Vascular Access Care

1. Vascular Access Care Educating staff and patients on importance of receiving preventive vascular access care

2. The Root Causes Identified • Clinical coordinator (CC) identified that patients having access issues had not been referred to a vascular access center for evaluation • Problem discussed with IDT during IDT meeting in February 2017, the following reasons identified as causes: • PCTs and RNs not accessing patient’s accesses appropriately • PCTs and RNs not making referrals to vascular centers • Clinic not utilizing vascular access binder appropriately • Vascular access referral process established in clinic not being followed

3. The proposed Interventions • IDT to review patients not passing KT/V during IDT meetings to identify if patient needs to be referred for access evaluation • CC to educate all patients on reason why they are being referred for access evaluation • MSW to educate and provide support for patients identified by CC needing MSW intervention • Vascular Access In-service -May 19, 2017 • Educated all staff on indications for referrals, services available to patients, hours of operations, referral and follow up process. • Staff invited to observe access creation to increase staff’s insight on process and increase empathy towards patients • Vascular Access Manager Binder utilization enforced • All referrals made to be filed in Access binder to be used as tracking method and used by CC to identify patient trends and areas or opportunities for clinic • PCT-XX and RN-XX designated as vascular access managers • Responsibilities: Refer patients needing access evaluation, complete referral forms and schedule appointment for patient, provide patient with appointment information in writing, follow up to ensure patient attended appointment • MSW to conduct patient Survey to obtain patient feedback and suggestions on current referral process

4. Patients meeting KT/V in numbers and percentages Graph reflects increase in patient’s meeting KT/V since IDT started identifying correlation between patients not meeting KT/V and being identified by CC as meeting the indicators for vascular access referral.

5. Vascular Access Referrals Significant increase in number of referrals made once interventions implemented. Decrease in May attributed to clinic being able to refer patients meeting indicators for referrals in pervious months.