Transforming Care at the Bedside
From HMCwiki
A collaboration between IHI, the Robert Wood Foundation and a plethora of healthcare workers resulted in a template to Transform Care at the Bedside. The group identified four primary design themes and developed associated goals. Each design theme is supported by high leverage improvements to help meet the goals. Spread is the inculcation method suggested -- with one or a few units piloting & tweaking intiatives until they are good enough to be adapted and transferred to other units.
The purpose of this article is to share/organize specific initiatives HMC Partners have made toward these design themes.
Contents |
SAFE AND RELIABLE CARE
Care for moderately sick patients who are hospitalized is safe, reliable, effective and equitable.Targets
- Adverse events are reduced to 5 (or less) per 1,000 patient days.
- Harm from falls is reduced to 1 (or less) per 10,000 patient days.
- Codes on med/surg units are reduced to zero
- 95% compliance with all key clinical process measures (all or nothing measure)for a high volume clinical condition.
High Leverage Changes Click blue words/links to see details on work done by HMC Partners and others.
- Create Early Detection and Response Changes (including RRTs)
- Prevent Adverse Drug Events
- Prevent High Hazard Drug Errors
- Prevent Nosocomial Infections
- Prevent Harm from Falls
- Develop Hospice and Palliative Care Programs
- Prevent Pressure Ulcers
- Prevent Surgical Complications
- Design Reliable Processes to Deliver Evidence-Based Care for a High Volume Clinical Condition
VITALITY AND TEAMWORK
Within a joyful and supportive environment that nurtures professional formation and career development, effective care teams continually strive for excellence.Targets
- Voluntary turnover for nurses is an average of 5% of less (per year).
High Leverage Changes Click blue words/links to see details on work done by HMC Partners and others.
- Build capability of front-line staff & mid-level managers in innovation and process improvement.
- Create teams (including patients) with the authority to act and transform care.
- Integrate students and residents.
- Develop staff and match roles & responsbilities to their skills.
- Enhance physical environment for staff.
- Optimize communications among clinicians and staff.
- Prevent staff injuries.
VALUE-ADDED CARE PROCESSES
All care processes are free of waste and promote continuous flow.Targets
- Nurses spend 70% of their time in direct patient care.
- Cost per discharge for the high volume clinical condition is reduced by 3% annually.
High Leverage Changes Click blue words/links to see details on work done by HMC Partners and others.
- Create acuity adaptable beds.
- Eliminate waste and imporve work flow in admission process.
- Eliminate waste and improve work flow in medication administration
- Improve work environment through physical space design.
- Eliminate waste and improve work flow in handoffs.
- Eliminate waste and improve work flow in discharge process.
- Eliminate waste and improve work flow in routine care for a high volume clinical condition.
- Enhance efficiency with technology.
PATIENT-CENTERED CARE
Truly patient centered care on medical and surgical units honors the whole person and family, respects individual values and choices, and ensures continuity of care. Patients will say, "They give me exactly the help I want (and need) exactly when I want (and need) it.”Targets
- 95% of patients are willing to recommend the hospital
- Readmissions within 30 days are reduced to 5% or less.
High Leverage Changes Click blue words/links to see details on work done by HMC Partners and others.
- Support and involve patients and families.
- Insure patient's physical comfort.
- Optimize transitions to home or other facility.
- Create patient-centered healing environments.
- Customize care to patient's values, preferences & expressed needs.
