Maryland Patient Safety Center Call for Solutions

Transcription

1 Organization: Johns Hopkins Bayview Medical Center Solution Title: Quiet at Night Program/Project Description, including Goals: The HCAHPS patient satisfaction scores in the Quiet at Night domain which includes the following question During this hospital stay, how often was the area around your room quiet at night? is below our 51 percent always goal for FY14. Our goal is a 3% improvement form FY13 or to be in the 75 th percentile. Further, if our hospital is too noisy and chaotic, it could negatively impact our patients recovery and slow down the healing process A noise reduction project and a sleep squad team that includes the Director of Service Excellence, Performance Improvement and Patient safety representatives, was initiated to improve our patients experience during their hospital stay. Our goal is to reduce the noise level at night and increase the HCAHPS patient satisfaction scores by 3% under Always category by June 30 th Process: The methodology used for the project is DMAIC: define, measure, analyze, improve and control. Brainstorming activities took place on the three involved units (Med A, Med B and Carol Ball Unit (CBU)) with front line staff and multidisciplinary teams to determine root causes and opportunities for improvement. All identified issues were then grouped into three main categories: clinical (pyxis, alarms, spectralinks), behavioral (staff to staff talking, patient to patient talking) and environmental (wheels, EVS carts, toilets, printers). The sleep squad team has been also conducting patient, family and staff interviews on a quarterly basis to identify additional factors that could contribute to an excessive level of noise on the units. 1

2 Solution: Multiple action items were developed and categorized based on the identified findings. The team is tracking the status of each intervention ensuring that the appropriate actions are taking place. The table below illustrates the proposed solutions along with the current status of each intervention. 2

3 Measurable Outcomes: We have been tracking and measuring the HCAHPS domain question each month and quarter. Many of the proposed interventions are currently underway and not fully implemented. The graph below depicts our results for the past two quarters for each of the involved unit (Med A, Med B and CBU) Quietness at Night- % Always Med A Med B CBU QTR4 FY13 QTR1 FY14 Goal for FY14-3% Improvement 75th Percentile Sustainability: Once our goals are achieved, our focus will be to ensure that our improvement is sustained and spread to the rest of the organization. The above mentioned actions will take place by conducting concurrent patient, family and staff rounds to ensure that the improved system remain in place which should be further reflected in our HCAHPS scores Role of Collaboration and Leadership: Reducing noise in the hospital setting has been one of the most challenging metrics measured in HCAHPS for hospitals across the US. Also, patients in semi-private rooms tend to experience lower satisfaction due to the different noise levels that are encountered from the presence of 3

4 another patient. Our CEO is extremely supportive of our initiative to reduce noise level in the patient care areas especially that most of the rooms available at Bayview are semi-private. At the same time, we keep the involved stakeholders and Bayview leadership informed on the progress of the project through various presentations and monthly staff meetings. The CEO showcased the Quiet at Night project and success stories at the town hall meetings attended by approximately 2/3 of Bayview employees. Our close interaction with the front line staff and unit champions gave us an insight on the issues contributing to the excessive level of noise and assisted the team in the development of specific solutions. The active engagement and commitment of our staff is a key component in the successful implementation and sustainability of our action items. Innovation: The proposed interventions are not only targeted to improve our HCAHPS scores but are beneficial to patients, family members and staff. Our process was committed to actively engage the staff in providing input, solutions and therefore holding each other accountable as we continue our quest towards our goal of a quiet and restful environment. The unique attributes of our project truly places the patient at the center of our care. Various institutions have chosen to offer a sleep kit for each patient upon admission. Our team opted to personalize our patient interaction and commitment to a healing environment via one on one conversation with each patient and offering either a sleep mask, tea bag or ear plugs. In addition, we completed research regarding the effectiveness of white noise to enhance restfulness. A pyramid grant was submitted and we are currently in the process of purchasing several white noise machines. One RN on one unit voiced her concern about the noise level of our printers. We engaged the appropriate personnel to assess that specific printer. Consequently, all printers on campus were assessed and recalibrated as appropriate. Related Tools and Resources: We used evidence based research related to the effect of noise on patient s outcome to support our findings. We have also created scripts and practiced with staff by role playing and encouraged language of caring when communicating with patients. Contact Person: Sheree Riley Title: Director of Service Excellence 4

5 Phone: (410)