Embed Size (px)
Citation preview
JCC Showcase
Feb 24, 2016
Chicken or the Egg?
Does Enhanced Recovery enable multi-disciplinary work or
does a multi-disciplinary approach enable Enhanced Recovery
implementation?
Lessons Learned from the BC Enhanced Recovery Collaborative
• No Disclosures
Sponsor: SSC
Advisory Panel:
Anesthesia, Surgery, Nursing/Admin
members from 6 regional HAs
BC Hip Arthroplasty Collaborative
Anesthesia COP
2 Patient Partners
Surgery COP
Co-Chairs:
Anesthesia, Surgery, Nursing/QI
Organizational Partner:
BC Patient Safety & Quality Council
Nutrition COP
Nursing COP
Multi-disciplinary in Content & Form
NHA •MMH
•UHNBC
VCH •VGH
•RH, LGH PHC
• SPH
•MSJ
Island Health
• NRGH
• CRH
• RJH, VGH, family physicians
IH
•KGH
•RIH
•KBRH
FHA
• RCH
• LMH
• SMH
• ARH, RMH, PAH, family physicians
Enhanced Recovery
Collaborative
Patient Education Working Group
Before You Do Anything Else, Do This!
Presented at JCC Showcase
February 2016 Garth Vatkin RN, MHA
Quality Improvement Consultant BC ERAS Nursing/Administration Co-Chair
3/8/2016 5
Medical practice, advancing at the speed of molasses. - Anesthesiologist
We don’t think you can do it! - Department of General Surgery
Strategies
• Point Person
• Rally the Troops
• Commitment
Strategies
**Line it up to create a sense of urgency**
Feedback
P & T
PAC LMAC
Success Indicators - Processes
0
10
20
30
40
50
60
70
80
90
100
Ba
se
line
Ja
n-1
5
Fe
b-1
5
Ma
r-1
5
Ap
r-1
5
Ma
y-1
5
Ju
n-1
5
Ju
l-1
5
Au
g-1
5
Sep-1
5
Oct-
15
No
v-1
5
Dec-1
5
% of Catheters Out by POD 2
Success Indicators - Outcomes • Baseline UTI rate = 6%
• Since new order set = <1%
Baseline Median LOS = 7 days
Now = 5 days
Success Indicator
Presented at JCC Showcase
February 2016
Nancy Garrett-Petts R.N.
Clinical Practice Educator
Royal Inland Hospital
Teamwork in Action Patient Centered Care Evidence Based
• Teamwork
• Materials
• Education sessions
• sustainability
Teamwork in Action Patient Centered Care Evidence Based
• Core team
• Motivated team members
• Patient’s ERAS Journey
• Effective champions
• How to build a team
Teamwork in Action Patient Centered Care Evidence Based
Teamwork in Action Patient Centered Care Evidence Based
Lanyard Tags Pt Education
Booklets
Resource Materials
Patient Log Book
Pre Printed Orders
• Paid time off the unit
• Multidisciplinary groups
• Resources
• Fun
Teamwork in Action Patient Centered Care Evidence Based
• Sharing data
• Real time chart audits
• Nursing unit orientation
• Core Team continues to meet
Teamwork in Action Patient Centered Care Evidence Based
Celebrate
Teamwork in Action Patient Centered Care Evidence Based
Teamwork in Action Patient Centered Care Evidence Based
20
ERAS Implementing at Multiple Sites
Brenda Poulton, RN, MN, NP Royal Columbian Hospital Fraser Health
21
Challenges
3 sites in FH
Teamwork from a regional perspective
Moving from “program” structure and returning to site based during collaborative
Data collection using NSQIP only model
22
Development of Tools
23
Tools to Assist with Data
24
Key Lessons Along the Way to ERAS in Colorectal Surgery
• Team –multidisciplinary members, ERAS champions + administration
• Site Coordinator with dedicated time • Engage all staff – ongoing education, sharing data to drive &
develop “shared” purpose of QI • Identify gaps in data collection methods EARLY • Engaged knowlegable patient • Focus on entire patient journey to improve process & outcomes
provide consistent patient experience
Angie Chan Project Manager,
Surgical Improvement Specialist Services Committee
Doctors of BC [email protected]
Nancy Garrett-Petts
Clinical Practice Educator Royal Inland Hospital
Garth Vatkin Co-Chair,
BC Enhanced Recovery Collaborative Quality Consultant- Surgical,
Interior Health [email protected]
Brenda Poulton
Nurse Practitioner – Pain Specialist Royal Columbian Hospital
www.enhancedrecoverybc.ca
