hi point genetics · 2018. 3. 26. · created date: 3/20/2018 11:35:55 am

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Achieving Top Decile HCAHPS Results &
the Impact of Nurse Led
Interdisciplinary Care Rounds
Vice President, Chief Nursing Officer
Mariners Hospital, Tavernier, Florida
Mariners Hospital, Tavernier, Florida
• 1) Identify the characteristics of a Critical Access Hospital
with top decile HCAHPS.
Care Rounds.
Rounds on HCAHPS.
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Top Box Trends Inpatient - Med/Surg
Mariners Hospital
Med/Surg
Mariners Hospital
Med/Surg
Our Mission…
is to improve the health and well-being of individuals, and to promote
the sanctity and preservation of life in the communities we serve.
Baptist Health is a faith-based organization
guided by the spirit of Jesus Christ and the Judeo-Christian ethic.
We are committed to maintaining the highest standards of clinical and
service excellence, rooted in utmost integrity and moral practice.
Consistent with its spiritual foundation, Baptist Health is dedicated to
providing high quality, cost-effective, compassionate healthcare
services to all, regardless of religion, creed, race or national origin,
including, as permitted by its resources, charity care to those in need.
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Mission
Baptist Health South Florida
Our Vision
Baptist Health will be the preeminent healthcare provider in the communities
we serve – the organization that people instinctively turn to for their healthcare
needs.
Baptist Health will offer a broad range of clinical services that are evidence-
based and compassionately provided to assure patient safety, superior clinical
outcomes, and the highest levels of satisfaction with a patient- and family-
centered focus.
Baptist Health will be a national and international leader in healthcare
innovation.
Our Guiding Principle…
Through our compassionate healthcare services, we seek to reveal the healing
presence of God.
Vision and Guiding Principle
Baptist Health South Florida
• 25 Bed Critical Access Hospital
• Baptist Health South Florida-
Florida Keys
• FY 2015
Statistics
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• Sleep Diagnostics
Mariners Hospital
More Services
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Mariners Hospital Honors
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• History of interdisciplinary
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Care Coordination
• Effective care teamwork and collaboration are essential
(O’Leary, 2011)
promotes best POC (Sisterhen et al., 2007)
• ICR decreases adverse events, improve communication and
collaboration, efficiency in care, support patient family
centered care, and improves outcomes (Bussey & Johnson,
2015)
2015)
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Research
• Will the implementation of interdisciplinary care
rounds (ICR) in hospitalized patients at a rural
hospital improve communication, collaboration,
quality outcomes?
Clinical Practice Question
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Presented basic plan for implementation
Invitations sent to potential team members for meeting
• Resistance
• Overwhelming to the patient
• Physicians
• HIPAA
Objections, Obstacles, & Challenges
• Meet with disciplines to develop logistics and plan
• Time?
• Days?
• Who? • All patients in ICU & MS
• Hospitalist ARNP, MS & ICU manager, Direct Care RN, SW, RT, PT PRN,
pastoral care, dietitian, care coordination (added later), infection control
(consulted PRN), pharmacy available
• What will be discussed? • POC, pain, medications, diet, discharge, care at home, wounds, patient
concerns, family concerns, etc.
Plan for Implementation
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• ↑ scores in overall patient satisfaction
• ↑ scores in communication with nurses
• nurses explained in a way you could understand; nurses
listened carefully to you; nurses treated you with courtesy
and respect
• ↑ overall discharge scores
• staff talk about help when you left; extent you felt ready for
discharge; speed of discharge process
• ↓length of stay
Desired Outcomes
• Direct Care RN
Education of RN
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• Introduce team
(help at home), follow-up care, and concerns from
patient/family
• Follow-up PRN
Conducting Rounds
• “I enjoyed it when a group of 6 or 7 nurses and attendants came in and chatted
with me for a few minutes”
• “This is amazing; can I take a picture of this? I’ve never seen this before at any
other hospital…this is great!”
• “I love seeing you guys in the morning, it makes me happy!”
• “Wonderful hospital, do you do this all the time?”
• “All of you are here for me? Wow! I feel special”
• “Will you all pray with me?” (we thought she wanted us to pray for her and then
she proceeded to pray for the entire group)
• “I was here a few years ago and have definitely seen an improvement since
then.”
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Patient Feedback
• Expected outcomes met
• Overall satisfaction increased
• Pain scores improved
• Medication scores improved
Evaluation
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Mariners Hospital
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Mariners Hospital
Mariners Hospital
Med/Surg
Mariners Hospital
Med/Surg
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Section - Discharge
Mariners Hospital
Mariners Hospital
Med/Surg
Mariners Hospital
Med/Surg
Mariners Hospital
Med/Surg
Mariners Hospital
Med/Surg
• Increased collaboration
• Nurses report an increased sense of connection to POC
• Improved quality scores
Outcomes
• Key personnel meet to determine effectiveness of
ICR
• Use language patient understands
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Follow-up
• Doctors
• RNs
• ARNP
• Patients
Challenges
• ANCC Pathway to Excellence
Vice President, Chief Nursing Officer
Mariners Hospital
[email protected]
305 434 1628
References
• Bussey, M., & Johnston, K. (2015). Implementation of nurse-led multidisciplinary rounds. Critical
Care Nurse. 35(2), 63-64.
• Dammeyer, J. A., Baldwin, N., Packard, D., Harrington, S., Christofferson, B., Christopher, J., &
Iwashyna, J. (2013). Mobilizing outcomes: Implementation of a nurse-led multidisciplinary
mobility program. Critical care nursing quarterly,36(1), 109-119.
• O'Leary, K. J., Haviley, C., Slade, M. E., Shah, H. M., Lee, J. and Williams, M. V. (2011), Improving
teamwork: Impact of structured interdisciplinary rounds on a hospitalist unit. J. Hosp. Med.,
6: 88–93.
• Reimer, N., & Herbener, L. (2014). Round and round we go: Rounding strategies to impact exemplary
professional practice. Clinical Journal of Oncology Nursing, 18(6), 654-660.
• Sisterhen, L. L., Blaszak, R. T., Woods, M. B., & Smith, C. E. (2007). Defining family-centered
rounds. Teaching and Learning in Medicine, 19(3), 319-322.
• Youngwerth, J., & Twaddle, M. (2011). Cultures of interdisciplinary teams: How to foster good dynamics.
Journal of Palliative Medicine, 14(5), 650-654.

hi point genetics · 2018. 3. 26. · created date: 3/20/2018 11:35:55 am

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