reflection agenda welcome (5 min) key note: mary mcfadden and judy tatman (5min) rt2c video (12 min)...
TRANSCRIPT
Releasing Time to Care (RT2C)Opening Ceremonies
Tuesday, August 7, 2012 1200-1500PPMC Cancer Center Amphitheater
AGENDA• Welcome (5 min)• Key Note: Mary McFadden and Judy Tatman (5min)• RT2C Video (12 min)• Team Presentations (75 min)• Closing Remarks (5 min)• Unit Tours (40 min)• Questions and Discussion (30 min)• Passing the Torch (application process (10 min)• Closing Ceremonies
Session ObjectivesAt the conclusion of this program the learner will be able to:
• Describe Releasing Time to Care as a methodology for unit-based improvement.
• Understand the value of RT2C in improving efficiency and effectiveness.
• Understand the clinical and satisfaction outcomes associated with RT2C.
• Understand the application process and plan for roll-out of RT2C at PPMC.
• Apply information to own practice, unit or department to strengthen participation in RT2C or move toward applying for RT2C.
Mary McFadden, MSN RN, CNE Robert Wood Johnson Executive Nurse Fellow
Judy Tatman, RN, BSN, MSRegional Chief Nursing Officer –
Oregon Region
7S: Surgical Oncology Unit
Knowing How We’re Doing Module
Lisa McKerlick, RN BSN-BC & Michelle McSherry RN BSN-BC
What is Knowing How We’re Doing (KHWD)?
KHWD on 7S
• KHWD is an approach to measure, track and help improve the objectives chosen by the unit.
• It will help you and your team see that the changes made are helping the team achieve your vision for your unit, and how the care you and your team give contributes to your organizations strategic goals.
• Our key components include:• Display of safety crosses on a board which is visible to all.• Twice-daily huddles discussing safety crosses, action plans,
and updates by staff.
KHWD on 7S
Do all of foley catheters have a medical indication?
7S FOLEY CATHETERS
If NO: It is a red day.
If YES: It is a green day.
1 23 45 6
7 8 9 10 11 1213 14 15 16 17 1819 20 21 22 23 24
25 2627 2829 30 31
1 23 45 6
7 8 9 10 11 1213 14 15 16 17 1819 20 21 22 23 24
25 2627 2829 30 31
March 2012
Charge Nurses: (Ask at the dayshift huddle): Did all POD #2 patients have the foley removal documented or have an order /progress note stating reason (medical indication) to leave in place beyond POD #2?
KHWD on 7S
7 South Foley
catheter data, to
decrease CAUTI’s
5R: Internal Medicine Unit
Well Organized Ward ModuleAmy Bruninga, RN BSN
What is the Well Organized Ward (WOW) module?
Well Organized Ward is an approach to simplify the workplace and reduce waste by having everything in the right place, at the right time and ready to go.
WOW uses a set process, called the 5S process, to help us find where changes need to be made on the unit.
This is not just about organizing and cleaning!
It is about setting up a process that makes everything ready to go for the next person. A set process agreed upon by everyone on how to keep an area that way.
Monitoring and maintaining the area.
Ability to change things that aren’t working.
5SSortSetShine
Standardize
Sustain
WOW on 5R
Why should we use WOW on our unit?
Increase the proportion of direct care time.
It will make the unit look and feel better.
Increase staff satisfaction by making things easier and giving them the voice to participate in the changes in the unit.
Decrease error
WOW on 5RData Collection
Who use’s the area and what for?
Interview the stakeholders.
Time a process
WOW on 5R
AssessWhat are we supposed to be using the drawer for?
Are things easy to find?
Do staff struggle in the area when attempting to accomplish a task?
What would a patient or visitor think?
What does this area say about our unit?
WOW on 5RDiagnose the area and the 5S Process
Sort Set and Shine
WOW on 5R
Standardize Sustain
WOW on 5RKeep your unit informed!
7N: Medical Oncology Unit
Well Organized Ward moduleTina Magsarili, RN
WOW on 7N
•Voting commenced over where the new cabinet would be located
•Up to this point the cabinet was in a supply room and the telemetry boxes and leads were found there• The batteries were in another supply closet with electrodes
and BP cuffs• The fax machine was in a totally different location
The Winner is?•The Zoo: a substation on our unit that contains a fax machine
WOW on 7N
•New process = 232 feet travelled to put one patient on telemetry•KEY: 232 feet = 0.88 minutes (52.8 seconds)•What does this mean?• Before it took 559 feet, Now it
takes 232 feet!
•Every time you need to set a patient up on telemetry you save 1 minute 18 seconds of time that you can use directly caring for your patient rather than chasing down equipment!
4R: Urology Gynecology Unit
Patient Status at a Glance ModuleNicole Bailey, RN CMSRN
What is Patient Status at a Glance (PSAG)?
The use of visual management to show important patient information so that it can be updated regularly,
seen at a ‘glance’ and used effectively.
Why do it?To ensure safe, reliable and efficient care by:
Making shift handovers quicker and safer for the patientMaking sure the patient journey from admission to discharge
runs smoothly without delaysSaving time looking for patient information
PSAG on 4R
• Team members decided on the goals of the board for our unit
•Goals: reducing interruptions, decreasing redundancy of information, eliminating duplicate information
•What information do we need to have “at a glance” and what is the most common information that nurses were interrupted for?
•This list was long!! From there, suggestions were narrowed down to about ten items for staff voting
5G: Diabetic Renal UnitRT2C Showcase unit
Admissions/Discharges Process ModuleCindy Christenson, RN
What are the process modules?
•Process modules allow staff to identify key processes to improve overall work flow
•Key component - use the same change implementation cycle as the other modules, but are less prescriptive
Process module on 5G: Admissions and Discharges
•We’ve made many changes on 5G in relation to the Admissions and Discharges
•How did we decide where to start this process?
Our biggest accomplishment to date…
The change in gowns saves:o $3,500 in annual laundry costs
o additional savings of $3,100
o 21 hours annually on 5G
o 197 hours annually house-wide
Our biggest struggle to date…
Lessons learned
•Continue to follow up on implemented changes!
Acknowledgements
Mary McFadden, CNE
Unit Tour Instructions•Each unit will guide a unit tour to bring to life the concepts presented
•Pick one unit to visit (7S, 5R, 7N, 4R, 5G)
•Each presenting RN has a sign for their
•No more than 20 people/unit please
Questions: Post Unit Tours
If you have further questions, please feel free to contact the following staff nurses on each unit:
7S - Lisa McKerlick, Michelle McSherry7N - Tim Czuk, Jenn Moore4R - Nicole Bailey, Susan Conley5R - Amy Bruninga, Stephanie Shadduck5G - Cindy Christenson, Candice Hoag, Grace Kelly
•Due date - August 20
•Return to Nursing Administration
•Next cohort announced August 31
•Contact Kristin Haydon with questions• x56336
Application Information
•Don’t forget to sign in AND complete the evaluation to receive your CE credits.
•For those who have been participating in RT2C, please stay for a debrief and dialog session.
Thank You!!!
1. How do we get to a place where we’re using the RT2C tools and methods as how we do our work while maintaining the staff driven aspect?
2. What are our major successes to date? What should we continue doing?
3. What challenges have we had? What are your suggestions for improvement?
Debrief