Southern California

Patient Care Cards

Submitted by anjetta.thackeray on Sun, 08/29/2010 - 21:21
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pdsa_ocirvine_medsurg_care card_pdf

These care cards allow patients to ask questions of their doctors and nurses. Team members can collect completed cards from the patients to address issues and concerns before the patients leave the hospital.

Non-LMP
Tool landing page copy (reporters)
Patient Care Cards

Format:
Zipped PDF

Size:
Printout, 2-sided, 4" x 6" index card

Intended Audience:
Unit-based teams

Best used:
Download and print these two care cards to give to patients for their comments, allowing teams to address in-patient concerns. One care card is for patients to ask questions of their nurses and make comments on their nursing care. The other card is for patients to ask questions of their doctors and make comments on care from their doctors. This tool is inspired by a card developed by the Medical-Surgical 4B unit-based team at Irvine Medical Center.

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Southern California
littlehank
lmpartnership.org
not migrated

Keep It Clean

Submitted by Laureen Lazarovici on Fri, 06/04/2010 - 08:59
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sty_EVS_WPS
Long Teaser

EVS workers and managers are tasked with keeping KP's facilities clean and germ free, but these departments are prone to lots of injuries. Find out in this story from the Summer 2010 issue of Hank how some of these departments are doing what it takes improve workplace safety.

Communicator (reporters)
Laureen Lazarovici
Photos & Artwork (reporters)
Panorama EVS attendant Rosemary Mercado, an SEIU UHW steward, says the department’s unit-based team helped reduce the number of needlestick injuries.
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Keeping It Clean
Deck
How EVS departments are building a culture of safety with partnership—and cutting injury rates
Story body part 1

The lady who talks to you from inside your GPS has found a new home, it seems, in the robotic carts deployed in the newly rebuilt Los Angeles Medical Center.

Instead of guiding you to your destination, she’s moving linen and trash along the long hallways and underground tunnels. By herself. Her gentle yet firm computerized voice tells workers in a docking room when the cart is ready to be filled, and sensors ensure she doesn’t run anyone over. She even can detect whether there are passengers in the staff elevators and patiently waits for the next empty one.

The robotic carts reduce wear and tear on the muscles and joints of the medical center’s Environmental Services (EVS) attendants. They are just one example of how managers and union members at this Southern California hospital are taking the lead in improving workplace safety for EVS departments.

Historically, EVS is a high-injury department because the job involves a lot of bending, lifting and moving equipment—not to mention working with hazardous chemicals. But the EVS department at Los Angeles Medical Center made such remarkable progress in reducing workplace injuries in 2009, its members earned a special bonus as part of the Performance Sharing Program (PSP). So did the EVS departments in Riverside and in Panorama City, which boasts the lowest injury rate in the region.

“Everyone wants to beat Panorama City,” laughs Manuel Covarrubias, the building services manager there. “It’s a friendly competition.”

But more important than the good-humored rivalry is the confidence these teams inspire in their counterparts. “They know it can be done,” Covarrubias says.

Even Kaiser Permanente’s oft-stated goal of a workplace free of injuries isn’t as far off as might be thought: The EVS department at the Eastside Service area in the Northwest region hasn’t had a single injury for two straight years. Regionwide, the EVS departments improved their collective injury rate by a remarkable 65 percent for the reporting year ending Sept. 30, 2009.

Management and union co-leads on these successful unit-based teams credit specific safety techniques, such as pre-shift stretching, and better equipment, such as microfiber mops and motorized carts. But they also say the communication and team-building skills they use by working in partnership are crucial to building not only systems of safety, but a culture of safety.

What works

Based on the experiences of successful EVS departments in Southern California and the Northwest, here’s what’s working to improve workplace safety.

Conduct safety observations: At Riverside Medical Center in Southern California, the management and labor co-leads of the EVS unit-based team conduct safety observations together. “We walk the units and look for safety hazards,” explains Cora McCarthy, EVS manager.

Evidence from Sunnyside hospital in the Northwest shows the effect this kind of effort can have. After the injury rate jumped up in the first half of 2009, Curtis Daniels, the medical safety coordinator, challenged UBT members to see how many safety conversations they could have to raise awareness of potential hazards. More than 6,000 conversations were reported in one month alone—and during the second half of 2009, the inpatient teams had only two workplace injuries.

By the numbers: The successful teams collect, track and—most importantly—share data, information and tips about workplace safety.

In Southern California, for instance, where there has been a 33 percent reduction of accepted workers’ compensation claims since 2005, the regional Workplace Safety department has built a customized incident investigation database, harnessing data that helps teams spot trends and come up with solutions. The database is only useful because employees are willing to report the injuries they suffer.

“At first, people were afraid,” says Eva Gonzalez, an EVS attendant at Panorama City and an SEIU UHW-West steward. “We assure them there is not going to be a backlash. Incident investigations helped, because people would show us how they got hurt and we let them say what happened. We ask, ‘What do you think we should do differently?’ ”

Ofelia Leon, the day shift supervisor who has worked at Kaiser Permanente for about three years, notes the fear of reporting was not unfounded: “At other (non-KP) hospitals, if you got injured, you got a caution or discipline, so people were afraid to report them.”

Employees also get regular updates about their progress toward their workplace safety goal. “We share information and let our members know where we’re at and where we need to be,” says Edwin Pierre, a 26-year EVS worker at LAMC. A huddle at the beginning of each shift includes a safety tip shared by an employee —creating a climate where workers get accustomed to speaking up and gain confidence that their voices are being heard.

Floor it, safely: To reduce injuries from lifting bulky mop buckets, EVS departments are buying more efficient microfiber mops that don’t require as many trips to empty, are wringerless, and use less water and cleaning solution. To keep those long hallways at LAMC clean while keeping workers safe, the EVS department replaced autoscrubbers with “chariots” that workers ride. “They have improved quality and morale, as well as safety,” says Abraham Villalobos, the hospital’s director of Environmental Services.

Maximize the micro: Microfiber is not just for mops. EVS departments in the Northwest now are using microfiber dusters with extendable handles proven to reduce worker strain. The new dusters also clean 45 percent faster than traditional methods and reduce chemical and water consumption up to 90 percent.

Tamper with hampers: The lids on trash cans and hampers were falling on workers’ arms and causing injuries—so the Panorama City EVS department bought new bins with hydraulic lids. They also put signs above hampers asking staff members not to overload the bins, because too-heavy loads were causing lifting injuries.

In a similar vein, “when needlestick injuries were up, we brought it to the table,” says Rosemary Mercado, an EVS attendant at Panorama City. The unit-based team decided to coach workers to hold the bags away from their bodies when taking them out of the laundry hampers. And they borrowed an idea from colleagues at nearby Woodland Hills Medical Center: They moved the hampers away from the sharps containers.

Take your time, take time off: “Be careful and take your time,” is the advice from Rebeca MacLoughlin, a housekeeper in the Northwest for seven years. Mindful of the link between fagtigue, morale and injuries, building services manager Manuel Covarrubias in Panorama City encourages employees to take time off when they seem to be getting sluggish. “I look for ways to cover people during summer to ensure people with less seniority can get some time off when they really want it,” he says.

Starting with stretching: Without exception, every EVS department that’s been successful at reducing the injury rate starts every shift with stretching. “Sometimes we dance and make it fun,” says Ofelia Leon, the day shift supervisor at Panorama City. The dance music of choice at LAMC is Michael Jackson. “I mean, who can’t dance to Michael Jackson?” wonders Pierre, the Pierre, the LAMC EVS attendant.

The bottom line: Investigating incidents, sharing safety tips, having on-the-spot conversations about working safely: These things are possible in large part because of the communication and team-building foundation fostered by the Labor Management Partnership.

'Our opinons matter'

Before, “It was just coming to work, doing whatever, and then leaving,” says Sandra Pena, the EVS labor co-lead at Riverside and United Steelworkers Local 7600 member.

“Now, it’s like there’s feedback back and forth all the time. It’s more of a team.”

“It makes you feel good as an employee to make improvements,” says Eva Gonzalez of Panorama City. “We know our opinions matter. We know we are not talking to the wall.”

Dilcie Parker, the labor co-lead at the LAMC EVS department, recalls how things were in 1999, when partnership started taking hold at her facility. “When we first began meeting, it was, ‘You sit on that side of the table, I sit on this side.’ I once arrived at a meeting and said, ‘I don’t sit next to management.’ You could feel the hate in the room.”

Management co-lead Villalobos doesn’t disagree. “Before, we couldn’t stand each other,” he says. “There was screaming.”

The turnaround, both say, came as a result of the LMP training the whole team received—from mapping root causes to issue resolution—and persistence.

“We started seeing the benefits in better quality and better attendance,” says Abraham Villalobos. “The reduction in injuries didn’t just happen this year. It’s about understanding the things we need. If we don’t get along, we can’t come up with projects to work on.”

This doesn’t mean everyone is holding hands and singing “Kumbaya.”

“There are still issues we disagree about,” says Parker. “But before, we used to get nothing solved. Now, issues get solved and they are off the table.” Recently, Parker, Villalobos and the team were in a meeting, crammed together in a tiny conference. The woman who once refused to even sit next to a manager found herself saying, “Look, Abraham, we’re actually touching.”

For information about EVS teams in Southern California, contact Dave Greenwood, workplace safety program director, at Dave.B.Greenwood@kp.org; for more information about workplace safety for EVS teams in the Northwest, contact Lori Beth Bliss, regional EVS manager, at Lori.B.Bliss@kp.org.

 

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Southern California
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hank
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Getting Home Health Care to the Patient On Time

Submitted by cassandra.braun on Mon, 04/26/2010 - 17:16
Headline (for informational purposes only)
Getting Home Health Care to the Patient On Time
Deck
UBT streamlines the intake process and works closely with referring departments
Topics

The Clinical Home Health Care team in San Diego needed to see discharged patients within 24 hours.

But they were hitting less than 50 percent success, and given their patients included those in hospice and palliative care, this was a problem.

At issue was a patient discharge list that might have 50 or more names. An intake nurse would dictate patient information to a department clerk, who would complete the forms. Only then would a home health visit get triggered.

This wasted time.

Modeled after a successful practice at Riverside Medical Center, the team did two things. First, they eliminated the clerk from the workflow and had the nurses process the patient information directly.

And second, they trimmed the list of names being referred to Home Health Care to only those patients who were getting discharged within the next 48 hours.

“We plan our day based on that list,” says Daniele Wilson, director of patient care services for home care. “But we cannot plan if that list is not updated. We needed to focus on the work that needed to be done more immediately.”

Home Health Care intake nurses also communicated with the discharge planners to get up-to-the-hour information on which patients will be released that day and need to be seen by a Home Health Care provider within the following 24 hours.

That group was reduced to about five daily patients, and in two months the number of referrals seen within 24 hours grew from 44 to 77 percent.

“It’s much easier to tackle when a list has a handful of names,” Wilson says. “When it was 50-some it was difficult to even know where to begin. It felt futile.”

The team included daily morning huddles to review the number of newly referred patients and their needs, as well as ongoing patient needs. They also improved communication with the referring departments, such as orthopedics and primary care.

“We reached out to different heads of departments to figure out how they operated,” Wilson says. “By understanding how they operated, it helped us know how we can interact with them.”

Lisa Tuckwell, RN, public health nurse and UNAC/UCHP member, learned to speak doc.

“We figured out the buzz words that got a doctor to act.”

Caption information for photo/artwork (reporters)
Nic Gallarte, IV RN, visits the home of Sandra Diaz to clean an open wound and the site where she had a toe removed, the result of diabetes complications.
Request Number
pdsa_SD HomeCare
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Long Teaser

San Diego's Clinical Home Health Care unit-based team borrowed a "best practice" from Riverside that helped them see more patients within the requisite 24-hour window following discharge from the hospital or referral from a physician.

Communicator (reporters)
Non-LMP
Notes (as needed)
206.jpg - Home health nurse Nic Gallarte cleans the IV line of patient Sandra Diaz, who was left immobile after surgery for diabetes complications.
127.jpg - Nic Gallarte, IV RN, checks the medication supply for patient Carmelita De Luna, who is still healing at home after several weeks at San Diego Medical Center to treat a lung infection.
025.jpg - Daniele Wilson (left), director of Patient Care Services and the team's management co-lead, and her labor co-lead Lisa Tuckwell, RN public health, address several issues during the Home Health Care unit-based team meeting.

Plan, Do, Study, Act
<teaser box -- high on page somewhere>

<headline>

Health care on wheels

<box text>

Nic Gallarte, an IV RN, has been a home health care nurse with KP for seven years. Watch a slideshow <hyperlink "watch a slideshow" to the slideshow> following him on his daily rounds as he visits patients in their homes.
Learn more (reporters)
Management co-lead(s)

Daniele.M.Wilson@kp.org, 619-641-4656

 

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