A Breath of Fresh Air: Reducing Defects in Plan of Care for Patients with C…


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Improvement Story session at the 2013 Saskatchewan Health Care Quality Summit. For more information about the summit, visit www.qualitysummit.ca. Follow @QualitySummit on Twitter.

This presentation will share the results of a Rapid Process Improvement Workshop (RPIW) event that focused on reducing defects in plan of care (admission through to discharge) for hospital patients with chronic obstructive pulmonary disorder (COPD). The RPIW team was the first in Saskatchewan to pilot new tools (standard orders, care maps, discharge education) designed to provide more consistent, collaborative care for COPD patients.
Better Teams

Jennifer Hamel; Kelly Johnson, Saskatoon Health Region; Sharon Misskey, Saskatoon Health Region

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A Breath of Fresh Air: Reducing Defects in Plan of Care for Patients with C…

  1. 1. A Breath of Fresh Air: Reducing Defects in Planof Care for Patients with COPDJennifer Hamel, Sharon Misskey, Carol Schmidt, Kelly JohnsonThis Session is sponsored by:
  2. 2. A Breath of Fresh Air:Reducing Defects in Plan of Care forPatients with COPDJennifer Hamel, Sharon Misskey, Carol Schmidt, Kelly JohnsonHealth Quality Summit 2013
  3. 3. Who Are We?A Breath Of Fresh Air
  4. 4. 7th Floor General Medicine44 Bed Medical Unit:• Top 3 Diagnoses: COPD/Pneumonia/ Heart Failure (withoutAngiogram)• Primary Nursing: RegisteredNurses, License Practical Nurses,Continuing Care Aides• Supported by Clinical NurseSpecialist, Clinical Nurse Educator,Physiotherapy, OccupationalTherapy, Respiratory Therapy,Social Work, CPAS, Dietary,Pharmacy,A Breath Of Fresh Air
  5. 5. Chronic Disease Management Resources• LiveWell COPDProgram• COPD NurseClinicians• SaskatchewanPulmonaryRehabilitationProgramA Breath Of Fresh Air
  6. 6. Getting To The Root CauseA Breath Of Fresh AirChart audits found that:-83% of patient care planswere missing at least oneout of the four elementsrecommended as bestpractice.-Standard order sets werebeing used only 33% ofthe time
  7. 7. A Breath Of Fresh Air• Information regarding patient/family circumstances not alwaysknown by care team• Lack of standard practice around patient education prior totheir discharge• Mobilization of the patient did not occur in tandem withPhysiotherapy• Patient not routinely referred to community resourcesPatient/Family Perspective – Pre RPIW
  8. 8. “The only variation should be theuniqueness of our patients”A Breath Of Fresh Air
  9. 9. Value Stream MapA Breath Of Fresh Air
  10. 10. Our TeamA Breath Of Fresh Air
  11. 11. ER access to Order SetsA Breath Of Fresh AirPre-RPIW Post-RPIW
  12. 12. A Breath Of Fresh Air
  13. 13. A Breath Of Fresh Air
  14. 14. A Breath Of Fresh Air
  15. 15. COPD PackageA Breath Of Fresh Air
  16. 16. Standard Discharge PackageA Breath Of Fresh Air
  17. 17. A Breath Of Fresh Air
  18. 18. What Did We Accomplish?A Breath Of Fresh Air
  19. 19. Patient/Family Perspective Post RPIW• Clear understanding from care team of patientand family needs for discharge• Nursing Standards of Care in place• Mobility plan is part of Nursing Care Map• Automatic referred for community counselling(Live Well program)A Breath Of Fresh Air
  20. 20. Where Are We Now?• Feedback from Patientshas been very positive• COPD Nurses noteoptimized inhaler useamong COPD patients• Unit Nursing staff sharethey feel more confidentin the care they areprovidingA Breath Of Fresh Air
  21. 21. Where are We Going?• April 2013 rolling outpackage to the otherThree GeneralMedicine Units• Continue to Audit chartsand Interview Patients• Goal is to roll out acrossthe Health RegionA Breath Of Fresh Air
  22. 22. A Breath Of Fresh Air