1 / 15

Transforming Care in the ICU

Transforming Care in the ICU. Seven Year Path to Excellence. Baptist Memorial Hospital-Memphis. Tertiary care hospital 736 total beds 68 ICU beds 38 bed general ICU 28 medical-surgical beds 10 bed neuro unit. Improved Patient Outcomes: . 35% reduction in ICU length of stay

vicki
Download Presentation

Transforming Care in the ICU

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. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Transforming Care in the ICU Seven Year Path to Excellence

  2. Baptist Memorial Hospital-Memphis • Tertiary care hospital • 736 total beds • 68 ICU beds • 38 bed general ICU • 28 medical-surgical beds • 10 bed neuro unit.

  3. Improved Patient Outcomes: • 35% reduction in ICU length of stay • 45% reduction in ICU mortality rate • 47% decrease in central line associated blood stream infections rate • 48% drop in ventilator associated pneumonia rate • 57% reduction in Sepsis mortality rate for protocol patients

  4. Objectives • Foundational Elements • Multidisciplinay Rounds • Intensivist Program • Daily goals • Small Tests of Change • Keep it simple • Small Changes=Big Impact • Reliability • Bundles • Evidence based-care How we did it.

  5. Our Aim • October 2002 • To promote patient/family centered care, prevent harm and improve patient outcomes by providing safe, efficient, evidence-based care.

  6. Transforming ICU Care: • “We ALREADY do all that” • Baseline for Head of Bed 30%, eye opener • Practiced in SILOS – with no determined plan or focus

  7. Established Foundational Elements • Multidisciplinary Rounds • start small • ICU Daily Goal/Patient Plan of Care • Start Small • Intensivist Coverage

  8. Implemented reliable evidence-based practices • Pre-extubation worksheet for RN/RT collaboration in the weaning – start small • Care bundles: Ventilator, Central Line – start small • Glycemic Control- a nurse driven-policy to initiate the Insulin Drip Protocol - start small • Severe Sepsis/Septic Shock protocol and bundles (resuscitation and management) – start small • MRSA screening – start small • Sedation/analgesia protocol and initiatives –start small

  9. ICU Glucose Control Revised policy to institute Insulin Drip Protocol for one BG >150 mg/dL Goal: > 80% Nurse-driven policy to initiate Insulin Drip Protocol for two BG >150 mg/dL

  10. :Implemented processes to identify and rescue worsening patients • Medical Response Team (MRT) • Sepsis Screening- • Code H • Early Warning System

  11. Improved Bed Flow • Bed Huddles • Color Coding System

  12. ICU Length of Stay FY02: 5.72 FYTD 08: 3.45 Goal: <4 days

  13. Implemented processes for integration of patient and family into care: • Flexible “open-visitation” • Family orientation to ICU • Family in MDR • Involved in daily goal settings

  14. Keys to Sucess • Involve frontline staff • Collaboration is Key • Design reliaiblity into processes • Use data to drive improvements • Design processes to be “the way we work” • Enlist Leadership • Celebrate Success

  15. Next Steps • Sustain, Sustain, Sustain • Sedation/Analgesia Protocol • Sepsis Work • Any challenge that will improve care and safety of our patients

More Related