New Knowledge, Innovation & Improvements

Timely discharge and reduction in length of stay (LOS) was a focus on many units in 2017, with a goal of keeping beds available for incoming patients. On 3B Telemetry in particular, the Unit Partnership Council developed a variety of tools to increase the number of patients discharged by noon. Some of the interventions include daily rounds with Care Coordination staff, signage stating "discharge by noon," identification of barriers, and a designated role of staff on PM shift to talk with patients/friends/families the night before discharge, to assure that transportation home, prior to 12 noon, has been arranged.

Bonnie Gebhart, Kim Komo, Kawa Fult, Roberta Hernandez, Laura Plambech
Lynn Taylor, Evelyn Taverna
Intraprofessional discharge rounds have been effective in reducing length of stay. Left to right: Laura Plambeck, PT; Bonnie Gebhart, Clinical Manager; Kawa Fuh, Care Coordinator; Lynn Taylor, CNS; Evelyn Taverna, CNS and Roberta Hernandez, RN.

Diabetes Chart

On November 14, 2017, which is also World Diabetes Day, the Insulin Basal Nutritional Correctional (BNC) model of diabetes management went live in Epic. The BNC is an evidence-based practice that has been shown to better control diabetes in the hospital setting. The implementation plan included education for physicians and nurses, including a knowledge test for nurses. A report created in Epic enables the team to track the patients on insulin for blood glucose control. Next steps are to steadily increase physician adoption of the new order sets.
Davinne Aurelio explains the new fall risk assessment
Davinne Aurelio, RN, (right) explains the new fall risk assessment tool to Stephen Miao, RN.

The team in Mental Health and Addiction Services (MHAS) noted that the hospital's fall risk assessment tool was not as sensitive for mental health patients as it could be. Led by Davinne Aurelio, RN, a team from MHAS discovered the Edmonson Fall Risk Tool, which has been validated for mental health patients. After receiving permission from the tool's originator to adopt it, the team developed the education for its use and worked with IT clinical staff to update Epic with this new fall risk tool.