Session Seven Connections: Cleanliness Kelly McCutcheon Adams, MSW, - - PDF document
4/5/2012 Session Seven Connections: Cleanliness Kelly McCutcheon Adams, MSW, LICSW, IHI Director Barbara Balik, RN, EdD, IHI Faculty April 4, 2012 2:00 3:00pm EST David Kim David Kim , Institute for Healthcare Improvement (IHI), is
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David Kim, Institute for Healthcare Improvement (IHI), is responsible for managing and coordinating a variety of programs based on Key Processes on the IHI Improvement Map. Mr. Kim is a graduate of Boston University. He has been with the IHI for 2 years. He enjoys sports, food, and travel.
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Kelly McCutcheon Adams, MSW, LICSW, Director, Institute for Healthcare Improvement (IHI), has served in this capacity for eight years for a variety of IHI Collaboratives and programs, particularly those focused on critical care. She is a medical social worker with experience in hospice, nursing home, sub-acute rehabilitation, emergency department, and ICU settings. She has also served as faculty for the US Department of Health and Human Services Organ Donation Collaborative and for the Gift of Life Institute.
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Barbara Balik, RN, EdD, Principal, Common Fire Healthcare Consulting, is also Senior Faculty at the Institute of Healthcare
leadership and systems for a culture of quality and safety, including patient- and family- centered care, patient experience, systems to improve transitions in care, and transforming care prior to or with optimization of an electronic health record implementation. She works with leaders to develop adaptive systems to excel and innovate in complex organizations, and to ensure sustained improvement and innovation every day. Ms. Balik's publications include the book, The Heart of Leadership, and the IHI white paper on “Achieving an Exceptional Patient and Family Experience of Inpatient Hospital Care,” among others. Previously, she served in senior leadership roles at Allina Hospitals and Clinics, United Hospital, and Minneapolis Children's Medical Center. 6
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At the end of this program, participants would be able to:
domains of patient experience improvement
communication, pain management, and cleanliness
─ Kendall Regional Medical Center ─ Regional Medical Center of Bayonet Point
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Pain Management and Connections
─ Process to understand patient definition of comfort preferences including light, heat,
shifts and disciplines
─ Mutually develop comfort goals that include pain management, medications, environment, and activity level for hospital stay and for self-management post-hospitalization.
─ Consider the care plan a shared document. Assure opportunities for patient input into the plan and review the care plan together
─ Develop or identify a specialized expert resource to consult with staff and care team regarding difficult pain management issues and train staff on current methods
─ Develop a policy or procedure for staff to follow when a patient has difficult pain
challenging pain issues with patients.
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Patient Experience Change Package: Overview
Key areas for improving specific domains of patient experience: Nurse Communication, Cleanliness, and Pain Management Staff and Physicians Patient and Family Connection
Leadership
Engagement Improvement/ Infrastructure Foundational Elements for Improving Patient Experience
Today’s Session
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─ Technical quality; competence of providers; reliability; coordination; pain
─ Respect; empathy; address emotional needs ─ Nurse/Team Communication
─ Cause stress or offer calm and healing ─ Cleanliness
» Berry and Seltman, Management Lessons from Mayo Clinic
─Make the cleaning process reliable and standardized. Consider checklists, posting cleaning schedule, and random audits.
─Reliably and frequently inspect all patient rooms for cleanliness, clutter, and needed
─Begin process of understanding comfort preferences around issues like light, heat, noise, and patient definition of cleanliness.
─Regular leadership rounding with patients and families, staff and physicians, and
work is really like), coaching, recognizing, correcting, role-modeling, and providing real-time service recovery when needed.
─Develop processes for patients and families to be able to directly access assistance when needed (Environmental Services, Nutritional Services, Rapid Response Team)
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4/5/2012 9 Regional Medical Center Bayonet Point HCAHPS data: Top Box answers for Room and Bath Cleanliness
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Kendall dall Regiona nal l Medi dica cal l Center Miami, i, Florida ida
HCA Patien ent Experienc ience e Collabora aborative ive
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Daily huddles in EVS Department (each shift)
interaction
New Uniforms for EVS Staff Welcome Card Unit Leader/Nurse Rounding
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Where we are now- Last Quarter 64% Current Score 74% How we achieved 74% 1. Scripting of staff, business cards in patients room, setting cleaning expectations for patient when they arrive, turndown service, patient visitation. 2. Updated equipment-Two Boost machine to improve productivity,
floor care. 3. Painting patient rooms and de-cluttering the walls 4. Refurbishing the patient room chairs total cost $32,092 verses over $200.000 in replacement cost (this figure Includes some bed replacement)
2011 Focus attention on 2 Central’s Cleanliness score to bring their score up from 64% to 82% (This week 2 Central’s score is 95%) Provide 24 Hour coverage in the Emergency Department 2012 Achieve the Top box 50 quartile by the end of the first quarter for all units and work with the Nursing Directors in improving the Hospitals
Suggestion: Cleanliness Program Accountability for 2012 Through Leadership support promote a sense of accountability of cleanliness for all hospital staff whenever they are in the presence of a patient. Use rounding as a means of measure.
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The only reference to cleaning in the HCAHPS survey is “Is your room and bathroom always clean?” EVS/Hospital Staffs Role 1. Rooms need to be cleaned thoroughly by EVS. 2. All staff that interacts with a patient needs to take ownership of the supplies they use by discarding material in the trash can, and picking up the trash from the floor that they drop. 3. If any staff see trash on the floor in a patient’s room they should pick it up (just like the no passing zone) 4. All Leadership has be involved in the expectation that the patient’s zone will be kept clean “ALL” the time. Unless all are involved and accountable, the hospital cannot have the “ALWAYS CLEAN” look to the patient. 5. Add Cosmetic Maintenance to either EVS or Plant Operations so that deficiency’s are addressed in a timely manner. 6. Change EVS from Unit of Service to square footage.
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