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TCAB at Medina Hospital 3/09 - Present Transforming Care at the Bedside Medina’s Aim Statement Focus Increase Patient Satisfaction Improve Work Environment Adopted Tests of Change Reducing and eliminating waste from the work environment Walkie Talkies White Boards Hourly Rounding Physician Communication Form More comprehensive and patient friendly Congestive Heart Failure discharge instruction packets Med-Surg Progress Report Key Metrics: Patient Satisfaction Pressure Ulcers/Falls Nurse Turnover Medina’s TCAB Impact If pain, did hospital staff do everything to control your pain? "Always Response" 100 80 60 40 20 0 Mar-Apr Jun-Jul Aug-Sept Oct Nov Dec Medina’s TCAB Impact Was your pain controlled? "Always Response" 100 80 60 40 20 0 Mar-Apr Jun-Jul Aug-Sept Oct Nov Dec Medina’s TCAB Impact During hospital stay did you receive help to bathroom as soon as you wanted? "Always Response" 100 80 60 40 20 0 Mar-Apr Jun-Jul Aug-Sept Oct Nov Dec Medina’s TCAB Impact During hospital stay was call light answered quickly? "Always Response" 100 80 60 40 20 0 Mar-Apr Jun-Jul Aug-Sept Oct Nov Dec Medina’s TCAB Impact Were you told of medication's possible side effects? "Always Response" 100 80 60 40 20 0 Mar-Apr Jun-Jul Aug-Sept Oct Nov Dec Medina’s TCAB Impact Did hospital staff tell you what medications were for? "Always Response" 100 80 60 40 20 0 M ar-Apr Jun-Jul Aug-Se pt Oct Nov De c Medina’s TCAB Impact PCU II Pressure Ulcer Prevalence Rate 25% 20% 15% 10% 5% 0% -5% June July August Sept Oct Nov Dec Jan Medina’s TCAB Impact Last Pressure Ulcer 39 days ago Last Fall 9 days ago Medina’s TCAB Impact PCU II Turnover RN 25% 20% 15% 10% 5% 0% 2008 2009 Dec Nov Oct Sept Aug Jul Jun May Apr Mar Feb Jan Dec Nov Oct Sept Aug -5% Current Tests of Change Standardized “Hand Off Communication” at the bedside including the patient Decentralizing where supplies are stored to improve efficiency Spread of positive tests of change throughout the hospital Questions ?