Transcript No Slide Title
Manager Toolkit for the Medication Administration Process
7/31/09
August September I C October December January A Phase 2
Optimizing Medication Administration Project
Overview
•
Linkage to BPE/BP/EFP:
Safe and without error •
Problem:
The current medication administration process is inefficient and prone to error. The current process requires many work steps (total process takes over 8 minutes) and multiple interruptions that cause workflow constraints and nurses not consistently verifying the “7 rights.” (right drug, patient, dose, time, route, rationale, documentation) As a result, there is a greater risk for medication errors. Further, our HCAHPS scores for communication regarding medication was at 58% “top box” in FY2008 (baseline).
•
Goal/Benefit:
Implement a standardized medication administration process which eliminates inefficient work steps, minimizes interruptions, prompts less log-ins, and improves bedside documentation in an effort to better use real-time information related to the 7 rights of medication administration, reduce errors, improve nurse productivity, and improve patient satisfaction scores to 59%. Phase 2: implement technology to enhance process •
Scope:
Full house roll-out.
•
Deliverables:
– – A safer and more efficient medication administration process Decrease in medication errors
Progress Since Last Update
- Process finalized and approved by practice committee and medication safety committee
(see attachment A)
- Policy modified
(see attachment B)
- Education plan developed
(see attachment C)
- Sustainability (Control) plan developed
(see timeline and attachment D)
- Communicated policy changes and education plan to chairs of respective committees
Next Steps
- Practice to approve policy (August 4 th ) - Education to approve roll-out plan (August 4 th ) - Education plan presented to managers (August 5 th ) Workplan and expectations, Tools, Resources, Manager accountability plan Policy roll-out (August 31 st ) Quality Council to approve reg review additions (Sept 1 st )
(see attachment D)
- Podcast out (September- Date TBA) - Unit to complete observations using paper form (September) - Unit to complete observations via regulatory review (October-ongoing) - DMAIC team to conduct staff interviews (September and October) - Staff to complete survey monkey (November- early)
(see attachment E)
- DMAIC team to f/u re: survey monkey results (November- late)
Key Metrics
• Total medication errors • Number of near misses • Medication administration time • HCAHPS Communication Regarding Medication Scores
Executive Sponsors:
Janney/Fennessy/Zoph
Sponsors:
Payson/Dejuras//Jacobsen
Issues/Concerns/Roadblocks
Education must reach staff by August 31 st Contingency Plan– Check in meetings with managers (A/D/R) Adherence to expectations for non-compliance
Project Owners:
Ashley Currier, Denise Anderson
Improvement Leader:
Ryan Inlow
Medication Administration Process Implementation Manager Workplan
August 2009 September 2009 October 2009
Education (All RNs)
6 th -31 st
Observations by units and DMAIC team
(*use observation form)
check in with manager from team (Ashley, Denise and Ryan)
25 th
Policy in effect
31 st
Unit check-in sessions with staff (Ashley, Denise and Ryan) Manager & leadership best practice discussion sessions
(optional —dates TBA)
Encourage Staff to view Sept. podcast Survey Monkey to staff (re: interruptions check in)
Date TBA
November 2009
F/U with units re: survey results (Ashley, Denise and Ryan)
December 2009
Observations submitted via the regulatory review
*ongoing —5 th of every month*
F/U with units re: regulatory review data (Ashley, Denise, and Ryan) 2010 Unit check-in sessions re: action items from survey follow up (Ashley, Denise and Ryan)
Launch Phase 2 (potential technology enhancemen ts/barcoding)
Implementation Phase Control Phase
Education Roll-Out Plan
•
Attend Manager meeting to discuss –
New Policy changes (Main policy and Appendix D)
–
Expectations of manager to assist with education (using
toolkit)
–
Copy of
Policy
*changes highlighted
– –
Copy of
Appendix D
*modified
Talking points
–
for managers Changes to highlight
– – – –
Expectations to discuss Observation and reg review plan Case Study ELM (in place of September M and M—
tentative
) Interruption/distraction action item reminder and follow-up plan (
survey)
–
Job Aid and Badge cards
–
Incorporation of observations into regulatory review
–
Observation form
distributed
– – –
Unit check-in sessions (completed by DMAIC team) Manager/leadership help sessions (coaching or observation assistance) Survey Monkey out to staff re: interruptions/distractions check in
• • •
Staff Survey Control Phase
Surveys will be completed by staff to acknowledge interruptions that are still occurring and the impact of these interruptions Survey questions include:
– – – –
In the past month:
–
My patients have had water at the bedside and available for medication administration.
I have had the dietary supplies that I need to administer medications.
I have had the medications available from the pharmacy. I have minimal interruptions from the care team while passing medications. The computer at the bedside was operational and ready to use during medication administration.
–
I have not been interrupted by the patient to attend to care needs such as turning, cleaning up or assisting to the bathroom during medication administration.
–
I have the equipment I need to administer medications such as infusion pumps and data scopes.