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Patient safety: No one walks alone
Visit LMPartnership.org for ideas and tools for your team.
FEATURED TEAM
Telemetry, San Diego (Southern California)
WHAT THEY DO
By viewing every patient—not just some—as fall risks, this telemetry UBT successfully piloted a falls-reduction initiative that has drastically decreased falls hospital-wide.
RESULTSFalls in a month
UBT roots out workplace injury mystery
FEATURED TEAM
Radiology, Redwood City (Northern California)
WHAT THEY DID
When workplace injuries started cropping up among technologists in Redwood City’s radiology department, UBT members worked with the manufacturer of the newly installed mammography equipment to make the machine easier to use. They also worked with ergonomic consultants to learn techniques for preventing repetitive movement injuries.
Visit LMPartnership.org for ideas and tools for your team.
RESULTSReduction in workplace injuries
Rx refill center boosts efficiency, cuts waste
FEATURED TEAM
Automated Refill Center at Pharmacy Distribution Center (Georgia)
WHAT IT DID
To reduce costs and the time it takes to stock medications that come in a variety of sizes, pharmacy workers:
•Order items in same-size packages (except for two antibiotics that come in specific quantities that clinic staff found useful)
•Stock items only in the largest containers available to reduce waste.
Visit LMPartnership.org for ideas and tools for your team.
RESULTS
Total Health: Counting the time pays off
Visit LMPartnership.org for ideas and tools for your team.
FEATURED TEAM
Family Medicine, San Mateo (Northern California)
WHAT THEY DID
This UBT got its members up and moving with a little friendly competition, forming small teams with four or five people. The teams tracked how much total exercise they did each week, and the ones that logged the most minutes or days of exercise won prizes. Staff members reported that the wellness activity lowered stress levels, got them in better shape and improved teamwork. RESULTS
Approximate employee participation
Vision team sees way to cut supply costs
FEATURED TEAM
Vision Essentials, Wheatridge Medical Office (Colorado)
WHAT IT DID
To reduce the cost of excess inventory of medications, the team:
•Reviewed all standing supply orders
•Tracked the cost and number of items ordered for on-hand pharmaceutical use
•Consulted with providers and reduced the amount and cost of ordered and stocked pharmaceuticals.
Visit LMPartnership.org for ideas and tools for your team.
RESULTUBT reduced cost of on-hand pharmaceuticals by 69 percent
FEATURED TEAM
Laboratory, Skyline Medical Office (Northwest)
WHAT IT DIDSaw an opportunity to save time and money by addressing a systems issue: Orders from Oncology were marked as “standing” so tests were repeated—even if a patient did not need the same tests done each time. Forty-five percent of tests done between February and June 2013 turned out to be unnecessary.
Collaborated with Oncology to start using a “golden ticket” to identify the specific tests a patient needs and expedite the process when patients go to the lab for their blood draw.
Visit LMPartnership.org for ideas and tools for your team.
Lab reduces waste, wait times and unneeded tests
RESULTTeam avoided processing 65 unneeded tests in four months, for annualized savings of $23,500
Patient education helps wait times plummet
FEATURED TEAM
Oncology Clinic, Moanalua Medical Center (Hawaii)
WHAT IT DID
To decrease wait times and sustain service improvement over time, this team:
•Advised patients to complete lab work at least one or two days in advance of their appointments
•Recruited medical assistants to help physicians track lab orders and ensure lab tests are completed
•Restricted most same-day appointments to treatments lasting 60 minutes or less, and reserved a two-hour window for lengthy appointments that cannot be postponed due to a patient’s schedule
•Staggered patient appointment times to address staffing shortfalls.
Visit LMPartnership.org for ideas and tools for your team.
RESULTAverage daily patient wait time
Meeting the KP.org challenge
FEATURED TEAM
Point Loma Primary Care, Module B (Southern California)
WHAT IT DID
To increase patient and members’ enrollment in kp.org, this team:
•Involved all UBT members in efforts to sign up health plan members on kp.org
•Posted signs at the registration kiosk encouraging sign-ups
•Used patient visits , elevator wells and waiting areas to the lab, radiology and pharmacy as opportunities for sign-ups
•Took advantage of “smart phrases”—short, standardized scripts—in KP HealthConnect to prompt caregivers to discuss kp.org with patients.
Visit LMPartnership.org for ideas and tools for your team.
RESULTKP.org enrollment
Scanning team reduces patient record errors
FEATURED TEAM
Scanning, Fresno Medical Center (Northern California)
WHAT IT DID
The team significantly reduced average errors rates in just six months by:
•Tracking, graphing and posting department-wide errors monthly
•Changing workflow to check for errors at each step of the process
•Huddling regularly to review errors and discuss potential solutions
•Reducing the number of patient records processed at a time.
Visit LMPartnership.org for ideas and tools for your team.
RESULTAverage errors per month
Storytelling helps with early cancer detection
FEATURED TEAM
Primary Care, North Lancaster Medical Office (Northwest)
WHAT IT DID
To increase the number of members completing the home test for colorectal cancer, this team:
•Identified members between the ages of 50 and 75 eligible for colorectal cancer screening
•Scripted a story about how physicians in the clinic had tested positive—but because the disease was detected early, they got treatment in time and are doing well
•Tracked distribution of the kits and followed up with members who hadn’t returned them.
Visit LMPartnership.org for ideas and tools for your team.
RESULTThe return rate for take-home fecal immunochemical tests (FIT) kits
Communication among teams improves mammogram rates
FEATURED TEAMAdult Medicine, Shady Grove Medical Center (Mid-Atlantic States)
WHAT IT DID
This UBT in Rockville, Md., worked with Primary Care and Radiology to resolve scheduling conflicts that caused patients to be turned away from same-day mammogram appointments. The team:
•Worked with Radiology on a process for sharing schedule information so the best days and times for same-day mammograms can be identified
•Set clear boundaries. For example, the Adult Medicine unit agreed not to send patients for mammograms after 3:45 p.m., when one radiology technician is trying to close out the day’s appointments without incurring overtime.
Visit LMPartnership.org for ideas and tools for your team.
RESULTMammogram screening rate
Getting to zero pressure ulcers
FEATURED TEAM
Respiratory Care, San Jose Medical Center (Northern California)
WHAT IT DID
To reduce reportable hospital-acquired pressure ulcers (HAPUs), the team set a goal of sustaining at least a 90 percent completion rate for patient skin assessments . They did this by:
•Conducting four skin integrity assessments per patient during each 12-hour shift
•Documenting observations in patient charts
•Electronically tracking assessments on a weekly basis
•Auditing assessments on a monthly basis
•Posting results with names of corresponding respiratory therapists
•Providing counseling and encouragement for those not meeting the goal.
Visit LMPartnership.org for ideas and tools for your team.
RESULTReportable HAPUs
Transforming transport
FEATURED TEAM
Adult Medicine, Capitol Hill Medical Center (Mid-Atlantic States)
WHAT IT DID
To reduce staff time spent transporting patients by wheelchair from the unit to the lab, pharmacy, hospital entrance or public transit stop, the team:
•Tracked transport times by staff members
•Obtained new, wider wheelchairs to accommodate more patients
•Coordinated transport times with other departments
•Created and staffed a dedicated transporter position.
Visit LMPartnership.org for ideas and tools for your team.
RESULTPatient transport times (minutes)
Lab gets quicker on the draw
FEATURED TEAMInfectious Disease/Oncology UBT (Northern California)
WHAT IT DID
To shorten wait times for blood draws, this Gilroy Medical Offices UBT:
•Shifted staff schedules so the lab opens earlier
•Staggered lunch breaks to spread out the loss of staff on the floor
•Educated physicians to improve the clarity of lab orders and reduce duplicative orders
•Cross-trained staff members so everyone can register patients and process specimens as well as draw blood. If eight or more patients are waiting to have blood drawn, the team goes into “all hands on deck” mode.
Visit LMPartnership.org for ideas and tools for your team.
RESULTAverage daily wait time (minutes)
Standing together to prevent patient falls
FEATURED TEAM
Ortho/Neuro Surgical UBT(Southern California)
WHAT IT DID
To radically reduce the number of patients who fall, the team at Fontana Medical Center conducted several tests of change, including:
•Calendar posts to make problems known to all when they occur, whether day shift or night shift
•Daily huddles include a patient safety briefing to air concerns or potential problems
•Blame-free debriefings after a fall to discuss what happened and how to prevent it
•Quick response to bed alarms indicating that a patient has gotten up.
Visit LMPartnership.org for ideas and tools for your team.
RESULTPatient falls decreased by nearly 40 percent
Medication reconciliation keeps patients safe
FEATURED TEAM
Infectious Disease/Oncology UBT(Georgia)
WHAT IT DID
To reduce duplicate medications listed in patient records, members of this team at the Cumberland Medical Office Building in Atlanta started by manually cleaning up patient charts. Then they instituted a new process for checking medications:
•Licensed practical nurses and medical assistants ask patients to bring their medications to office visits
•MAs and LPNs review patient medications and note on member’s chart which ones the patient is or is not taking
•Providers confirm medications with the member and remove the duplicate oncology medication from the patient’s record
•MA prints out the patient’s medications and gives the list to the nurse practitioner who, with the clinical pharmacist, reviews it and removes expired medications.
Visit LMPartnership.org for ideas and tools for your team.
RESULTPercent of duplicate medications per office visit
Assigning ownership of surgical instruments saves thousands
FEATURED TEAM
Head and Neck Surgery(Colorado)
WHAT IT DID
To reduce the number of surgical instruments lost before and after surgeries, nurses in this Franklin Medical Office UBT in Colorado now “own” a set of instruments.
Team members are responsible for counting the instruments at the beginning and the end of the day, similar to reconciling a cash box in a retail environment.
Visit LMPartnership.org for ideas and tools for your team.
RESULTThe number of lost or broken instruments
Team improves nutrition service while cutting waste
FEATURED TEAMFood and Nutrition department(Northern California)
WHAT IT DID
This San Jose Medical Center team identified ways to prevent costly food waste, where unused formula, supplements and food end up in the garbage. Small tests of change included:
•Conducting a “wasted meal study” to learn how much money was being lost to unused meals ($16,000 a year)
•Improving communication with unit assistants about patients’ eating patterns and discharge data
•Paying closer attention to expiration dates on supplements and adjusting the ordering accordingly.
Visit LMPartnership.org for ideas and tools for your team.
RESULTMonthly food expenses cut by 10 percent
UBT helps new members navigate KP
FEATURED TEAM
Adult Primary Care, Falls Church(Mid-Atlantic States)
WHAT IT DID
To improve member retention and help Kaiser Permanente grow, members of this UBT:
•Involved Spanish-speaking staff in welcoming 3,200 new Spanish-speaking members
•Used the New Member Identifier tool in KP HealthConnect™ so staff could help orient new members, or those who haven’t been in for a while
•Called new members to set up appointments, help refill prescriptions and address other needs
•Sent welcome letters and a road map on how to get started as a Kaiser Permanente member and patient
•Passed out a new member kit with contact numbers.
Visit LMPartnership.org for ideas and tools for your team.
RESULTFavorable patient satisfaction scores
Wait times down, courtesy scores up
FEATURED TEAM
Laboratory(Northwest)
WHAT IT DID
To cut wait times that could sometimes exceed 45 minutes, the Mt. Scott Medical Office lab moved to a one-on-one model in which:
•A technician stays with each patient from check-in to blood draw
•The technician returns to the check-in desk to take the next patient
•More team members are freed up to reduce the queue, rather than having a dedicated member working the computer.
Visit LMPartnership.org for ideas and tools for your team.
RESULTImproved patient satisfaction and an unexpected jump in technician courtesy scores