Slide1 l.jpg
Sponsored Links
This presentation is the property of its rightful owner.
1 / 30

Jennifer Berry Martin School of Public Policy and Administration University of Kentucky Master in Health Administration Capstone Project Spring 2008 PowerPoint PPT Presentation


  • 181 Views
  • Uploaded on
  • Presentation posted in: General

An Evaluation of the Implementation of Code H (Help) And Its Impact on Patient Satisfaction. Jennifer Berry Martin School of Public Policy and Administration University of Kentucky Master in Health Administration Capstone Project Spring 2008. Purpose.

Download Presentation

Jennifer Berry Martin School of Public Policy and Administration University of Kentucky Master in Health Administration Capstone Project Spring 2008

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


An Evaluation of the Implementation of Code H (Help) And Its Impact on Patient Satisfaction

Jennifer Berry

Martin School of Public Policy and Administration

University of Kentucky

Master in Health Administration

Capstone Project

Spring 2008


Purpose

  • Identify the implementation process of

    Code H

  • Reveal if Code H is achieving its intended goals of increasing patient satisfaction

  • What changes can be made to Code H to improve its effectiveness and increase patient satisfaction?


Background

  • An infant died due to narcotic misuse, severe dehydration, and multiple breakdowns in communication

  • UPMC Shadyside initiated a rapid response team called Condition Help


Condition Help

  • Condition codes usually are activated by health care providers

    This code is different. It asks patients and visitors to be part of the care team by alerting caregivers to clinical changes.


What is Condition H?

  • Provides a hotline for hospital patients and their family members to call when there is:

    • a noticeable, clinical change in the patient and the health care team is not responding to the patient’s or visitor’s concerns

    • a breakdown in how care is being managed or confused

  • The Lexington hospital modeled its program after UPMC and called it Code H.


Why was Code H implemented?

  • In response to :

    • Medical errors

    • Joint Commission

      • National Patient Safety Goals

      • Speak Up


Significance of Project

  • Proper implementation of Code H=

    • Increased patient satisfaction

  • Evaluation will inform the hospital of actions it can take to increase the effectiveness of change in the future.


Data Sources

  • Personal Observation: Field Notes

  • Code H Log Sheet

  • Patient Interviews

  • Code H Follow-Up Questionnaire


Gustafson Change Model

  • Tension for Change

  • Mandate

  • Change agent commitment

  • Tension level

  • Data on severity (collected & communicated)

  • Feedback

  • Measures (outcome & intervening variables)

  • Pilot test

  • Safety

  • Decision & Plan

  • Troubleshoot

  • Commit to change

  • Superior Alternative

  • Benchmarking

  • Multiple options

  • Evidence of superiority

  • Complexity

  • Radicalness

  • Change Attempt

  • Pilot tests

  • Individual actions

  • Support

  • SocialProcess

  • Power group ▪ Simplify

  • (involvement & endorsement)▪ Funds

  • Middle management ▪ Instructions/Rules

  • (involvement & endorsement)▪ Materials

  • Respect for change agent

  • Relative threat to supporters

  • and opponents

  • Ability

  • Skills

  • Assess qualifications

  • Training plan

  • Self efficacy

  • History of change

  • Perceived chance of success

  • Change agent prestige


Methods

  • Each element in the Gustafson Change Model is important but at a different degree. The “level of importance” was assigned based on the organization and change itself.

  • Levels of Importance as shown in the Likelihood of Success Table:

    • critical

    • adequate

    • minimal


Methods

  • Unmet= hospital did not take any action

  • Partially met= hospital achieved approximately half of the Gustafson requirements

  • Met= achieved at least 90% or more of the Gustafson requirements


Likelihood of Success


Likelihood of Success


Results: Field Notes


Results: Field Notes


Results: Field Notes


Results: Field Notes


Level of importance

Critical

Mandate

Tension level

Data on Severity

Change agent commitment

Troubleshoot

Pilot test

Pilot test

Training plan

Measures

Instructions

Middle mgmt.

Simplify

Commit to change

Partially Met/ Adequate

Ind. actions

Safety

Unmet

Met

Level of achievement

Respect for change agent

Funds

Materials

Power group

Threat

Category

Tension for Change

Superior Alternative

Support

Ability

Decision & Plan

Change Attempt

Feedback

Complexity

Radicalness

Evidence of superior

Multiple options

Benchmark

Assess qualifications

History of change

Chance of success

Change agent prestige

Minimal

Results: Plotted Graph

Results


Results: Code H Log Sheet


Results: Follow-Up Questionnaire


Results: Patient Interviews


Problem 1

  • Critical and unmet element- Pilot test

  • Solution: Conduct at least one mock Code H every quarter


Problem 2

  • Critical and partially met elements- Instructions/Rules and Troubleshooting

  • Solution: Ensure that these areas are discussed thoroughly before implementing any change

    • Flow chart

    • Contact person


Problem 3

  • 24% of Code H calls were classified as pain control/medication related

  • Solution: Ensure that all staff are responding to medication needs in a timely manner

    • Check sheet

    • Medication log


Problem 4

  • 64% of interviewed patients did not receive information on Code H upon admission

  • Solution: Monitor and verify that all patients receive Code H information upon admission

    • Check sheet


Problem 5

  • Questions on Code H protocol and response

  • Solution: Increase Code H education

    • Flow chart

    • FAQ’s

    • Breeze module

    • Validation tool


Limitations

  • Participant-observation

  • Subjective study

  • Time


Conclusion

  • Gustafson provides a model which should be utilized for any future changes the hospital implements

  • Code H data should continued to be gathered in order to see what impact it has had on patient satisfaction


Thank You

  • Dr. Wackerbarth, chair

  • Dr. Talbert, second chair

  • Dr. Hankins, reader

  • Lynn Kolokowsky, J.D., Director of Risk Management/Patient Safety, outside adviser


Questions?


  • Login