Practical Interventions

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Practical Interventions

Tools that have been used within our organization but not tested using Safer Culture as a measure.

 

• Clinical Postpartum Pathway
  Applies to: Group Enabling Factors | Communication & Information ExchangeThe “standard” elements of clinical care that need to be completed are often missed, with subsequent patient care and potential safety consequences to both mother and baby. Further, many discharge activities could be spread throughout the hospital stay, decreasing reliance on completion of all tasks on the morning or day of discharge. Barriers to patients achieving clinical milestones prevents timely discharge and can lead to delays in further plan of care.

  Memorial Hermann staff nurses worked with the Six Sigma team to develop a mechanism to improve communication with a complete milestone pathway checklist.  This pathway checklist was then integrated into Multidisciplinary Discharge Rounds (MDDR) to review plan of care and identify barriers to clinical care and discharge.

• Multidisciplinary Discharge Rounds (MDDR)
  Applies to: Group Enabling Factors |Teamwork & Collaboration | Communication & Information ExchangeMultidisciplinary Discharge Rounds (MDDR) are a component of the daily model of care in which multidisciplinary team members (physicians, nurses, case managers, ancillary personnel, etc.) meet at a single location to have focused, structured communication, highlighting barriers to discharge and progression through medical milestones.

  MDDRs differ from clinical and or teaching rounds in that discussions are in a standardized format and directed to the concise review of all patients on the nursing unit with the objectives of:

  – Identifying barriers to patient progression
  – Identifying possible resource utilization issues
  – Identifying possible discharge needs
  – Initiating interventions to prevent complications and delays in discharge
  – Coordinating plan of care among disciplines
  – Managing patient care for quality and utilization improvement opportunities

  The rounds are intended to improve team communication and enhance accountability for a clear effective patient plan of care. At the conclusion of rounds for each patient, all participants should clearly understand their own action items for the next 24 hours as well as the overall plan for the day and plan for the stay, including key clinical goals, facilitating patient discharge plan, recognizing outstanding procedures/ lab tests, and steps to remove barriers to care progression.

• Obstetrics Patient Safety Nurse
  Applies to: Organizational Enabling Factors | Group Enabling Factors |Teamwork & Collaboration | Communication & Information Exchange | Incident ReportingThe Obstetrics (OB) Patient Safety Nurse is responsible for data collection and education, is the director of an anonymous event reporting system, and the leader of adverse event reviews. This position helps to lead the charge on improving patient safety.
• Patient Ambassador Program
  Applies to: Organizational Enabling Factors | Communication & Information Exchange | Incident ReportingThe Patient Ambassador is a designated person whose position is responsible for acting as liaison between patients/families and the hospital, through Human Resources management /administrative staff, thus providing a specific channel through Human Resources by which patients can seek solutions to concerns, issues and unmet customer expectations. They assist patients in interpreting hospital policies and procedures and actively seek resolutions to identified problems and concerns of the patients/families. This position was implemented five years ago in Memorial Hermann’s Women’s Services and was so successful it quickly spread to every unit in the hospital.
• Patient and Family Advisory Council
  Applies to: Organizational Enabling Factors | Group Enabling Factors | Teamwork & Collaboration | Communication & Information ExchangeCreate an avenue to involve the patient and family voice as a partner with the clinical teams in quality improvement and patient safety initiatives within the perinatal department. At Memorial Hermann we used a 5-step process to implement a patient and family advisory council. More detail is available in the Safer Culture Whitepaper.
• Patient Safety Dashboards
  Applies to: Organizational Enabling Factors | Communication & Information ExchangeMemorial Hermann designed dashboards to visually display unit-based trends in safety and clinical effectiveness outcomes and to benchmark these outcomes against national quality standards and system standards. They improve information sharing of quality metrics for unit leaders across Women’s Services by showing customized data specific for Patient Safety outcomes, Women’s Services Clinical pathway, Perinatal Core Measures, and OB Milestone Pathway.

Perinatal Nurse Navigator
Applies to: Organizational Enabling Factors | Group Enabling Factors | Teamwork & Collaboration | Communication & Information Exchange

The Perinatal Nurse Navigator is a person in the position to conduct appropriate clinical assessments of patient referrals and present assessment information to physicians; participate in marketing hospital services and continuous quality improvement with external referral sources, social workers, discharge planners, case managers, healthcare professionals, families and patients. The Perinatal Nurse Navigator is responsible for increasing the utilization of clinical services offered by the hospital. This position was implemented five years ago in Memorial Hermann’s Women’s Services and has been incremental in increasing communication, continuity of care and safety between hospital staff and the patient to improve the patient experience.