Unit-based teams

Game Changer: Putting the Patient First

Submitted by tyra.l.ferlatte on Mon, 10/18/2010 - 16:21
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Long Teaser

A team in South San Francisco that improved the surgery-scheduling process for patients and teams in San Diego that took a hard look at their service scores demonstrate what things look like when teams truly consider what's best for the patient as they make decisions.

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Non-LMP
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note: there are links in "highlighted stories and tools" section.

caption for second photo (hank25_coverstory3):
Streamlining the process: The new pre-surgery checklist developed by a South San Francisco UBT has helped patients and improved communication for everyone involved. Dr. Brian Tzeng (center) helped lead the work.

caption for third photo (hank25_coverstory6):
Improving service: Terry Caballero, a surgery scheduler and SEIU UHW member, helped spark the work that led to a streamlined surgery-scheduling process.
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Making things easier: Members of a San Diego Medical Center turn team help KP patient Deborah Allen shift in her bed.
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Highlighted stories and tools (reporters)
Benefits to teamwork

In South San Francisco, Dr. Brian Tzeng, who’s an anesthesiologist, and others on the team say that working on the project through the unit-based team allowed them to understand each others’ roles and responsibilities better—and also gave them an opportunity to hear and contribute an opinion from that perspective.

“One of the great benefits of this group was it was an outlet for multiple providers at different levels to voice their concerns and actually be heard,” Dr. Tzeng explains. “The greatest frustration for many individuals is we all had great ideas but didn’t know how to make that happen. We realized through this group we had a means to make those changes.”

Dr. Tzeng is certain the team’s accomplishments are the result of every team member’s commitment to working out the best solution in the patient’s best interest. There were no politics, just concern for the member.

“To us, this is not a job,” says Debbie Taylor. “We come here to serve a patient.”

And what about Caballero’s initial concern, that patients weren’t getting enough advance notice about when they have to be at the hospital? The team has been slowly chipping away on that as well. In October, they expect to start giving patients two days’ advance notice of their arrival time at the hospital.

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Game changer: Putting the patient first
Deck
Teams in South San Francisco and San Diego work to keep patients front and center
Story body part 1

What happens when teams truly walk a mile in their patients’ shoes? They often discover their own actions are making that mile a rocky one for patients—and as a result make huge breakthroughs in the way they deliver care.

In the case of South San Francisco’s multidepartmental pre-admission team, observing their processes from the other side of the gurney spurred them to dramatically streamline the pre-surgery and admitting process for patients. With the member at the forefront of their thinking, the team members turned a two-inch-thick packet of confusing, redundant information into a streamlined, one-page checklist. And a funny thing happened—while redesigning the process to help patients, the team improved the way it works.

“Patients would often get confused and weren’t sure what the next step in the process was,” says Brian Tzeng, MD, the Peri-operative Medicine director. “We realized we didn’t have a clear path for the patient to follow.”

Other teams throughout Kaiser Permanente are making similar realizations, framing their performance improvement work by asking the question, “What’s best for the patient?” If a possible solution doesn’t work well for the member and patient, then there’s more brainstorming to be done. These teams are taking the Value Compass to heart—organizing their work not just around the four points but examining what they’re doing from the patient’s perspective.

What does that mean for frontline teams? At the San Diego Medical Center, the Emergency Department sees up to 300 patients every 24 hours. Physicians and staff members are always on the go, delivering on the ultimate bottom line—saved lives. What could be more important? Clinical quality is high; patients are seen in a timely manner and the rate of unscheduled return visits is good.

Yet the results of a recent patient satisfaction survey bothered the team. The department scored well overall, but their patients gave it only 63 percent approval on one question: While you were in the Emergency Department, were you kept informed about how long the treatment would take?

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hank
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Preparing You for Surgery

Submitted by cassandra.braun on Wed, 09/22/2010 - 18:16
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tips_presurgerychecklist

A South San Francisco pre-admissions team developed this one-page, easy-to-use checklist to help prepare their patients for surgery.

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Team develops surgery prep checklist.

Format:
PDF and Word DOC

Size:
1 page, 8½” x 11”

Intended Audience:
Teams working on improving the pre-surgery process for patients.

Best used:
Use this document as a model to consider how your facility might revamp the presurgery process and create your own one-page checklist for patients. 
This checklist was developed by a multidepartmental team in South San Francisco that wanted to streamline the presurgery process for patients. As a result of using it, 80 percent of patients are now being confirmed as pre-admitted 24 hours before surgery and the completeness and accuracy of admissions rate has hit 99.4 percent.

Read more about the process in the Fall 2010 Hank.

 

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hank
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Poster: Tracking Our Progress

Submitted by Kellie Applen on Wed, 09/15/2010 - 15:01
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Format
Topics
Content Section
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bb_charting_our_progress

Use this poster to track and show off what your team is working on.

Non-LMP
Tool landing page copy (reporters)
Tracking our progress

Format:
PDF

Size:
8.5” x 11”

Intended audience:
Union Coalition represented employees and frontline managers

Best used:
Use this poster to track what your team is working on. Display it prominently on bulletin boards, in break rooms and other staff areas, so everyone knows where the team stands.

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Transforming KP
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bulletin board packet
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Sand Canyon Goes Green With Blue Wrap Recycling Shawn Masten Mon, 09/13/2010 - 12:18
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Southern California
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Irvine goes geen with blue wrap reycling project
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Project saves money and helps the environment--and assists local disabled adults, too
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sty_sandcanyon_blue wrap recycling
Long Teaser

New blue wrap recycling project at Sand Canyon Surgicenter saves money and the environment and helps the disabled.

Story body part 1

Looking for ways to make the Sand Canyon Surgicenter in Irvine more efficient, Albert Olmeda wound up learning a lot about blue wrap—like the fact that it makes up nearly 20 percent of the waste generated by hospital surgical services. 

The lead Central Services technician and SEIU UHW member also learned that this heavily used hospital product, an industrial strength plastic used to maintain the sterility of medical and surgical instruments until opened, is not biodegradable and persists in the environment. 

But recycled blue wrap can be sold as raw material for use in the production of other plastic products. Today, the surgicenter’s unit-based team has gone green with a blue wrap recycling project that is not only saving money and protecting the environment, but also aiding the community. 

“The biggest problem with the blue wrap is when we throw it in the landfill, it’s there forever,” says Olmeda. “That’s a big concern especially considering how much blue wrap we use.” 

How recycling works

About 600 pounds of blue wrap is collected every week from the center’s six operating rooms. It is picked up free of charge and sorted by Goodwill of Orange County, which sells it to a Houston recycling services company. The company reprocesses the plastic into beads that are used in various products, including railroad ties, pallets and artificial siding for decks, docks and houses. 

The surgicenter has been recycling its blue wrap and plastic bottles since September 2009, reducing the facility’s solid waste disposal fee by 10 percent annually. The savings amount to a modest $5,880—but there’s a greater payoff. Proceeds from the sale of blue wrap and other recyclable products enable Goodwill to provide education and training programs for developmentally and physically disabled adults, including a state-of-the-art fitness center. 

Peter Bares, business development manager for Goodwill of Orange County, says the relationship with Kaiser Permanente has gone beyond expectations. “It is kind of the perfect storm because of the nature of what we do and why we do it and the materials that the hospital generates,” he says. 

Getting buy-in

As the frontline staff person responsible for the surgery center’s blue wrap disposal, Olmeda—and his fellow UBT members—championed the recycling cause, educating the staff at weekly in-services and UBT huddles.  The team got the rest of the department on board by integrating the blue wrap recycling process without creating additional tasks. 

“We figured if we changed workflows, staff wouldn’t want to do it.” says UBT co-lead Nicole Etchegoyen, a surgery scheduler and SEIU UHW steward. “But if we asked them, ‘How would this work best for you?’ then everyone would get involved, and they did.” 

The team members designated a single container for blue wrap in each operating room. They also placed a larger bin for collecting multiple bags of discarded blue wrap near the soiled utility room, where the trash is taken on its way out of the surgery center. 

“It’s not a big deal,” EVS worker and SEIU UHW member George Sollars said, hoisting bags. “We just carry it over here on our way out this door. It’s one of the easiest jobs. And it’s for a really good cause.” 

No trash, just recycling 

The hardest part was making make sure that other trash didn’t make it into the blue wrap recycling containers accidentally. Labeling the containers with signs reading ‘Recycling Blue Wrap Only’ helped, as did regular reminders by UBT members. 

Now, everyone in the operating rooms—from doctors, nurses and surgical techs to nursing assistants and EVS workers—makes sure that the blue wrap containers aren’t contaminated with other trash, Etchegoyen says. 

Olmeda does periodic spot checks. “Everybody who plays a role in the operating room has to look out to make sure no trash is going inside the containers,” he says. “It’s a team-building thing.” 

“If it wasn’t for the UBT, this wouldn’t be happening,” said Ramin Zolfagar, MD, department head and UBT member. “We are helping the environment by ‘going blue,’ so to speak, and the end result is gym equipment for the disabled—which makes it all the more worthwhile.” 

After learning about the project at a recent Orange County UBT fair, other departments are thinking about emulating it. 

Visit the Goodwill of Orange County website to find out more about their work.

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Notes (as needed)
link to related slideshow and psda when available. (Highlighted resources box)
For more information about this team's work contact Nicole.M.Etchegoyen@kp.org
Paul go ahead and publish when finished.
Blue wrap recycling in the operating room at the Sand Canyon Surgicenter
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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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ZIP
Southern California
littlehank
lmpartnership.org
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Working Agreements

Submitted by kevino on Tue, 07/27/2010 - 06:58
Tool Type
Format
Topics
Working Agreements

Use this worksheet to develop working agreements. Includes considerations and agreements.

Non-LMP
Tyra Ferlatte
Tool landing page copy (reporters)
Working Agreements

Formats:
Word document, PDF

Size:
8.5" x 11"

Intended audience:
UBT co-leads

Best used:
This worksheet can help you and your co-leads craft successful working agreements to plan, run and evaluate meetings. 

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DOC
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PDF
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Meeting Agenda Template

Submitted by kevino on Tue, 07/27/2010 - 06:51
Tool Type
Format
Running Your Team
Keywords
Topics
Meeting Agenda Template

Use this template for creating the meeting agenda for participants to help them stay on track. 

Non-LMP
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Meeting Agenda Template

Format:
PDF or Word document

Size:
8.5" x 11" 

Intended audience:
Unit-based team co-leads

Best used:
Fill in this template and distribute to meeting participants to help everyone stay on track. 

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Unit-based Teams
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tips (checklist, etc.)
PDF
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UBT Tracker User Guide

Submitted by anjetta.thackeray on Tue, 07/13/2010 - 17:32
Tool Type
Format
other_UBT Tracker user guide

This step-by-step guide shows users how to use UBT Tracker, an online tool for tracking team performance, recording tests of change and more.

Non-LMP
Tyra Ferlatte
Tool landing page copy (reporters)
UBT Tracker User Guide

Format:
PDF

Size:
57 pages; 8.5"  x 11"

Intended audience:
Unit-based teams and UBT and performance improvement consultants and facilitators

Best used: 
Download and print the guide to use in team huddles and meetings, or at consultant and facilitator coaching sessions. This booklet provides detailed instructions on using UBT Tracker.

You may also be interested in: 
Five tip sheets that cover the basics on how to use UBT Tracker and get the most out of it.

 

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Integrating Workplace Safety Into UBTs

Submitted by Kristi on Sat, 07/10/2010 - 19:11
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Format
Keywords
Taxonomy upgrade extras
Integrating Workplace Safety Into UBTs

This 11-slide presentation includes tools on how to integrate workplace safety into the work of unit-based teams.

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Format:
PPT

Size:
11 slides

Audience:
UBT co-leads, unit-based teams, Workplace Safety consultants and unit-based team consultants

Best used:
This presentation includes tools on how to integrate workplace safety into the work of unit-based teams. Show the presentation or share the content in meetings and huddles. The following tools and templates are provided:

  • Workplace Safety Checklist
  • UBT/WPS Presentations
  • Path of an Injury
  • WPS Action Plan Template
  • Risk Map
  • Risk Matrix

You also will find guidelines for developing a successful workplace safety plan, plan monitoring and suggestions for ongoing oversight.

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Workplace Safety
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powerpoint presentation
PPT
lmpartnership.org
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Communicating With CARE

Submitted by kevino on Sat, 07/10/2010 - 08:37
Tool Type
Format
Running Your Team
Taxonomy upgrade extras
tips_communicating with CARE

Four important steps that will help ensure good communication with colleagues and KP members alike—and a helpful mnemonic to remember them with.

Tyra Ferlatte
Tool landing page copy (reporters)
Communicating With CARE

Format:
PDF

Size:
8.5" x 11"

Intended audience:
Frontline managers, physicians and workers

Best used:
Discuss these concepts for better communications witih colleagues and patients in huddles and at meetings; show you CARE!

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tips (checklist, etc.)
PDF
lmpartnership.org
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