The Clinical Excellence Program has been working across the NHRMC system to identify and address opportunities for improving value by providing the highest quality care and reduced patient costs.
In August 2018, the Clinical Excellence Team partnered with the Congestive Heart Failure Team to develop some initiatives to improve value to patients. Led by Rachel Hayworth, RN, and Dr. John Rommel, the CHF team has been driving quality improvement through CHF Steering Committee and the Heart Strong team.
By collaborating with the Clinical Excellence Team, they gained a new perspective on their efforts. The Clinical Excellence Team facilitated communication and collaboration between the CHF Team, the Emergency Department, the Observation Units and other clinical departments.
The combined team identified best practices, implemented standardized pathways and educated staff in all related departments. In doing so, bedside teams were empowered to deliver high-value, waste-free and coordinated care.
The CHF Clinical Excellence Team has improved the value of care for patients by implementing strategies such as:
- Revising and aligning the CHF admission order sets to drive evidence-based care delivery
- Creating a treatment pathway for CHF patients who present to the ED
- Developing an observation pathway and treatment plan for CHF patients
- The nursing education plan was revised to focus on CHF treatment priorities and incorporating into daily care using Interdisciplinary Rounds and smart text capabilities
- The CHF Case Managers revised their workflow to reach more CHF patients
- Ensuring all appropriate CHF patients are placed on the CHF Unit to receive focused treatment
Throughout this effort, there have been key takeaways that will support future improvement efforts such as:
- Don’t underestimate the physicians’ willingness to develop and lead the implementation of evidence-based care pathways
- Allow all team members the opportunity to provide input, talk through differing opinions and come to consensus in a room of trust and respect
- Keep the core team small, but pull in key people for specific initiatives as appropriate
- Our ACPs have an outstanding perspective of front care processes and play a key role in process improvement
- Our Lean culture has enabled this team to work quickly and efficiently with many people and complex initiatives
The CHF Clinical Excellence Team is comprised of the following core members: Dr. Charmaine Lewis (hospitalist), Dr. Lauren Wilson (hospitalist), Dr. Chris Reavill (emergency medicine), Steve Brown (nursing), Elizabeth Lee (case management), Marianne Billeter (pharmacy), Rand Pennington (medicine), Bridgette Williams (cardiology) and Amber Woodard (IS Applications), Abby Roetger, Sandy Mitchell, Dr. Clyde Harris and Claire Corbett (CE Department). This team uses in depth data analytics, process engineering and rapid cycle PDSA methodology to drive improvements.