The Achieving Competency Today (ACT) Issues in Health Care Quality, Cost, Systems, and Safety course closed out its 2018-2019 academic year with seven interprofessional teams presenting improvement projects to address challenges in health care delivery.
Team members joined the over 675 participants who have completed 105 improvement projects through ACT.
The ACT course is held twice yearly from September to December and from January to April through the Institute for Learning, Leadership and Development (iLEAD). Enrollment for next year’s Fall 2019 and Winter 2020 sessions opened in June. For more information please contact Education Coordinator Claire Rudolph at firstname.lastname@example.org.
STAT Meds: Signed, Sealed, Delivered
This project aimed to increase the number of STAT medications administered in the surgical ICU within 20 minutes by 10% in two weeks in accordance with Pharmacy goals. To shorten time between medication arrival onto the unit and medication administration time, the team designed an intervention using a red flag system as a visual aid to notify staff when STAT medication is ordered and when it has arrived. While the data analysis results were inconclusive, the team advocated that further interventions could assist in reducing times of STAT medication orders.
Let’s Talk About Rx, Baby! Will Price Transparency Increase Prescription Adherence?
This team sought to decrease by 10% the number of patients from the Family Medicine Wilmington Hospital Inpatient (WHIP) service who do not fill newly prescribed medications within three days of discharge. The team focused price transparency with an intervention that could potentially address both cost and buy-in drivers for non-adherence. Throughout the four-week cycle, members of the team and/or WHIP met with patients to go over medication costs and address any barriers. While not getting the results that were expected, the team found that patient satisfaction with the process improved and suggested that the WHIP and Internal Medicine teams could continue collecting data and piloting new interventions to increase adherence among their discharged patients.
This project aimed to reduce Vocera-associated alarm fatigue and patient care interruptions by decreasing the total number of pages on 4 West by 10% within one month. With the assistance of key stakeholders in Vocera Information Technology, 4W Unit, Christiana Care Hospitalist Partners and the Center for Provider Wellbeing, the team designed an implementation project that included education on Vocera standards through emails, posters placed on the 4W floor and surgical residents’ lounge, and an in-person meeting with nursing and surgical residents. Through these efforts the team concluded that continuing education of 4W nursing and general surgery residents and expanding the intervention to additional nursing floors and other residency programs could help in decreasing the total number of Vocera pages.
Who Ya Gonna Call?
This team sought to increase communication between Rapid Response Team (RRT) providers and Primary Care teams by 25% over a two-week period at Christiana Hospital. Working with key stakeholders in Information Technology and others across the system, the team was able to change the RRT webpaging format to include a new question concerning contacting the Primary Care team. They also increased awareness of the new change through various communication methods to Christiana and Wilmington hospitals. Their results have shown an increase of about 25% of the Primary Team being contacted for RRTs called by making changes to the RRT webform and notifying providers of such changes.
Medication Reconciliation in the Ambulatory Setting: When Cerner Attacks
This project was designed to increase the completion of a documented reconciliation by a Wilmington Adult Medicine provider by 25% by April 2019. The team partnered with key stakeholders from the Wilmington Adult Medicine practice. The intervention occurred by providing a brief medication-reconciliation instructional packet that provided education to providers on the proper steps needed to complete a medication reconciliation according to Cerner. After the intervention the team observed a 31.5% increase in medication reconciliation rates over a two-week period, well above their goal.
Passing Medications with Ease-Maybe Not!
This project aimed to reduce the number of medication errors as a result of shared medication drawers in the semi-private rooms in Christiana Hospital’s 5E unit (Heart Failure unit) to zero over a 6-month period. Through contributions from key stakeholders in Nursing, Pharmacy and others, the team was able to introduce new labeled drawer bins, as well as a reorganization of drawer contents, to the 5E semi-private rooms. Pre- and post- intervention survey results showed decreased perception of medication errors among 5E nurses who had patients in semi-private rooms.
Adventures of the Wellness Wagon
This team had a goal to increase resident physicians’ awareness and their likelihood of utilizing Center for Provider Wellbeing resources, such as VITAL WorkLife and Resource Liaison Line by 50% by March 31, 2019. Working with key stakeholders in the Center for Provider Wellbeing, Employee Health, and VITAL WorkLife, the team used the Wellness Wagon to provide short and quick education in surprise visits to residents at Christiana and Wilmington hospitals. During the intervention, the team effectively reached 63 residents with largely positive feedback from surveys distributed at the visits.
Facilitators make it happen
Judy Guidash, BSN, RN, CPHQ, Clinical Data Quality specialist, and Karen Ellis-Brisbon, FNP, Primary Care quality and safety fellow, were awarded the ACT facilitator training program certificate of completion. Other ACT team facilitators were LaRay Fox, M.Ed., CNMT; Jeremy Cristol, M.D.; and Loretta Consiglio-Ward, MSN, RN.