Unit-Based Teams Get Results: 2017

1. Unit-Based Teams Get Results:2017 How UBTs Are Improving Quality, Service and Affordability for Kaiser Permanente Members and Patients February 2017

2. QUALITY: Making Early Detection Easy Eye Care Services, Redwood City Medical Center (Northern California) This team uses prompts in the KP HealthConnect electronic health record to book cancer screenings for eye-care patients identified as overdue for a screening.

3. QUALITY AND AFFORDABILITY: Reducing Hospital Stay Times 7 South Medical-Surgical Team, FontanaMedical Center (Southern California) To safely reduce hospital lengths of stay for joint-replacement patients, several departments worked to improve care coordination, allowing 64 percent of patients to return home within a day of surgery.

4. BEST PLACE TO WORK: Engaging for Safety • West Los Angeles AmbulatoryCare Pharmacy • After a series of injuries, the team made changes to encourage people to speak up about safety concerns. Changes included: • monthly rounding by team co-leads • ergonomic training for all • quick resolution of problems

5. AFFORDABILITY: Avoiding Unnecessary Emergency Visits • Ridgeline Behavioral Health Unit-Based Team, Denver • The team reduced the number of Emergency Department visits (an outside cost for this non-hospital region) by their patients, while ensuring patients get the care needed. Steps included: • studying the issue, including team members’ own ER utilization • informing all patients about urgent care alternatives to emergency visits

6. BEST PLACE TO WORK: Rethinking How Work Is Done Family Medicine Team, Gilroy Medical Center (Northern California) Long, chaotic meetings became focused, productive—and quick—when the team used a visual board to share information and track results. The practice has more than doubled team engagement scores and spread to dozens of other locations.

7. SERVICE AND BEST PLACE TO WORK: Team Builds Capacity, Beats Stress • Mt. Scott Pharmacy (Northwest) • Hit by high patient volume and glitches with a new software system, the team: • jointly reorganized schedules • used performance improvement tools to improve workflow • made stress-busting, wellness activities part of their routine

8. AFFORDABILITY: Practical Steps Bring Down High Drug Costs • Zion Outpatient Pharmacy,San Diego Medical Center • To reduce wasteful spending, this team: • studied its ordering and inventory practices • worked with pharmacists to better manage the ordering of specialty drugs • increased bulk purchasing

9. QUALITY: Serving Changing Patient Populations • Adult Medicine, Capitol Hill Medical Center (Mid-Atlantic States) • To help their free blood pressure clinic keep up with demand, team members: • lent monitors to high-risk patients to test their blood pressure at home • did daily phone check-ins and outreach to patients • increased the number of office appointments for high-risk patients

10. AFFORDABILITY: Cutting Supply Costs • Linen Team, Kaiser Sunnyside Medical Center, Northwest • The team asked units across the hospital to help reduce the cost of their scrubs and linen inventory. To meet its goal, the team: • gave units that were high linen users a review of par levels to ensure they had what they needed on hand • tracked each unit’s preferred scrub sizes and stocked par level accordingly, so the unit gets only what it needs

11. QUALITY, SERVICE AND AFFORDABILITY: Reducing Rework With Simple Fix Colorado Regional Lab, Stapleton Support Center To minimize the number of colon cancer home-screening kits rejected for faulty labeling, the team developed a laminated card showing the best ways to apply and fill out specimen labels. The fix reduced rework and improved quality and service.

12. AFFORDABILITY: Streamlined Service Saves Money Emergency Department Clerical Team,South Sacramento Medical Center (Northern California) Team launched an e-signature project using laptops to capture patient signatures at intake and discharge. This eliminated paperwork, improved service and reduced costs.

13. QUALITY:Faster Start Times for Emergency C-sections • Labor and Delivery, Kaiser Westside Medical Center (Northwest) • Team cut the time taken to begin an emergency C-section once a decision is made. • When the physician decides to operate, the physician, nurse and charge nurse confer to make sure everyone is ready. • Nurse writes the target incision time on a white board and states the goal for the whole team to see and hear.