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6C/6A MEDICAL PCU

6C/6A MEDICAL PCU. Manager: Cristal Mabe Presentation: Amanda Evans Orlando Health April 20, 2015. Has Anyone Noticed Something New?. GEMBA BOARD – What is it?.

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6C/6A MEDICAL PCU

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  1. 6C/6A MEDICAL PCU Manager: Cristal Mabe Presentation: Amanda Evans Orlando Health April 20, 2015

  2. Has Anyone Noticed Something New?

  3. GEMBA BOARD – What is it? • Gemba is “a Japanese concept of continuous improvement designed for enhancing processes and ultimately reducing waste” (PEX, 2015). • Consists of Weekly 15 Minute Huddles • All TMs and All disciplines are welcome to join • Led by your leadership team

  4. Why is this New Initiative So Important to Orlando Health? • Standardize our approach for process improvement across the organization. • Train leaders to effectively hold weekly meetings and present unit scores and reports in a concise and effective way. • Allow all TMs to participate in the process improvement initiatives. • Ensure that TMs are knowledgeable about unit quality data, service scores, and recognitions. • Creates transparency within the department and organization by providing unit information to patients, family, and staff.

  5. What is included on the GEMBA Board? Suggestions

  6. What is included on the GEMBA Board?

  7. Process Improvements Initiatives • Does the process work? Yes or No? • How can we revise the process to fit our needs? • What changes do we make if any?

  8. What is included on the GEMBA Board?

  9. What is included on the GEMBA Board?

  10. So what Process Improvements are we currently working on…. • 100% Bedside Report (Both RNs and NAs) • White Board Updates • NAs placing date and initials on EKG Electrodes • The ED Handoff Pilot • Unit Audits: • Charts • Wounds • CLASBI • Catheters (Foleys and Central Lines) • Fall • Handwashing • Leadership Rounds

  11. What do we need improvement in immediately? • RESPONSIVENESS, QUIETNESS, & PAIN MANAGEMENT

  12. It’s time to get things right • Global Aim: To increase 6C Medical PCU’s Patient Satisfaction by improving responsiveness to their needs. Overall patient experience goal: 75%. • Specific Aim: To respond more quickly to patient needs as evidenced by an increase in Press Ganey scores regarding responsiveness to 80% by October 31, 2015.

  13. What does the research say? • One study stated that patient’s perceived the call-light as “the button” that was the only effective way to initiate interaction with a nurse and the get the help they might need “right now.” • The nurse call-bell was found to be “one of the few ways that patients can exercise control over their care and over their existence on the unit.” • “The call bell is the patients’ lifeline.” • Overall findings: “Both regular rounding and short response time to call lights are essential activities that boost patient safety. (Lasiter, 2014)

  14. What does the research say? • Evidence-Based Nursing Suggests Hourly Rounding: • Reduces the Number of Call-light Episodes • Reduces the Number of Times a Patient Needs to Make a Request • Improves Patient Satisfaction • Improves Quality of Care by Fostering Patient Safety(i.e. Reduces Falls) (Petras, Dudjak, & Bender, 2013)

  15. How do we measure how many call-lights we have on our unit? • Audit Log at the Call-Light • Everyone (U.S., Charge Nurses, RNs, and NAs) must track key information: Room #, Pt’s name, Time, RN name, NA name, and complaints/requests/needs/mistake • Audit for 1st week of every month during the next 6 months. • Common Call-light Uses • Toileting • Request for an item/action • Positioning Needs • Pain Medication • Beeping Machine • Ice/Water/Tissue

  16. How are we going to reduce call-lights as a team? • Hourly Rounding (use white board to initial) • Purposeful Rounding – 4 P’s (position, potty, pain, & possessions) • 100% Bedside Report • 100% Utilization of the White Board (include patient in the discussion of the POC being transcribed on the board)

  17. How are we going to monitor compliance? • Leadership Rounds • White Board Audits (Including Hourly Rounding Boxes) • Bedside Report Handoff Audits • ***3 STIKES YOUR OUT RULE IS BACK***

  18. When are we officially starting? May 1st, 2015 Please see your leadership team if you have any questions or concerns. Thank you for the hard work you all demonstrate on a consistent basis!!

  19. References: • Lasiter, S. (2014). “The button”: Initiating the patient-nurse interaction. Clinical Nursing Research, 23(2), 188-200. doi:10.1177/1054773813479794 • Petras, D.M., Dudjak, L.A. & Bender, C.M. (2013). Piloting patient roundings as a quality improvement initiative. Nursing Management, 44(7), 19-23. doi:10.1097/01.NUMA.0000431432 • PEX. (2015). Introduction to the concept of gemba kaizen. Process Excellence Network. Retrieved from http://www.processexcellencenetwork.com/lean-six- sigma-business-transformation/articles/gemba-kaizen/

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