transforming

Mardele Lorenson, RN, (left) assistant patient service manager, waits quietly while Marie Yi, RN, retrieves medications on the General Neurosciences/Epilepsy Care Unit (SP 6-3). Transforming Patient Care includes evidence-based enhancements to minimize disruptions that can lead to errors, such as medication safety "quiet zones" around Pyxis machines.



In 2010, Yale New Haven Hospital launched Transforming Patient Care (TPC) to improve patient safety and experience by giving nurses more time at the patient's bedside.

This past spring, the Saint Raphael Campus launched TPC throughout all inpatient care units, adopting and hard-wiring consistent, evidence-based practices. This fall, learning from the SRC, YSC inpatient units launched an advanced version of TPC to optimize the time staff spend with patients and improve the overall patient experience and quality outcomes.

"We have learned how to break through barriers in executing all 10 evidence-based practices consistently," said Diane Vorio, RN, vice president, Patient Services, and associate chief nursing officer. "The launch at the Saint Raphael Campus and advancement at the York Street Campus will help ensure that all inpatient nursing units are consistently using TPC evidence-based practices 24/7."

These practices include: safety huddles at 7 am and 7 pm, nurse-to-nurse paperless report and handoff with patient, clinical technician/patient care technician/patient care associate rounds during nurse report, nurse-to-CT/PCA report, hourly nurse and CT/PCA rounds, patient goals on the whiteboard, real-time documentation at the bedside, including medication documentation, daily manager schedule checks and medication safety zones.

TPC engages many departmental "synergy teams," such as Environmental Services, Food and Nutrition, Plant Engineering, Materials Management, Pharmacy and Respiratory Care. These teams have designed method changes that are monitored consistently for sustainability.

With senior sponsorship by Sue Fitzsimons, RN, PhD, senior vice president, Patient Services, and Thomas Balcezak, MD, chief medical officer, the YSC optimization began in late September at a kickoff meeting with TPC steering co-chairs Vorio and Paul Patton, vice president, Human Resources, nursing directors, patient service managers and assistant patient service managers. Directors and managers have overseen the five-week implementation, which includes a HealthStream module and real-time coaching.