ACH President and Physician-in-Chief Jonathan Ellen, M.D. presented the annual All Children's Hospital Quality Improvement Awards at a brief ceremony on Friday, March 1.
"The efforts we are celebrating today were designed, led and implemented by employees dedicated to doing the best for our patients and families," said Dr. Ellen. "They required teamwork, coordination, measurable objectives and a willingness to challenge the conventional way of doing things. They show that our employees are willing to ask important questions about how we can do things better, propose a solution, and be willing to adjust their thinking when data suggest a different approach."
He added, "As we pursue our Pathway to the Top we will put even greater focus on Quality and Patient Safety. These will be the key elements of our bright future-when we are doing our very best in this area it will impact every part of that Pathway."
Three unit-based projects tied for first place:
Hazardous Drug Handling - Easy as Red, Yellow, Green:
To standardize hazardous drug handling at ACH and be consistent with best practice guidelines, this team did a great deal of work. They created a clinical policy, developed a color-coded, hospital-specific hazardous drug list and work flow diagrams, upgraded the online MSDS, renovated the hospital's waste stream, and created and implemented multidisciplinary education. The project was launched on 7 South and later rolled out to other areas of the hospital. Congratulations to team members Teri Vrchoticky, Beth Carberry, Amy Spence, Debbie Del Favero, Dawn Napolitano, Lisa Smith, Shamelle Clagette, Larry Green and Michael Dansberger.
A Lean 5S Approach to Pyxis Supply Cabinet Improvements: The OR staff sought to reduce the time spent locating and retrieving supplies from the orthopedic Pyxis supply cabinets. The project team used 5S principles to reorganize the supply cabinets, reducing the estimated 1,100 hours per year that had been spent searching for items. This approach has proved sustainable and has been expanded within the OR and throughout other areas of the hospital. Congratulations to team members: Doug DeRosa, Annette Jenkins, Dan Pilla, Sarah Heacock, David Bryant, and Green Belts Todd Whipple and Chris Snyder.
MRI Without Sedation: The goal for this project was to decrease the need for sedation for MRI in NICU patients. MRI without sedation is safer and more cost-effective; it eliminates the need for IV access, intubation, ventilation, chest x-rays and NPO status. Knowing that babies fall asleep after eating, the team changed procedure for infants who met inclusion guidelines. MRI scans were scheduled after feeding, and the use of a papoose-like immobilizer helped the infant feel securely bundled. With this project, the rate of NICU brain MRIs completed without sedation went from a baseline of 42.9% in 2010 to 66.3% in 2012. Given this success, this practice was extended to infants from other inpatient units, the EC and the outpatient population. Congratulations to team members Evan Harris, George Alvarez, Dipti Amin, Karen Theobald, Mary Ann Bruton, Karen Schmitt and Cindy Driscoll.
The winning hospital-wide project was Medication Reconciliation: Optimizing Processes Leveraging Technology. This team included representatives of pharmacy, nursing, nursing education, clinical informatics, quality, IT and the ACH hospitalist program. Their goal was to improve the quality, reliability and utilization of the medication history entered into the electronic medical record at time of admission. They tested their proposed reconciliation process using the patients of the hospitalist service on the 8th floor.
Changes adopted following rapid cycle testing improved medication safety and made documentation a more efficient and reliable process. All of the participating prescribers and 93% of nurses in the pilot location agreed that the new process achieved its patient safety goals. The improvements have been sustained and make a valuable contribution to patient safety. Congratulations to team members Beth Carberry, Lisa Moore, Ron Ford, Chris Snyder, Hella Ewing, David Hunt, Joyce Anderson, Kathleen Arnold, Cindy Driscoll, Calvin Popovich, Gary Humphrey, Pam Neely, Rachel Pelaez, Julie Pham, Dipti Amin and Kristina Kochman.