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PVH Takes a Look Back During National Healthcare Quality Week
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Healthcare quality is important to all individuals for improved patient care and healthcare delivery systems. The Institute of Medicine states such areas as efficiency; safety; timeliness; patient-centered, effective, and equitable care are important for all individuals. Here at Penobscot Valley Hospital, we agree. Staff at PVH work daily to ensure that the care you, or a loved one, receive is in line with the Institute of Medicine’s goals. The high level of attention to the quality of services provided at PVH make it an excellent facility. PVH would like to take a moment to celebrate National Healthcare Quality Week and thank the dedicated employees for the quality of care they provide. Below are the highlights from some of the projects that PVH has been working on to ensure quality and exceed your expectations.
Falls Team and all staff have been working on decreasing the likelihood of falls. Falls are a significant risk for someone on new medications, an unfamiliar environment, or in a weakened condition. The new patient beds are helping; policy development, assessment tools, and alerts are areas of focus. Thanks to the diligence and dedication of the entire PVH staff, the falls rate has significantly declined.
The Food Services Team and Nutritional Services are working on improving satisfaction with meals and increasing the number of healthy options available. Illness can decrease appetites and good nutrition is necessary for healing. The appeal and satisfaction of the meals is very important. According to a national survey, this team has achieved a greater than 90% success rating for several months.
Information Systems (IS) is working to improve the abilities of the Electronic Medical Record. The records are important for a comprehensive review of important clinical information for our doctors to provide excellence in care. IS is also providing a new addition to the electronic medical record in the Emergency Room. This new electronic documentation system will provide the physician with test results and other information for optimal, timely care.
The Laboratory is working to make sure specimens are correctly collected and labeled. Each patient is asked to state full name and date of birth to avoid confusion with patients who may have the same or similar names, such as Jr. and Sr. “Right patient” and “right specimen” are two of the five rights of specimen collection identified by the laboratory to improve patient safety and prevent errors. The lab has also assessed the hours of availability that our community needs and have opened additional hours on the weekends as an added convenience for the patients.
The staff in the offices of Dr. Sbayi, Dr. Miller, the Specialty Clinics, and Penobscot Valley Primary Care are working on preventative practices with hand hygiene, patient education and making sure that the patients have an up-to-date medication list prior to departure. Having an updated medication list is very important in patient safety to avoid possible safety risks with healthcare personnel in an emergency, at the doctor’s office or in a specialist’s care.
Rehabilitation Services provide Inpatient and Outpatient care. Inpatient care is important for recuperation and returning to our daily activities. The skilled care they provide in the Swing Bed program is essential. Occupational Therapy, Speech Therapy, and Physical Therapy all work together to prevent falls and making sure patient evaluations are completed quickly.
The Patient Financial Services team is working on improving the satisfaction with billing. They have made it easy to reach their office by placing notices in the discharge folders explaining who to call if you have any questions. It is very important to show all of your insurance cards when you are registering to avoid receiving a bill that should go to your insurance company.
In the Quality Improvement Department, staff developed a physician orientation process and materials for first time physicians to the area. The materials are evaluated by the physicians at each visit and new materials are added or changed based on their recommendations. Culture of safety is an ongoing project that asks patients and family to “speak up” if there are questions regarding care, including:
· Did you wash your hands?
· That medication doesn’t look familiar.
· Are you sure I take this?
Patient Registration has recently started e-signatures for the consent to treat. The new system allows for the information to be saved electronically. There are also processes in place to reduce the wait times with pre-registration for testing and surgery. If you are interested, please call our registration staff at 794-3321 and they will be happy to assist you.
The Environmental Services team is working to keep infections at a minimum by providing specialized cleaning. Checklists have been developed, similar to those pilots use for take off, which are designed to limit skipping a step. The department has had great success and has been greater than the ninetieth percentile in the Avatar National Data for Cleanliness in the hospitals.
Case Management works on discharge services needed and starts this process upon the patient’s admission. There are also patients that wish to be close to home after an illness at another hospital and are referred to PVH for Skilled Care or medication management prior to going home. The Case Management Department receives the information and works diligently to provide a smooth transition of care. They receive Swing Bed referrals and make every effort to assure timeliness of communication.
Infection Control is on everyone’s mind at PVH. The Infection Prevention Practitioner at PVH completes rounds, reviews all cultures and assesses the needs of the patients and staff. Right now, the influenza season is upon us and the practitioner is working to provide clinics and ensure eligible patients and staff are immunized.
The Emergency Department is working hard on hand hygiene, pain management, and administering proper antibiotics for pneumonia within six hours of arrival. If there is testing needed for pneumonia, then the tests are completed prior to treatment being administered. The ED has reached this goal 100% of the time! They are also working to improve throughput for people with chest pain and strokes. Once notified by phone, EMS or ED physicians and staff are notified by radio of the patient so that immediate resources are available for the patient’s arrival. This project has brought immediate results for time sensitive medications and transfer if necessary.
Inpatient Care is working to improve safe patient handling. This has brought new equipment and training to staff. New ceiling lifts, Sit to Stand machines and wheelchair scales are a few of the items installed in the last year. The new beds can be set at ultralow positions and assist in mobility as well. Medication Safety is also a top priority. At PVH, scanning systems have been put in place to promote safety in administration of the medications. The medications are currently profiled to individual allergies and medication required to identify any unwanted risks. There are comprehensive dispensing systems that utilize bar code scanning.
Inpatient Care is also conducting bedside reporting at each change of shift. Bedside reporting helps to introduce the next nurse on duty and involves the patient in their care plan for the day. It also outlines certain goals the patient has for pain, treatment, and care for the day. Questions from patients are always encouraged to promote understanding of the care they receive at PVH and to manage their illness after discharge. A new video has been filmed to outline what patients need to do to assist us in keeping them safe from falls, communication omissions, hand hygiene of themselves and visitors and many other topics.
Surgical Services is completing “time outs” to promote safety. The project asks the patient, surgeon and staff to identify key safety areas prior to entering the surgical suite and also has components before surgery to avoid any adverse events. This checklist is utilized world wide by the World Health Organization. The surgical team has also implemented the SBAR (situation, background, assessment, and recommendation) form of communication to the inpatient staff when the patient requires admission to the hospital. The SBAR is designed to focus the report and avoid areas being forgotten or omitted during this very busy time. All nursing units are currently using this method of communication even when calling physicians in the middle of the night.
All of the dedicated Medical Staff at PVH are also working to improve processes related to providing excellent care. Infection control, treatments, and patient satisfaction are all areas that are monitored and improved on an ongoing basis. The Hospitalist program has developed education on the services they provide and methods for families and the patients to ask questions and be a part of the care process. Telemedicine (a safe, electronic communication link with EMMC specialists) for the ICU and the Emergency Department has provided immediate consults and review of testing and documentation.
Other advances at PVH include:
1. Senior Leadership at PVH have been completing safety rounds to identify components of care that could potentially be an issue and review resources required to implement the changes. There are also daily meetings called “Strive for Five” that are check-ins to identify any areas of communication needed for the day.
2. The Marketing and Fund Development is working hard to get our customers feedback. The move to improve requires suggestions and issues identified by the patients we wish to serve. There are many survey tools PVH uses to try to capture this information; however, direct feedback by our patients is still the best medicine for improvement. The department has developed suggestion cards in waiting areas and the Medical Arts Building offices to assist us in our goal to exceed expectations.
3. Obstetrical Care has educational books to improve the information provided during a short hospital stay.
4. PVH has been providing outpatient injection medications, IV device flushing, and IV therapy medications and now has a quiet, private Infusion Room available for patients.
5. Human Resources developed a new employee handbook and has implemented a revised process for employees to be evaluated on an annual basis. The new format is easier to use and allows for easier access to the forms.
6. Plant Operations is reducing the biohazard waste by identifying and educating staff on appropriate disposal methods.
7. Cardiopulmonary is working on improved educational materials for the patients they serve.
8. Central Supply is diligently reviewing any items for recalls and is providing infection control with the new Ozone laundry methods.
9. The Fiscal Services Department developed a consistent reporting tool for traveling nurses, doctors, etc. This form helps each individual staff member responsible for setting up a traveler. The form has been completed, tested, and is now in use.
10. Health Information Management is making sure the patient records are secure, complete and timely. There are new processes like e-signing and new coding applications to ensure the accuracy in the records.
11. Imaging is working on limiting “No Show” visits by providing telephone calls for reminders. There is also a new x-ray room and soon there will be digital mammography available in this department.
12. The Pharmacy is monitoring kidney functions with certain medications, blood thinning agents, and antibiotics. The department has added 24/7 coverage for all medication orders to increase safety. They have also added an antibiotic stewardship program to oversee the utilization of antibiotics and therapeutic levels during treatments.
All of these advances in patient care show that Penobscot Valley Hospital and their staff are truly committed to patients first. Last year, PVH provided over $1 million in free care to those in need in our community. The hospital also provides many additional community benefits including blood drives, educational seminars, free meeting space, drug use prevention and smoking cessation programs. PVH invites you to stop by and see all of these improvements first hand. |
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