Improving the Patient Experience for
Joint Replacement by Using a
Guided Process
Julie Benz
Director of Outpatient Therapy...
Avera McKennan – Sioux Falls SD
* Hub of the Avera Health System
* Established over 100 years ago
Within the Avera McKennan network…
• 13 regional hospitals
• Avera Behavioral Health Center
• Avera Heart Hospital of Sout...
We are nationally recognized for excellence in:
Cancer treatment Stroke care and neurosciences
Orthopedics Women’s health ...
Our Aspiration
Through service and process
excellence, Avera McKennan will
lead the nation in high quality,
affordable hea...
Rural Innovative
Most advanced use of e-services
Strives to be at the forefront of
innovation
Top 10 Trailblazing Hospitals
“Goals determine what you
are going to be."
Julius Erving
Objectives
1. Identify problems facing the
Orthopedic Unit
2. Identify innovative concepts that
improve the processes to p...
Orthopedics at Avera
McKennan
•32 – bed unit
•700 Jt Replacements/year
•2 - Primary Orthopedic Groups
•1987 established Ea...
Challenges
Competitive environment
 Reducing volumes
Patient Satisfaction below the Top Box
performers.
 * Quality Out...
Innovative Ideas & Proven
Concepts
• Process Excellence - Lean
• Purposeful Hourly Rounding
• Leader Rounding
• Pain Team ...
Lean – Process Excellence
Visual Management Control
•To clearly and immediately notify
management and workers whether
the work area is normal or abn...
Supplies at POU on 2WB pod
Purposeful Hourly Rounding
Visual Management Control
Patient out of room
Even Hour Round Complete
Odd Hour Round Complete
Intentful Leader Rounding
Leader with staff
Daily with staff on shift
Quarterly with every staff
Senior Leadership - weekly
Pain Team
Instituted a Pain Team –
Anesthesiologist - Pharmacist
Pharmacist on the floor during the
day and available at n...
What were we challenged by-
Getting the right
information to the patient
and their family at the
right time
“To shoulder greater accountability for
outcomes, health systems must partner
with patients to close gaps in
communication...
Program Goals
1. Improve patient experience
2. Ensure patient adoption and
engagement
3. Improve Patient Satisfaction
4. D...
Reports Available
To numerous to mention but
valuable information that drives
our process changes.
Weekly Report Summary
March 3, 2014 - March 9, 2014
Patient Activity
New Enrollments 4
New Registrations 4
Total User Logi...
Other Changes
• Aquatic Therapy Post Op Day1
• Dietary Aid on the floor 8hours/day to
assist with nutritional need of the
...
Results of our Efforts
Fall Reductions
3.06
5.59
8.03
10.70
5.37
13.16
4.58
5.88
15.97
2.81
1.74
3.64
0.00
2.00
4.00
6.00
8.00
10.00
12.00
14.00
...
Patient Satisfaction
Question Mar – 12 to Feb 13 Mar-13 to Feb-14
Overall Rating of
Hospital
70.7% 75.5%
Likelihood to
Rec...
Surgical Growth
Total Care
Avera Total Care
Nationally Recognized Quality
2014 Healthgrades Awards
Five-Star Awards in:
• Orthopedics
• Neuroscience
• Gastrointestina...
Nationally Recognized Quality
One of the 100 Top Hospitals®
in the nation in 2013 as
named by Truven Health
Analytics
Nationally Recognized Quality
• No. 1 hospital in South
Dakota in 2012-13
and 2013-14
Nationally Recognized Quality
• QUEST High Performing
Hospital in 2013
Premier Health Care Alliance
Nationally Recognized Quality
• Community Value
Leadership Award
• Community Value 100®
Hospitals list
Cleverley + Associa...
Questions
Thank you
Improving the Patient Experience for Joint Replacements by Using a Guided Process
Improving the Patient Experience for Joint Replacements by Using a Guided Process
Improving the Patient Experience for Joint Replacements by Using a Guided Process
Improving the Patient Experience for Joint Replacements by Using a Guided Process
Improving the Patient Experience for Joint Replacements by Using a Guided Process
Improving the Patient Experience for Joint Replacements by Using a Guided Process
Improving the Patient Experience for Joint Replacements by Using a Guided Process
Improving the Patient Experience for Joint Replacements by Using a Guided Process
Improving the Patient Experience for Joint Replacements by Using a Guided Process
Improving the Patient Experience for Joint Replacements by Using a Guided Process
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Improving the Patient Experience for Joint Replacements by Using a Guided Process

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Hospitals must find ways to differentiate their services and programs from their competition, while facing the obstacles of reduced reimbursement, a larger focus on patient satisfaction, and increased accountability and quality requirements.
The Avera Orthopedics department did an evaluation of the patient experience for their Total Joint Replacements program from end-to-end, including an assessment of their online experience for e-patients. A care path was then optimized with transition gaps resolved and duplicative work eliminated. A web-based patient guidance system was implemented that provided patient benefits in convenience and efficiency.
Avera found that guided patient engagement through the total episode of care improves patient readiness, increases treatment adherence, reduces risks of setbacks, and speeds up recovery.
In this session you will learn
The problems faced by the Avera ortho dept
Defining a process to evaluate hospital service line patient experience from end-to-end
Addressing pain management scores through multiple initiatives
Innovative concepts that used lean processes to positive outcomes
The effects of purposeful hourly rounding and leader rounding
How to create a streamlined care path, reducing variances and duplicative work
Benefits seen in setting patient expectations early and offering convenience of online e-patient engagement
About the Speaker:
Benz Julie_color_smallJulie Benz is the Director of Outpatient Therapy Services at Avera McKennan. Julie has been employed with Avera McKennan for 30 years. She received her degree in Physical Therapy from the University of Iowa and Masters in Administrative Studies from the University of South Dakota.

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Improving the Patient Experience for Joint Replacements by Using a Guided Process

  1. 1. Improving the Patient Experience for Joint Replacement by Using a Guided Process Julie Benz Director of Outpatient Therapy Services March 20, 2014
  2. 2. Avera McKennan – Sioux Falls SD * Hub of the Avera Health System * Established over 100 years ago
  3. 3. Within the Avera McKennan network… • 13 regional hospitals • Avera Behavioral Health Center • Avera Heart Hospital of South Dakota • 85 primary and specialty care clinics
  4. 4. We are nationally recognized for excellence in: Cancer treatment Stroke care and neurosciences Orthopedics Women’s health care Pediatrics and neonatal intensive care Behavioral health Emergency, trauma and critical care Surgery Gastrointestinal care Avera McKennan’s flagship facility is our 545-bed tertiary care hospital in Sioux Falls.
  5. 5. Our Aspiration Through service and process excellence, Avera McKennan will lead the nation in high quality, affordable health care.
  6. 6. Rural Innovative Most advanced use of e-services Strives to be at the forefront of innovation Top 10 Trailblazing Hospitals
  7. 7. “Goals determine what you are going to be." Julius Erving
  8. 8. Objectives 1. Identify problems facing the Orthopedic Unit 2. Identify innovative concepts that improve the processes to positive outcomes.
  9. 9. Orthopedics at Avera McKennan •32 – bed unit •700 Jt Replacements/year •2 - Primary Orthopedic Groups •1987 established Easy Street •2002 initiated Joint Camp
  10. 10. Challenges Competitive environment  Reducing volumes Patient Satisfaction below the Top Box performers.  * Quality Outcomes  Falls  Pain Management
  11. 11. Innovative Ideas & Proven Concepts • Process Excellence - Lean • Purposeful Hourly Rounding • Leader Rounding • Pain Team – one call response • Total Care - PGS
  12. 12. Lean – Process Excellence
  13. 13. Visual Management Control •To clearly and immediately notify management and workers whether the work area is normal or abnormal. –Shadowing/Labeling –Andon Signals –Downtime Clocks –Process Control Centers © 2007 OpEx, Inc. All Rights Reserved.
  14. 14. Supplies at POU on 2WB pod
  15. 15. Purposeful Hourly Rounding
  16. 16. Visual Management Control Patient out of room Even Hour Round Complete Odd Hour Round Complete
  17. 17. Intentful Leader Rounding Leader with staff Daily with staff on shift Quarterly with every staff Senior Leadership - weekly
  18. 18. Pain Team Instituted a Pain Team – Anesthesiologist - Pharmacist Pharmacist on the floor during the day and available at night for med review
  19. 19. What were we challenged by- Getting the right information to the patient and their family at the right time
  20. 20. “To shoulder greater accountability for outcomes, health systems must partner with patients to close gaps in communication and coordination while managing care beyond the acute care or physician office setting” » The Advisory Board
  21. 21. Program Goals 1. Improve patient experience 2. Ensure patient adoption and engagement 3. Improve Patient Satisfaction 4. Drive staff efficiency 5. Create a compelling competitive differentiator
  22. 22. Reports Available To numerous to mention but valuable information that drives our process changes.
  23. 23. Weekly Report Summary March 3, 2014 - March 9, 2014 Patient Activity New Enrollments 4 New Registrations 4 Total User Logins 46 Unique User Logins 22 Item Completion 1st Functional Outcome 5 Preparedness Survey 1 Hospital Experience Survey 2 Recovery Survey 1 Surgeon Experience Survey 2 Transition Experience Survey 1 2nd Functional Outcome 1 Avera TotalCare Program Survey 0 6 Month Functional Outcome 0
  24. 24. Other Changes • Aquatic Therapy Post Op Day1 • Dietary Aid on the floor 8hours/day to assist with nutritional need of the patient. • Daily Rounds with RN, Case Manager, Social Worker, Therapy and physician liaison
  25. 25. Results of our Efforts
  26. 26. Fall Reductions 3.06 5.59 8.03 10.70 5.37 13.16 4.58 5.88 15.97 2.81 1.74 3.64 0.00 2.00 4.00 6.00 8.00 10.00 12.00 14.00 16.00 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Rateper1,000PCD 2 West Ortho Falls Jan-Dec 2012 Fall Rate Magnet BenchmarkMagnet Benchmark is the average rate for 8 quarters. Actual 5.61 1.95 3.453.44 1.58 9.12 1.59 0.00 3.42 5.84 5.37 3.45 2.97 0.000.00 2.00 4.00 6.00 8.00 10.00 12.00 14.00 16.00 Jan FebMar AprMayJun Jul AugSep Oct NovDec Jan Feb Rateper1,000PCD 2 West Ortho Falls January 2013-February 2014 Fall RateMagnet Benchmark is the average rate for 8 quarters . Actual
  27. 27. Patient Satisfaction Question Mar – 12 to Feb 13 Mar-13 to Feb-14 Overall Rating of Hospital 70.7% 75.5% Likelihood to Recommend 75.3% 86.8% Transitions of Care 59.6% 64.5% Pain Management 68.1% 74.6%
  28. 28. Surgical Growth
  29. 29. Total Care Avera Total Care
  30. 30. Nationally Recognized Quality 2014 Healthgrades Awards Five-Star Awards in: • Orthopedics • Neuroscience • Gastrointestinal services • Critical care
  31. 31. Nationally Recognized Quality One of the 100 Top Hospitals® in the nation in 2013 as named by Truven Health Analytics
  32. 32. Nationally Recognized Quality • No. 1 hospital in South Dakota in 2012-13 and 2013-14
  33. 33. Nationally Recognized Quality • QUEST High Performing Hospital in 2013 Premier Health Care Alliance
  34. 34. Nationally Recognized Quality • Community Value Leadership Award • Community Value 100® Hospitals list Cleverley + Associates
  35. 35. Questions Thank you

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