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change excellence
Members of the 10 East patient care team who participated in Performance Innovation include (below, left to right) Ada Ibe Offurum, MD; Thomas Harris, Carolyn Washington-Bryant, BSN, RN; and Shawn Hendricks, MSN, RN.
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How Dialogue Leads to Change a n d on t o ex c ellenc e When a team has the right tools to form a tool kit, everything clicks into place for them to get the job done. That became clear to the staff of 10 East when they took advantage of two “tools” that the Medical Center uses to continuously improve patient care and employee satisfaction. This unit was among the first hospital departments to participate in Performance Innovation, which led to improvements on the Employee Opinion Survey. Performance Innovation (PI) is the Medical Center’s name for a process also known as “lean” and “Six Sigma” in other industries. The Employee Opinion Survey is UMMC’s tool to get direct feedback from all staff members and measure progress in employee satisfaction. “[Employee opinion] drives change – I see it happening,” says Thomas Harris, unit secretary on 10 East. “When attending C2X forums, leadership lets you know what requests have been made by staff and how they are being implemented in different facets within the institution. I feel this alone lets the employees know their voices are being heard.” The medical unit on 10 East has been using the PI process to make better use of staff time, so that nurses and other caregivers are delivering the maximum benefit to the patient. For example, the unit worked with Patient Transportation and other departments to stage a few “Rapid Improvement Events,” or RIEs, that resulted in eliminating the problem of patients having to wait in the hallway outside their rooms to be transported to another part of the hospital, such as for an X-ray. The process had the secondary effect of raising staff opinions about their ability to communicate, their physical work environment, their capacity for teamwork and many other areas measured by the Employee Opinion Survey. “The data from the EOS scores from 2010 to the scores in 2011 definitely show the impact of leading change and improving performance,” says Shawn Hendricks, MSN, RN, nurse manager of 10 East. “Our scores in several areas increased and improved from 2010 to 2011, giving us a rating of ‘excellent’ in those categories,” she said.
Here are a few topics covered in the survey, followed by actions taken to improve employee satisfaction in those areas: Communication:
Relationship-based care (RBC) white boards installed in each patient’s room improved communication among staff, patients and families. Because the nurses can’t always make it to the physician rounds, they now have the ability to review the RBC board for any pending test, consultations, education, etc. The info is updated daily, and used during the bedside report by the oncoming and off-going nurses, to include the patient in the discussion of the plan for the day, and during rounding by the medical teams to assist in disseminating discharge plans and pending tasks for the patient. Also, Hendricks says, “We standardized and tweaked the text-paging format to decrease nurses’ less-urgent calls to the teams and texting pertinent info and adding the nurse’s name and call-back number to the pages we do send out.” Teamwork:
Interdisciplinary groups working within the PI process to stage an RIE gave everyone better insight into one another’s roles, responsibilities and plights.
The EOS is the voice of the nurse and assists in driving change now and in the future. Carolyn Washington-Bryant
Physical Work Environment:
It had been stressful for nurses to see patients waiting in the hallway on a stretcher or wheelchair for an hour or more to be transported to an X-ray or other procedure. But the patienttransportation RIE eliminated and solved this problem. “We’ve had no patients have to wait in the hallway since that RIE last May,” Hendricks says. Employee Engagement:
“We had participation from all disciplines engaged in the RIEs to assist in improvements on 10 East. We were able to get the persons who would be affected to be part of the discussions and work for improvements and changes,” Hendricks says. Carolyn Washington-Bryant, BSN, RN, a senior clinical nurse on 10 East, says, “The EOS is the voice of the nurse and assists in driving change now and in the future.” “You can only drive change when you engage those who actually do the day-to-day work,” says Ada Ibe Offurum, MD, assistant professor of medicine, who cares for patients on 10 East and has been actively involved in the RIE and performance improvement along with unit staff. “If the Employee Opinion Survey represents the individual and collective thoughts, opinions and suggestions about the working environment here at UMMC, then it is probably one of the more accurate ways to know which direction to go to effect change.” When attending C2X forums, leadership lets you know what requests have been made by staff and how they are being implemented in different facets within the institution. I feel this alone lets the employees know their voices are being heard.
Thomas Harris
Employee Opinion Survey Highlights
Data from the 2011 Employee Opinion Survey results show that we have maintained the significant gains of the last four years. Here are a few highlights:
Robust response: Participation in the survey was great,
Here’s what we aced: The Employee Opinion Survey
with 74 percent (5,190) of the staff completing the anonymous
launched the same day that The Joint Commission arrived for
survey online.
the unannounced four-day thorough assessment of the hospital
High marks for communication: Staff members gave the
for reaccreditation, so it should come as no surprise that the
organization a very good score for communications, better than the national average by 6 percent, with 82 percent of employees agreeing that “When changes occur, reasons are explained.”
question that scored the highest was: “I understand my role in The Joint Commission survey.” A total of 97 percent of the staff gave a positive answer to that question.
Shared sense of pride in our work: For the question, “I am proud to work for UMMC,” 96 percent of the staff gave a positive response.