Being a nurse or other member of the Team on an inpatient unit in a busy hospital can be a very hard job. Our patients, especially the elderly, have many needs. A nurse must be well schooled in the science of medical care and he or she must also be a humanist. The inpatient’s progression is not always predictable – the Team never really knows what is around the corner.
Our inpatient Teams at GBMC are doing a marvelous job of caring for our patients and also finding the time to improve towards our quadruple aim of better health outcomes, better care experience, less waste/lower cost and more joy for those providing the care. This week our Unit 45 Team shared with me some of their accomplishments. After their Thursday morning huddle, Amanda Stevens, RN ran down the huddle checklist with me. She showed me how the Unit had gone 43 days without a patient fall! We discussed what the Unit had done to get to that fantastic accomplishment including the use of “hourly rounding” where every patient is visited at least once per hour by either a nurse or a medical technician and is asked, among other things, if he or she needs to use the toilet. (Getting up to go to the toilet unassisted is a major trigger for falls among elderly and debilitated patients.) She also credited the standardized use of bed alarms for at risk patients.
We then discussed the Lean Daily Management metric on hand hygiene. Every shift, a nurse audits his or her colleagues’ hand hygiene and the previous day’s performance is discussed at the huddle and then tallied on the run chart in the nursing station. (We will be formalizing our approach to Lean Daily Management with a weeklong kaizen in April).
Amanda showed me that the daily audits were hovering in the 97% reliability range this week. It is the return to the daily audit that has helped the Unit get its monthly unit measure done by the “secret shopper” back above 85% after the “special cause” of opening new beds in November. Amanda shared a number of other things that were discussed from the huddle checklist and I thanked her for her great leadership. I then thanked many members of the Team and asked them how they enjoyed being actors. They looked at me a bit puzzled and then one of them said: “Oh, you mean the video!”.
The Unit Manager of Unit 45, Eileen Skaarer, RN had shared with me that to do a little team building, to continue the hand hygiene buy-in, and to have some fun, the Unit had produced a video. I think that you will agree after watching it, that it really does seem like they had some fun doing it, and I am sure it increased their team spirit and further locked in their awareness of the need to “wash in and wash out”. I am very grateful to the staff on Unit 45 for all that they are doing and also that they found a way to put some of the joy back in caring for their patients.