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Leadership Patient Visits: An Opportunity for Daily Connection. Workshop Goals . purpose and process of LPV tools for supporting LPV benefits of LPV challenges and ongoing process improvements for LPV. Leadership Patient Visits @ SBH. 8:30-9:00am 5 days per week (Monday to Friday)
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Leadership Patient Visits: An Opportunity for Daily Connection
Workshop Goals • purpose and process of LPV • tools for supporting LPV • benefits of LPV • challenges and ongoing process improvements for LPV
Leadership Patient Visits @ SBH • 8:30-9:00am • 5 days per week (Monday to Friday) • Rotation of inpatient units and ED • Chance to speak with patients, families and staff
The problem with LPV “So, what do you think of the food?” start an A3…
A3: Reason for Action • There is no clear connection between our improvement goals and our daily Leadership Patient Visits (LPV). • We are missing opportunities to connect with patients, families and staff.
Initial State • Waning attendance • Unwritten rules • No one goes to Mental Health or Palliative • Felt like an audit
Target State • A sustainable process is in place to support Leadership Patient Visits, including a huddle and a debrief, and involving the Managers of areas to be visited. • All Executive Directors and Program Directors will attend Leadership Patient Visits two times per week.
Gap Analysis • No purpose or clear process • Disconnect between Patient Sat, Patient Safety, LPV • How does this relate to my work? • Managers don’t come to visits on their own units • “I’m not comfortable visiting patients”
What we understand now It’s about anxiety, not resistance
Solution Approach: Standard Work • PDSA Cycles • Pre-Visit Huddle • Script or verbal prep • Manager’s role • What to say to staff • Introductions on the unit, visiting patients • Post-Visit Debrief • C-suite or on the unit?
Cue cards to guide visits • Patient Satisfaction Highest Score • Patient Satisfaction Opportunity Area • Ask Patients • Celebrate with Staff
Benefits • Listen to patient voices DAILY • Managers now involved • Structured process in place • Data drives visits • Visible Leadership team • Improvement ideas, proactive • Feedback to unit staff
Powerful Stories • Woman in palliative care wanting to marry her partner • New mom disowned by parents, we are first visitors • Woman in mental health felt her physical concerns were being ignored (and the reverse in Medicine) • Elderly gentleman in isolation so grateful for the visit, as he felt “isolated” and lonely • “Your system needs a quarterback. Not one person seems to own this care for me!” • +++feedback on whiteboard iterations
Changes we’ve made as a result of LPV • Improved signage for wayfinding • Larger meals for postpartum moms • Large, welcoming FREE signs for art gallery • Handrail installed in main hallway • More art-at-the-bedside opportunities • Better mental health support for patients • Removal of cluttered pamphlet racks, posters • More free newspapers for patients • Long-term parking, TV, phone rates • Fixed cold showers! -Lodging for families
Ongoing Challenges • It’s hard to maintain and keep fresh • patient sat data is quarterly • Attendance • Managers still don’t own • Staff unsure about purpose of visit • Where is the best spot to prep and to debrief?
Next Steps • Add Atrium, Parking • How can the questions go deeper over time and connect from one month to next? • Involve charge nurse, as well as Manager? • Streamline prep at Patient Safety & Quality office • E-appts to individual Directors and Managers for their areas
Resources • Standard Work Process for LPV • Rotation of areas to visit • Monthly Schedule • Script to guide visits (cue cards) jbyrd@sbgh.mb.ca
Cue video • Our experience with Leadership Patient Visits • Video produced April 2012