Samaritan Health Services Lisa Chiles, PMP, CSM

Transcription

1 Samaritan Health Services Lisa Chiles, PMP, CSM November 1, 2013

2 Samaritan Health Services Service area: 290,000 residents in Linn, Benton, Lincoln and portions of Polk and Marion counties 5 Hospitals 70+ primary care and specialty physician clinics Employee base: 5,100 Health plans: Three insurance plans serving more than 45,000 people 2

3 Samaritan s Lean Approach Seize the Opportunity Build a Lean Understanding Build a Lean Community Celebrate the Wins!! 3

4 Seize the Opportunity Samaritan engaged with OAH and learned of the Purdue Lean Certification Training Lean opportunities recognized throughout the system Gained Samaritan executive sponsorship Thank you to Partnership for Patients! 4

5 Build a Lean Understanding Teams of 6 from each of the 5 Samaritan hospitals sent to the Purdue Yellow Belt Lean Training 12 individuals from Samaritan sent to Purdue Green Belt Training 5

6 Build a Lean Community Green Belts formed the Lean Community of Practice Our charter: Communicate, Champion and Propagate the SHS LEAN Vision to the greater SHS Organization. Provide LEAN Training and Education to the SHS system Provide Leadership, Tools, and LEAN Expertise to the SHS Organization. Manage the LEAN portfolio of projects. 6

7 Community of Practice SHS CoP: - Monthly meetings (2 nd week of the month) - Define common processes, metrics, tools,etc. - Provide updates on system wide Lean projects - Provide consistent messages/goals to CoPs SPCH CoP SNLH CoP GSRMC CoP SHS CoP SLCH CoP SAGH CoP Site CoPs: - Monthly meetings (3 rd or 4 th week of the month) - Provide updates on site-specific Lean projects - Help in the site dissemination of Lean processes, tools and messages 7

8 Community of Practice Communicate Train & Educate Tools & Expertise Manage Lean Projects Project Stats: 42 Requested 16 Active 11 Completed 8

9 Celebrate the Wins As a result of Lean projects at SHS we ve realized the following: Patient Care Improvements: Consistent documentation of assessment and ordering of VTE prophylaxis s across system Standardized the reporting of ADR s and removed paper reporting at LCH 30% reduction in wait time at our Pre-Op Clinic with minimal outliers Standardized Discharge process for Pneumonia patients (measuring reduced readmits) Standardized Follow up Scheduling for Discharged Patients (measuring reduced readmits) 2 months+ of no Falls at NLCH Financial Improvements: Increased revenue by hitting the 100% mark for the VTE core measure Increased thru put in the Pre-Op Clinic Process/Employee Productivity Improvements: Decreased steps for Medical Staff Providers with documentation of assessment and ordering Improved the delivery thru put of our Software Development team 5 day reduction in delivery of new Software Solutions Standardized the process for onboarding new Technology to our Service Desk 9

10 Good Samaritan Regional Medical Center Jennifer Zeck, RN, BSN & Bill Howden, RN, MSN November 1, 2013

11 Good Samaritan Regional Medical Center Corvallis, Oregon

12 About Us Good Samaritan Regional Medical Center Largest hospital of five that are a part of Samaritan Health Services 188 Beds Level 2 Trauma Center Offers multiple comprehensive surgical specialties 12

13 VTE Assessment & Ordering Definition VTE Venous thromboembolism What are they VTEs are the formation, development, or existence of a blood clot or thrombus within the venous system. WHY CMS Requires Documentation on all adult inpatients except mental health, pediatric, comfort care after 2 nd day, and OB. Lack of consistent documentation of assessment and ordering of VTE prophylaxis. We discovered we were unable to measure if assessment or ordering were completed on non-surgical & non-icu patients. This became more apparent during the implementation of the new EMR.

14 Anecdotal Observation ALP boots sitting on nurses station counter Pre Project Data Measurement For the patients sampled within the Surgical Care Improvement Project (SCIP) Patients denominator for VTE prophylaxis ordered = 97 % Patients denominator for VTE prophylaxis timing (meaning the nurses documented the ALPs were on or med given) = 96 % For non-surgery patients on PCU 30 charts prior to EPIC were randomly selected from Jan and Feb 2013 Risk assessment was documented 10 times in various places = 33% VTE prophylaxis was order 23 times = 76%

15 Barriers

16 Solutions Find Provider Champions Adopt new assessment tool Adopt new order process driven by assessment tool Obtain Provider ownership Implement into EMR (build in Epic is currently under construction) 16

17 Solutions 17

18 Advice for Others & Lessons Learned Make sure you have physician champions. What appears to be a simple problem is often more complex. Changes to the EMR take longer than anticipated. Make sure to involve all stakeholders early on. Pick deadline and stick to it. 18

19 Successes TBD 19

20 Plan for Spread Education Implementation in system EMR 20

21 Next Steps Assessment is Hard STOP Assessment links to orders Provider Champions, VTE process team will educate al 10/01-11/01 Go Live in November Measure monthly a sample of qualifying patients for 100% assessment and order done Findings reported to Quality Council If measurement doesn t show sustained improvement, the team will reconvene to make further corrections 21

22 Next Steps (cont d) Focus on order to implementation phase Once VTE prophylaxis is ordered how is it getting to the patient on a consistent basis? 22

23 Contact Info Bill Howden, RN, MSN Jennifer Zeck, RN, BSN Jennifer Zeck, Gillian Hyde, Maureen Murphy, Janell Anderson, Bill Howden Not shown: Michel Bryant 23