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Surgical Day Care at Victoria General Hospital

Surgical Day Care at Victoria General Hospital. Using Huddles To Improve Communication in Surgical Day Care (SDC) presented at Spotlighting Surgical Improvement in BC November 15 & 16, 2012. Background. Strictly a SDC unit (no Short Stay) 20 stretcher bays

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Surgical Day Care at Victoria General Hospital

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  1. Surgical Day Care at Victoria General Hospital Using Huddles To Improve Communication in Surgical Day Care (SDC) presented atSpotlighting Surgical Improvement in BCNovember 15 & 16, 2012

  2. Background • Strictly a SDC unit (no Short Stay) • 20 stretcher bays • Average of 40-45 patients per day. On busy days we can have up to 55 pts • We are separate from the Main OR (up one floor) but we do have a SDC OR just down the hallway from us – More on this later

  3. We were playing the “telephone game”

  4. Purpose • We had no formal means of communication with the whole group on a daily basis • Staff lacked clarity on some issues. Without clarity, people create stories • Isolated areas in our unit and 2 Ors (one on separate floor) • Manager comes and goes depending on issues that have come up

  5. Core Team • 9 RNs • One LPN that works in a treatment room in a separate area of the hospital • CNL • CNE (shared with PARR) • Manager • Housekeeper • Associates: Surgeons, anaesthesia, OR and PARR

  6. Culture in our unit What staff say we could improve on: • Working conditions • Safety Climate • Perceptions of Senior and Local Management What staff say we do well: • Stress recognition • Job satisfaction

  7. Surprises and Improvement Opportunities: • Teamwork Climate Nurse input is well received Disagreements are resolved appropriately Physicians and Nurses work together as a well coordinated team

  8. Leadership Decision: • During BCPSQC conference June 2012 the concept of team huddles and planning sessions (start of the day for the OR teams) was discussed • Manager and CNL made this the first priority for culture change and improvement

  9. Data Debrief • Survey results posted in a common gathering area for staff (Pod #4) • Weekly staff meetings to go over results • Got clarification and feedback on questions • Voted on what we wanted to work on (staff chose 2, Manager chose 1)

  10. Improvement Focus Daily Team Huddles Arrive in SDC • Easy to implement • Would be a start to improving Safety Climate, Teamwork Climate, Perceptions of Senior and Local Management • Enables daily input from staff (alerts, workload, changes, etc.)

  11. Aim Statement “SDC will do twice daily team huddles at 0735 and 1250. All staff will attend including, Manager, CNL (will lead the huddle), RNs, Unit clerk, housekeeper, and when possible physicians. We will achieve this 90% of the time (9 out of 10 huddles/week). We will start huddles the last week of June”

  12. Tests of Change • Started June 25, 2012 • Everyone attended the huddles Immediately a success with staff! • Outline is reviewed regularly (informal PDSA cycles) with staff and leadership input

  13. We have adjusted times to be 0815 and 1430 • Staff only attend one huddle not two (reduce redundancy) • We have started to include announcements for the day and reminders for the week • Manager attends regularly. As decided by staff the minimum is 3 afternoon huddles/week

  14. Next Steps • Keep refining it so that the process is quick and efficient. • Still asking improvement questions • Is physician involvement possible – not with current times

  15. Supports Staff and leadership commitment!

  16. Supports Cont’d • On going PDSA cycles to refine the process • Buy-in from the core team

  17. Barriers • Gathering staff – Will Vocera change this? • Keeping it short – avoiding too many announcements, can become a social gathering • Challenge to create an end statement to huddles

  18. Lessons Learned • Aha! Moment: BCPSQC conference • Input from staff is important • Change is continuous • This is only a small part to culture change and there is more to come • Wasn’t as much push back from staff as we anticipated

  19. Contact Nancy Reichheld, Manager PARR and SDC Victoria General Hospital nancy.reichheld@viha.ca Cheryl Larcombe, Clinical Nurse Leader SDC Victoria General Hospital cheryl.larcombe@viha.ca

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