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Improving the Patient Experience for
Joint Replacement by Using a
Guided Process
Julie Benz
Director of Outpatient Therapy Services
March 20, 2014
Avera McKennan – Sioux Falls SD
* Hub of the Avera Health System
* Established over 100 years ago
Within the Avera McKennan network…
• 13 regional hospitals
• Avera Behavioral Health Center
• Avera Heart Hospital of South Dakota
• 85 primary and specialty care clinics
We are nationally recognized for excellence in:
Cancer treatment Stroke care and neurosciences
Orthopedics Women’s health care
Pediatrics and neonatal intensive care Behavioral health
Emergency, trauma and critical care Surgery
Gastrointestinal care
Avera McKennan’s
flagship facility is
our 545-bed
tertiary care
hospital in Sioux
Falls.
Our Aspiration
Through service and process
excellence, Avera McKennan will
lead the nation in high quality,
affordable health care.
Rural Innovative
Most advanced use of e-services
Strives to be at the forefront of
innovation
Top 10 Trailblazing Hospitals
“Goals determine what you
are going to be."
Julius Erving
Objectives
1. Identify problems facing the
Orthopedic Unit
2. Identify innovative concepts that
improve the processes to positive
outcomes.
Orthopedics at Avera
McKennan
•32 – bed unit
•700 Jt Replacements/year
•2 - Primary Orthopedic Groups
•1987 established Easy Street
•2002 initiated Joint Camp
Challenges
Competitive environment
Reducing volumes
Patient Satisfaction below the Top Box
performers.
* Quality Outcomes
Falls
Pain Management
Innovative Ideas & Proven
Concepts
• Process Excellence - Lean
• Purposeful Hourly Rounding
• Leader Rounding
• Pain Team – one call response
• Total Care - PGS
Lean – Process Excellence
Visual Management Control
• To clearly and immediately notify
management and workers whether
the work area is normal or abnormal.
–Shadowing/Labeling
–Andon Signals
–Downtime Clocks
–Process Control Centers
© 2007 OpEx, Inc. All Rights Reserved.
Supplies at POU on 2WB pod
Purposeful Hourly Rounding
Visual Management Control
Patient out of room
Even Hour Round Complete
Odd Hour Round Complete
Intentful Leader Rounding
Leader with staff
Daily with staff on shift
Quarterly with every staff
Senior Leadership - weekly
Pain Team
Instituted a Pain Team –
Anesthesiologist - Pharmacist
Pharmacist on the floor during the
day and available at night for med
review
What were we challenged by-
Getting the right
information to the patient
and their family at the
right time
“To shoulder greater accountability for
outcomes, health systems must partner
with patients to close gaps in
communication and coordination while
managing care beyond the acute care
or physician office setting”» The Advisory Board
Program Goals
1. Improve patient experience
2. Ensure patient adoption and
engagement
3. Improve Patient Satisfaction
4. Drive staff efficiency
5. Create a compelling
competitive differentiator
Reports Available
To numerous to mention but
valuable information that drives
our process changes.
Weekly Report SummaryMarch 3, 2014 - March 9, 2014
Patient ActivityNew Enrollments 4
New Registrations 4
Total User Logins 46
Unique User Logins 22
Item Completion 1st Functional Outcome 5
Preparedness Survey 1
Hospital Experience Survey 2
Recovery Survey 1
Surgeon Experience Survey 2
Transition Experience Survey 1
2nd Functional Outcome 1
Avera TotalCare Program Survey 0
6 Month Functional Outcome 0
Other Changes
• Aquatic Therapy Post Op Day1
• Dietary Aid on the floor 8hours/day to
assist with nutritional need of the
patient.
• Daily Rounds with RN, Case Manager,
Social Worker, Therapy and physician
liaison
Results of our Efforts
Fall Reductions
3.06
5.59
8.03
10.70
5.37
13.16
4.58
5.88
15.97
2.81
1.74
3.64
0.00
2.00
4.00
6.00
8.00
10.00
12.00
14.00
16.00
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Rate
per
1,0
00 P
CD
2 West Ortho FallsJan-Dec 2012
Fall RateMagnet BenchmarkMagnet Benchmark is
the average rate for 8 quarters. Actual
5.61
1.95
3.453.44
1.58
9.12
1.59
0.00
3.42
5.845.37
3.452.97
0.000.00
2.00
4.00
6.00
8.00
10.00
12.00
14.00
16.00
Jan Feb Mar Apr MayJun Jul AugSep Oct NovDec Jan Feb
Rate
per
1,0
00 P
CD
2 West Ortho FallsJanuary 2013-February 2014
Fall RateMagnet Benchmark is the average rate for 8 quarters . Actual
Patient Satisfaction
Question Mar – 12 to Feb 13 Mar-13 to Feb-14
Overall Rating of
Hospital
70.7% 75.5%
Likelihood to
Recommend
75.3% 86.8%
Transitions of Care 59.6% 64.5%
Pain Management 68.1% 74.6%
Surgical Growth
Total Care
Avera Total Care
Nationally Recognized Quality
2014 Healthgrades Awards
Five-Star Awards in:
• Orthopedics
• Neuroscience
• Gastrointestinal services
• Critical care
Nationally Recognized Quality
One of the 100 Top Hospitals®
in the nation in 2013 as named by Truven Health Analytics
Nationally Recognized Quality
• No. 1 hospital in South
Dakota in 2012-13
and 2013-14
Nationally Recognized Quality
• QUEST High Performing
Hospital in 2013
Premier Health Care Alliance
Nationally Recognized Quality
• Community Value
Leadership Award
• Community Value 100®
Hospitals list
Cleverley + Associates
Questions
Thank you
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