130 - “One Thing” Initiative Taking the V-tach out of Surgical Patient Experience
Description: Background/ Current 2018 Situation qV-Tach of Patient Experience in all questions/domains qInconsistent work qUnsustainable results qAchievements based on “Luck.” Our aim is to qDemonstrate standard work and process throughout the perioperative surgical experience for both the patients and families and for the Staff and Surgeons qAchieve > 50th percentile ranking in all 5 Domains for rolling 8 quarters ( Magnet EP21EO Ambulatory) Drivers q“ONE THING” Approach - Same thing, same way, every patient, every day ØPatients ØStaff/Surgeons ØActions ØResultsThe "One Thing approach" was developed as a result of inconsistent and very low patient experience scores. The team was consistently tracked from October 2016 - October 2017. Standard work, scripting, and tasks were developed and tracked from October 2018 - June 2019 with significant improvement and sustainability with simple tasks. The goal of this study was to simplify the approach with meaningful actions and tasks. We created simple actions such as acknowledging that “we know you may be scared how about a warm blanket? This will help your comfort, it’s like a hug to start.” This simple action aligned with the question care for my comfort. We developed a discharge folder that had an area for literature and instructions but it also has our scripted “Discharge Time Out,” to ensure the staff did the discharge “same thing, same way, every patient every day.” The scripting using the strategy of mirroring the questions and reduction of materials provided to patient was an imperative that aligned with discharge instructions on Key topics such as nausea, bleeding, signs and symptoms of infection and medications. We reduced the materials from over 100 pages to very concise thoughtful 4-5 pages. In interviewing patients we found they were so overwhelmed by the amount of information it was often never referred to, this lead to low scores in discharge category as well as low scores in areas such as bleeding and nausea. Introductions of roles have also been key in aligning with patients questions. Our team has also worked in partnership with our Anesthesia group to develop a communication board demonstrating moves throughout the continuum of surgery keeping families informed as to the times and movements of care. We have also been able to capture data from our event reporting system, enabling immediate root cause and analysis with recommendations from the team to incorporate change in practice and safe habits using the “Discharge Time Out” to prevent instances of failure to remove IV prior to Discharge. The department has achieved 2 Top Tenth percentile units for the entire year and above corporate goal for 3rd unit scoring in the top 20th percentile.