It's been real hectic around here the last
couple of days.
I hope it slows down.
We've made some mistakes this week.
What do you mean?
I had a voice message last night from one of our
patients, Howard Biel.
Did you know that we never called him back with the
results of his INR yesterday?
I hope the results came back normal.
Here, take a look.
Yeah, that's within the normal range of two to
three seconds.
I'll make sure I call him this afternoon and tell
him to stay on the same dose.
We had another near miss like this a couple of
weeks ago.
I hate to admit it, but looking at our data,
Howard's not the only one who hasn't received
results back.
We're having some real communication challenges
in our office.
I think we need to implement TeamSTEPPs here.
Remind me about TeamSTEPPs again?
It's a great program with lots of different tools to
improve communication and teamwork.
We'll need someone to lead the effort, and I think
Valerie is the perfect person.
She's a great communicator and works well with
the other staff.
And she went to that workshop on quality improvement.
Yeah, she went to a workshop put on by Jackie Hardy.
She's a practice facilitator who helps
teams in the office setting.
Valerie said that the workshop provided some
information about TeamSTEPPs.
And I think she followed up with more training on
TeamSTEPPs, too.
I think she'd enjoy teaching the staff about
all of the new things she's learning.
Then let's do it.
Valerie!
Hey!
Thanks for offering to be our improvement leader.
Oh, I really wanted to find a way to improve the
care of our patients on anticoagulants.
It's been a great opportunity to learn from
a practice facilitator and develop this plan to
implement TeamSTEPPs.
Let's get started on it.
First, I need to make sure that you agree with the
timelines for achieving our goals.
I created this process outline for our patients
on anticoagulants to see where there are
opportunities for improvement.
Working together, the team will design and test
processes that they think will work better.
In the meantime, we can use TeamSTEPPs tools to
improve our communication and then apply it to the
care of our patients.
That sounds great.
Let's take a look.
We're going to have to make some changes to the
way we've done things in the past.
With the whole team working together, I
believe we'll improve patient satisfaction and
safety.
This will help us do a better job of getting lab
results to our patients, too.
Going forward, we'll make it a point to call our
patients with their results.
Some of them will need us to contact their provider
to validate changes in the doses of their medicines.
I agree.
My role in this, as I see it, is to teach our team
members about communication tools and
help develop processes that work.
The first step is to take this plan to Dr. Simmons
and Cindy and make sure we're all in agreement.
I pulled these articles that describe
evidence-based practices, but we'll definitely need
Dr. Simmons's buy-in.
I agree, Valerie.
As a matter of fact, maybe we could start with
Dr. Simmons and do a Rapid Cycle Improvement Project.
We could help him do a couple of
Plan-Do-Study-Act cycles and see what happens, and
then spread our practice change across our entire
office.
Exactly, that's how it works.
I want to give this to Dr. Simmons tomorrow and
by next week, we can do our first cycle.
Sounds good.
I think it's reasonable that we set a timeline of
2 weeks for Dr. Simmons to do this.
That gives us enough patients so that we can
pilot test the new process, study it, and make
any changes we need, before repeating the
cycle.
But how are we going to know if this is working?
Well, that's why we need these measures of success.
I've listed a few of them here.
I want to get Dr. Simmons's input in
case he wants to add anything.
I like that.
Once we work with Dr. Simmons, I want to
make sure that everyone is comfortable in sharing
their feedback so we can tweak some of these things
further if needed.
Absolutely, we need everyone's buy-in so we
can truly own this process.
I mean, that's an important success factor
in making it all work.
Thanks, everyone, for taking time to meet,
review our progress and celebrate with us this morning.
Valerie has been working really hard to help us
improve our communication and provide better care
for our patients.
I want her to share with you all the improvements
that we've worked on as a team.
I want to start by thanking all of you.
This kind of success doesn't happen unless
we're all contributing to it.
We've made some changes to our process, and I want to
show what we've achieved.
I think the results speak for themselves.
Over the past 3 months, we've increased
the number of callbacks to our patients on the same day
as their lab to 98 percent.
I'd like it to be 100 percent, but 98 percent is
still a lot better than 72 percent, which is
where we started.
You can see from the run chart that we've sustained
our performance or met our target goal for the past
3 months.
That's a really good process measure, but to me
the most telling metric is the clinical outcome of
our patients.
We've reduced the number of INRs out of the normal
range by 50 percent.
Our teamwork made that great improvement!
Well, it's clear to me that this work has helped
us as a team as well as our patients.
Using TeamSTEPPs, we now start with a brief in the
morning and then develop a common plan to help me
to anticipate the team's needs through the day.
The Task Assistance Tool has actually been very
important for us, especially on days when
we're really busy.
I agree, Hank.
Mutual support is one of the most powerful things
that I've ever encountered.
It's really great to hear you all talk about how
TeamSTEPPs tools have helped.
We have met every one of our goals for the past month,
and I think we have a lot of reasons
to celebrate.