f3 rapid fire: it's in your hands - r. gibson and l. bond
Post on 10-Feb-2017
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Improving Hand Hygiene in Medication
Administration
Anecdote
“Every nurse does it (ensuring hand hygiene during medication administration)
differently” ~Clinical Resource Nurse
Aim of Your Project• 100% compliance with hand hygiene
standards in medication administration
• Engage direct care Nurses in process reconstruction using LEAN methodology
• Explore REALLY rapid process improvement methods
Background
Team Members• Lynda Bond, BCMHAS Quality Director• Graham Worsley, PHSA imPROVE Director• Rafel Gryzyb, PHSA imPROVE facilitator• Dave Bhauruth, BCMHAS Quality & Safety
Leader• Cynara Radley, BCMHAS Clinical Nurse
Coordinator• Ross Gibson, BCMHAS Quality & Safety
Leader
Changes Tested
• Tested “Mini Kaizen” REALLY rapid process improvement workshops
• Used ‘cascade’ of 1-2 day events across all inpatient units to engage nurses in redesigning medication admin process to more efficiently ‘marry’ the 7 rights and the 4 moments
Results so FarChild Psychiatry unit
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Baseline RPIW Final Week 1 Week 2 Week 3 30 Days 60 Days 90 Days 6 Months 9 Months 1 Year
Com
plia
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with
Med
Adm
in s
tand
ard
wor
k
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Results so FarEating Disorders unit
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Baseline RPIW Final Week 1 Week 2 Week 3 30 Days 60 Days 90 Days 6 Months 9 Months 1 Year
% o
f sta
ndar
d st
eps
follo
wed
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40
60
80
100
Results so FarAdolescent Psychiatry unit
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Baseline RPIW Final Week 1 Week 2 Week 3 30 Days 60 Days 90 Days 6 Months 9 Months 1 Year
Com
plia
nce
with
Med
Adm
in s
tand
ard
wor
k
0
20
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60
80
100
Results so FarChild and Adolescent Psychiatric
Emergency unit
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60
80
100
Baseline RPIW Final Week 1 Week 2 Week 3 30 Days 60 Days 90 Days 6 Months 9 Months 1 Year
% o
f sta
ndar
d st
eps
follo
wed
0
20
40
60
80
100
Results so Faroverall external audit
Lessons Learned(methodology)
• Process owners need to drive the planning• Participants need to clear calendars• Get more direct care staff involved to
reduce need for ‘spread’• VERY organic process: hard to keep it
small. Important “Incidental findings”• Need “branding” : “What’s a Kaizen?”
Lessons Learned(Sustainability)
• Process owners need to commit to take-away tasks.
• Auditing is a challenge• Ensure agreements in final hour are
reasonable• VERY organic process: hard to keep it
small. • Important “Incidental findings”
Next Steps: Future Focus• Unit leaders meeting to discuss
sustainability plan• Considering using Mini Kaizen
methodology after a Root Cause analysis process to implement recomendations
Contact Information• Ross Gibson, Quality Leader• BC Mental Health and Addiction Services• 604-812-7522• regibson@cw.bc.ca
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