish, D., Wood, W., & Friese, C.R. (2012, September-October). Bedside shift to shift nursing report: Implementation and outcomes, 21(5), Street, M., Eustace, P., Livingston, P., Craike, M., Kent, B., & D., P. (2011). Communication at the bedside to enhance patient care: A survey of nurses experience and perspective of handover. International Journal of Nursing Practice, 17,

19 PFE 2: Shift Change Huddles / Bedside Report REFERENCES (cont) Zhani, E. E. (2012), Joint commission center for transforming healthcare releases tool to tackle miscommunication among caregivers. Retrieved from ( _hoc/) Maxson, P., Derby, K., Wrobleski, D., & Foss, D. (2012, May-June). Bedside nurse to nurse handoff promotes patient safety. Medsurg Nursing, 21(3), Kerr, D., Lu, S., McKindley, L., & Fuller, C. (2011). Examination of current handover practice: Evidence to support changing the ritual. International Journal of Nursing Practice, 17,

20 Questions? CONTACT INFORMATION Susan Schultz, MSN, RN, FACHE Vice President of Patient Care Services and Chief Nursing Officer Mount Carmel New Albany Surgical Hospital 7333 Smith s Mill Road New Albany, Ohio schultzs@mchs.com