d4.call to care. deborah bachand
TRANSCRIPT
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NO DISCLOSURES
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all toCARE
Deborah Bachand RN, BAManager Quality Improvement
Projects Surgical Services
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By June 2015, Island Health staff will demonstrate
a 20%* improvement in patient satisfaction** with
surgical discharge processes* by implementing
a post -operative follow-up phone call 24 hours post
discharge from surgical units.
AIM STATEMENT
* From 65% to 85%
** BC Ministry of Health Surgical Patient Experience Survey 2012
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Surgical Patient Satisfaction Survey* reveals gaps in our discharge information:
o When to resume normal activityo Danger signals to watch foro Discussion of anxieties and fearso Family communication with Physiciano Information about recovery at homeo Medication side effects
* 2012 BC Ministry of Health
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I called a patient following his simple inguinal hernia repair, he reported that he spent the night in the emergency room with numbness in one leg.
He was sent home no treatment required.
I realized I had neglected to tell him about the possible side effect of Marcaine injected at the end of the procedure.
A Patient’s Story
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PATIENT FEEDBACK PROVIDES IMMEDIATE QUALITY IMPROVEMENT OPPORTUNITES
FOR HEALTH CARE PROVIDERSHow is you pain? Rate your pain on the ‘Pain Scale’
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Everyone is doing it...
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Walmart ® Customer Care Survey
Hyundai® Customer Care Agreement
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WE CAN DO IT TOO…
They will expect it
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All surgical daycare patients will be contacted within 24 hours of discharge
24 hour discharge call
*Required Organizational Practice
ACCREDITATION 2015 ROP*
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INITIAL RESULTS
• Collated from call work-sheets
• Discharge Abstract Database (DAD)
• Patient experience research project
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Discharge Access Database
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Follows well trodden evidence based best practice paths to improve patient satisfaction and surgical outcomes…
Link to ERAS
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• Other Programs
• Other Health Authorities
Interest is spreading
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‘CALL TO CARE’
Can be initiated anytime a patient is
released home or to another care setting.
How does the patient want to be contacted?e.g. phone/mobile, email, text, Facetime®
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Team Members• Patients, families/care-givers• Pre-admission clinic caregivers• Surgical team• Data analyst QI consultant• Project manager• Surgical unit managers & directors• PAC, Surgical unit, and PACU staff• Health Records Staff• Unit clerks• Clinical Nurse Educators• Surgical IT• Community Liaison
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Successful ImplementationWhat does it take?
• Courage
• A strong champion at pilot site
• Enlist unit staff to help design the pilot
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Call worksheet
SIX (6) Questions
1. How are you feeling?
2. Problems with dressing?
3. How is your pain?
4. N/V (are you eating)?
5. Can you mobilize?
6. Any questions/concerns?
Average time 2 minutes
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The story so far….
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Lessons Learned• Not everyone believes what you believe
• A complex system change requires senior leadership and a frontline champion for implementation
• The post-discharge phone call should be ‘The way we do business’
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Next Steps
• Implement in SDC for all Island Health Sites
• Analyze DAD data from research project
• Capture patient feedback in EMR to share with staff and physicians
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Don Berwick
The only goal of patient focused care can be to treat your patients the way you want to be treated
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Contact Information
Deborah Bachand RN, BAManager Quality Improvement Projects Surgical Services