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Patient screenings go up when department focuses on the “why”
Department: Head and Neck Surgeury/Audiology, South Bay Medical Center
Value compass: Best qQuality
Problem: Unsatisfactory Insufficient rate of giving necessary second blood pressure tests given to patients with elevated hose initial readings. is elevated.
Metric: Rate of giving second blood pressure test, by individual clinician
Labor co-lead: Jennell Jones, RN, UNAC
Management co-lead: Kathy Malovich, RN
Physician co-lead: Dr. William Cervantes (ad hoc)
Small test of change: Provide all tTeam leaders provided members with their individual performance scores on administering needed second blood pressure tests. They Ccustomized training and other follow-up plans accordingly, including coaching the team on Proactive Office Encounter procedures. At huddles, they discussed the importance of controlling high blood pressure for patients. They emphasized that it is , and as a clinical strategic clinical goal and performance sharing program goal for the medical center. region.
Results: In June 2009, some team members had scores for second blood tests as low as 35 percent. Now, aA year later in s of June 2010, all individual scores are 92 percent or better. Four of six team members are at 100 percent. As a team, their score for second blood tests went up from 84.8 percent in September 2009 to 92.1 percent in June 2010.
Next steps: Train S several new members members who have recently have joined the team, including staff represented by representatives from each of the department’s unions, a staff member from audiology, and an ad hoc physiciaphysiciann.
Biggest challenge: Helping staff in a specialty practice department understand the importance of routine screenings, which had not been part were a new part of the employees’ day-to-day work until recently,. as the screenings have been in family practice departments.
Advice to other teams: Huddle one to two times once or twice a week for 10 or 15 minutes. Recognize staff when they meet key milestones. Focus on one or two tests of change, not a long laundry list of initiatives.
What would the team do differently next time: Run the test of change and assess progress more quickly.
Side benefits: Staff is more focused on the Proactive Office Encounter because they see the value for the health plan member.
Background:
High blood pressure is often called “the silent killer” because those who have it don’t exhibit symptoms until it’s extremely high. Also called hypertension, high blood pressure left untreated can lead to heart disease, stroke, and kidney problems. Controlling high blood pressure is one of several Clinical Strategic Goals medical centers in the Southern California region are striving to meet. One of the Performance Sharing Program goals in the region is controlling high blood pressure.
In tThe head and neck surgery department had been compiling, monthly reports detailing the number of missed second blood pressure checks .But they were initially reviewed without a follow-up plan. Huddling in the morning several days a week gave team members a chance to learn the “why” behind the screenings and follow through on a plan of action.
“We discuss why this is important and what it means to our members, that it can save lives, especially for those who haven’t been diagnosed,” says department administrator Kathy Malovich.
High blood pressure is often called “the silent killer” because those who have it don’t exhibit symptoms until it’s extremely high. Untreated hypertension can lead to heart disease, stroke, and kidney problems
“As supervisors, we can give them the data, but it’s the staff that comes through,” she Malovich says. “It is their wanting to have better numbers.”
Focusing on individual scores was “absolutely key,” says Leroy Foster, who was DA when the test of change began (he’s now DA of other departments at the medical center). “People think they’ve done the second test because they know they should have,” he says Leroy Foster, who was DA when the test of change began. “Maybe they got distracted by any number of things.” Being able to point to hard data helped move the team to improve, he says.
Huddling was also a key to success. “I used to think, ‘You guys have way too many meetings,’” says Jennell Jones, the labor union cco-lead. “But now I see how meeting keeps people connected.”