Improvement Story session at the 2013 Saskatchewan Health Care Quality Summit. For more information about the summit, visit www.qualitysummit.ca. Follow @QualitySummit on Twitter. This presentation will share the results of a Rapid Process Improvement Workshop (RPIW) event that focused on reducing defects in plan of care (admission through to discharge) for hospital patients with chronic obstructive pulmonary disorder (COPD). The RPIW team was the first in Saskatchewan to pilot new tools (standard orders, care maps, discharge education) designed to provide more consistent, collaborative care for COPD patients. Better Teams Jennifer Hamel; Kelly Johnson, Saskatoon Health Region; Sharon Misskey, Saskatoon Health Region

1. A Breath of Fresh Air: Reducing Defects in Plan
of Care for Patients with COPD
Jennifer Hamel, Sharon Misskey, Carol Schmidt, Kelly Johnson
This Session is sponsored by:

2. A Breath of Fresh Air:
Reducing Defects in Plan of Care for
Patients with COPD
Jennifer Hamel, Sharon Misskey, Carol Schmidt, Kelly Johnson
Health Quality Summit 2013

3. Who Are We?
A Breath Of Fresh Air

4. 7th Floor General Medicine
44 Bed Medical Unit:
• Top 3 Diagnoses: COPD/
Pneumonia/ Heart Failure (without
Angiogram)
• Primary Nursing: Registered
Nurses, License Practical Nurses,
Continuing Care Aides
• Supported by Clinical Nurse
Specialist, Clinical Nurse Educator,
Physiotherapy, Occupational
Therapy, Respiratory Therapy,
Social Work, CPAS, Dietary,
Pharmacy,
A Breath Of Fresh Air

5. Chronic Disease Management Resources
• LiveWell COPD
Program
• COPD Nurse
Clinicians
• Saskatchewan
Pulmonary
Rehabilitation
Program
A Breath Of Fresh Air

6. Getting To The Root Cause
A Breath Of Fresh Air
Chart audits found that:
-83% of patient care plans
were missing at least one
out of the four elements
recommended as best
practice.
-Standard order sets were
being used only 33% of
the time

7. A Breath Of Fresh Air
• Information regarding patient/family circumstances not always
known by care team
• Lack of standard practice around patient education prior to
their discharge
• Mobilization of the patient did not occur in tandem with
Physiotherapy
• Patient not routinely referred to community resources
Patient/Family Perspective – Pre RPIW

8. “The only variation should be the
uniqueness of our patients”
A Breath Of Fresh Air

9. Value Stream Map
A Breath Of Fresh Air

10. Our Team
A Breath Of Fresh Air

11. ER access to Order Sets
A Breath Of Fresh Air
Pre-RPIW Post-RPIW

12. A Breath Of Fresh Air

13. A Breath Of Fresh Air

14. A Breath Of Fresh Air

15. COPD Package
A Breath Of Fresh Air

16. Standard Discharge Package
A Breath Of Fresh Air

17. A Breath Of Fresh Air

18. What Did We Accomplish?
A Breath Of Fresh Air

19. Patient/Family Perspective Post RPIW
• Clear understanding from care team of patient
and family needs for discharge
• Nursing Standards of Care in place
• Mobility plan is part of Nursing Care Map
• Automatic referred for community counselling
(Live Well program)
A Breath Of Fresh Air

20. Where Are We Now?
• Feedback from Patients
has been very positive
• COPD Nurses note
optimized inhaler use
among COPD patients
• Unit Nursing staff share
they feel more confident
in the care they are
providing
A Breath Of Fresh Air

21. Where are We Going?
• April 2013 rolling out
package to the other
Three General
Medicine Units
• Continue to Audit charts
and Interview Patients
• Goal is to roll out across
the Health Region
A Breath Of Fresh Air

22. A Breath Of Fresh Air