Implementing Project RED: A Dynamic Process at midland memorial hospital

1. Sherron Meeks, RN, MPAL Brenda Evans, BSN, RN, CCRN, CNML Implementing Project RED: A Dynamic Process at midland memorial hospital

3. Introduction to Project RED • Small work group • Determined the pilot program • Stroke patients from Midland County who were discharged from the organization between normal work hours (8-5) • Implemented pilot program June 2011 • Elements of performance: • Patient education started within 24 hours of admission • Provided a booklet for retaining information (meds, etc.) • Patient education reinforced daily by DA • Follow-up appt made and written in booklet by DA • Follow-up phone calls performed within 3 days of discharge • Medication questions • General information • Follow-up with physician information • Attending physician provided information through EMR access and/or letter • Enrolled patients for 1 quarter • Only 1 patient was readmitted (for elective surgery)

4. Professional Practice Council Charter for 2012: • Improve the Discharge Process • EMR developing a composite discharge document with ALL the discharge instructions included • Integration of ALL disciplines into the discharge process • Nurse checklist for “Full Stop” if patient has not received/understands discharge teaching • Integration of call-backs by Clinical Managers to discharge patients • Pilot on medical floor (Welcome Brenda Evans, Director of Adult Medical Services)

5. In an effort to address patient concerns about missing information at the time of discharge and improve patient transition from one setting to another we developed a discharge checklist. September 2011, Institute for Healthcare Improvement (IHI) had series of 6 Webinar presentations on ways to reduce re-admissions and close the gap in transition of patients from one setting to another.

6. Presentations on tools and templates useful in the development of discharge checklist and timely post-hospital follow-up process were presented. We took a sample template and created one to match the needs of our organization and then trialed it on our medical unit. This unit had extremely large number of complaints related to missing discharge information and education (4medical)

7. Our tool was rolled out and has been adjusted to support our facility and patient population needs Now at the time the discharge order is obtained the nurse starts review of the check list information with the patient and checks off as progress is made. Final review of completed checklist done and signed just prior to patient leaving the unit. Then a post discharge follow-up call to the patient, within 72 hours of discharge to check status and ability to keep follow-up appointments.

8. Roll-out of the Nurse Checklist process to two stroke units (PCU/ONN) this month. Monitoring the Stroke readmission rates for those two units (already tracking these readmission rates) for the next quarter. Continue to integrate each unit until all have been included.

9. Roll-out of the Nurse Checklist process to two stroke units (PCU/ONN) this month. Monitoring the Stroke readmission rates for those two units (already tracking these readmission rates) for the next quarter. Continue to integrate each unit until all have been included.

11. Thank You! Questions? sherron.meeks@midland-memorial.com brenda.evans@midland-memorial.com