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Operational Transition to Pavilion A a patient-centered approach

Operational Transition to Pavilion A a patient-centered approach. Phillip Chang Amy Harrington Julie Ribes Garland Strang Vince Willoughby Audrey Yates. 128 patients. up to 48 ventilated, ICU patients. 12 -hour move. Safe, Efficient, & Comfortable. Safety First.

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Operational Transition to Pavilion A a patient-centered approach

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  1. Operational Transition to Pavilion Aa patient-centered approach Phillip Chang Amy Harrington Julie Ribes Garland Strang Vince Willoughby Audrey Yates

  2. 128 patients up to 48 ventilated, ICU patients

  3. 12-hour move

  4. Safe, Efficient, & Comfortable

  5. Safety First

  6. Picture of complicated ICU move

  7. Ensuring a Safe Move • “too sick to move” • Move Team composition • Acuity based • ICU: RN + NCT + RT • Acute/Progressive Care: 2 transporters • Standard Operating Procedure • Check lists • Signage • Communication, Communication, Communication

  8. Contingency Plans • Utilization of Rapid Response Team • Designated Trauma Bay as “pit-stop” • Code carts placement • “Andon” cord

  9. Military Precision extensive planning

  10. Calculations • Simulation of moves • ICU: 48 patients • 45 minutes per move (2,160 minutes) • Takes 4 move teams 9 hours • Team = RN + NCT + RT • Acute Care: 80 patients • 30 minutes per move (2,400 minutes) • Takes 5 move teams 8 hours • Team = 2 transporters

  11. 12-hour move

  12. Issues Influencing Move Day Choice

  13. Issues Influencing Move Day Choice

  14. Sunday

  15. day “t-30” • Staff education • In the loop • Ann’s blog • CareWeb • Countdown clock • Tour new facilities • Finalize work assignment • Training of move teams • Customer Service (maps, material for family) • Order food for move team on day of move

  16. day “t-7” • Initiate strict cohort • Clearing of work space, lockers • Safety walk-through for each manager, e.g., • Cleanliness / infection control • Adequate stocking of supplies, equipment, & medication • Functional ProPacks • Functional oxygen tanks and regulators • Functional phones, Vocera badges, & walkie-talkies • Functional elevators • Functional IT items

  17. day “t-7” • Distribute move plans • Checklists to staff • Nurses • Nursing Care Techs • Respiratory Therapists • Transporters • Customer services • MD

  18. day “t-6” to “t-3” • Monitor progress of “cohorting” • Daily email reminders of move • Physicians • Nurses to continue to clear out personal items • Discharge planning (physicians & patient care facilitators)

  19. day “t-2” • Family education • Sincere apologies • Distribute educational materials & maps • Signage for move team (way finder) • Practice run for transport teams

  20. day “t-1” • Huddle • John Philips & designee • MDs • Attending from affected services • Chief residents • RNs • Capacity Command Center • Patient Care Managers • Respiratory Therapists • Transport Representative • Customer Service Representative

  21. day “t-1” • Check-list style • Patient identification and list generated • “too sick to move?” • “discharge within 24 hours?” • Potential downgrade • Patient assignment made • Location mapping • Route mapping

  22. day of move “t-0” • Command center • Communications • Vocera • Walkie-talkie • Small independent units • Patient care managers – “audible” • Elevator operators • Baggage & tag disposables for transport (incentive spirometer, toothbrush, etc) • Hand out gift packages

  23. Sequence of move • Acuity based • ICU first • Nurse-centric • Minimal hand-offs • Minimal double-staffing

  24. SOP (standard operating procedure) during move

  25. 5-star moving experience

  26. Luxury hotel-style porter (customer service or volunteer) for patient and family belongings Welcome basket for our first inpatients – a small gesture for their inconvenience

  27. Conclusion • Safe • Efficient • Patient & Family Centered

  28. Operational Transition to Pavilion A • AIM: • Move 128 patients from Pav H to Pav A safely and efficiently by May 2011 • MEASURE: • Total cycle time, Patient Census Report • CHANGE: • Map current state process • Measure and test small cycle of change • Develop standard work • Implement process changes in current day-to-day operations Exec Sponsor: Ann Smith and Janice Marks Owners: John Phillips and Kathleen Kopser Leaders: Phillip Chang, Amy Harrington, Julie Ribes, Garland Strang, Vince Willoughby, Audrey Yates Members: Juanita Warner, Shari Fullenlove, Sean Reynolds, Rodney Conner, Leah Perkins, Christy Wilbur, Jon Philips, Julie Blackburn, Brandy Mathews, Jan Davis, Gordon Bingham, Debbie Sublett Meets: July 22 from 800 AM to 5 00 PM, August 30 from 100 PM to 500 PM September 20 from 800am to 100pm

  29. 1st floor route

  30. 2 nd floor route

  31. Asks

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