Credit Valley Hospital Patient Flow

1. Credit Valley Hospital Patient Flow Purpose of Initiative To improve the flow of admitted patients from the emergency room to the medical units and improve the flow of discharged patients leaving the inpatient medical units. How We Know It Worked Significant time reductions were achieved. 21% improvement in overall non-productive bed time, an 80% reduction in time to vacate the room and an average admission process improvement of 2 hrs and 46 min.

2. Reducing Hospital Acquired Clostridium difficile Purpose of Initiative To reduce rates of hospital acquired Clostridium difficile at The Credit Valley Hospital by implementing a “bundle” of best practices. How We Know It Worked Rates of C difficile declined over the nine month period during which the bundle was implemented, with the exception of the final month.

3. Slow Stream Rehabilitation (SSR) Program Purpose of Initiative To establish a rehabilitation program on 1E for patients with complex medical conditions, to improve functional status, facilitate discharge back to the community, assist in bed utilization and patient flow across the continuum. How We Know It Worked Improved staff satisfaction and patient outcomes. Since Oct 2007, 35 patients have been admitted to SSR and 60% have been discharged to home or a retirement home rather than long term care.

4. Decision Support and Information Management Using Credit Valley’s Business Intelligence Tool Purpose of Initiative A centralized approach to data management and reporting in order to enhance decision support and sustain evidence based decision making. How We Know It Worked The BI Tool provides easy access to clinical and financial information facilitating performance measurement and management.

5. MOREOB (Managing Obstetrical Risk Efficiently) in Labour and Delivery Purpose of Initiative The MOREOB Program is a continuous patient safety improvement program for physicians and nurses focusing on teamwork and communication to manage clinical risk and adverse events. How We Know It Worked 75% reported that the program has been effective in improving patient safety. 86% would recommend the program.

6. Perinatal Immunization Project Purpose of Initiative To improve and standardize the antenatal screening and post partum immunization for perinatal patients. How We Know It Worked A 23% improvement was noted in the communication of antenatal blood work information being available for care providers.

7. The Facilitation of Heart Healthy Lifestyle Choices By Cardiac Patients Purpose of Initiative To increase the adoption of heart healthy behavior changes in discharged cardiology patients. How We Know It Worked Improved capture of patients for outpatient education and follow-up from 15% to 54% as well as improved adherence to heart healthy behavior changes through discussion of barriers and objective setting (92% adherence versus 59% in control group)

8. Restraint Minimization Purpose of Initiative The creation of a hospital wide philosophy of least restraint that focused on patient safety and improved quality of care. How We Know It Worked Outcomes audits demonstrated a decline in the use of restraints. Unapproved restraints were not utilized. There has been a noted improvement in the use of alternatives for restraint.

9. A Critical Analysis of Systemic Therapy Delivery (The Stream Team) Purpose of Initiative To improve efficiency of the Systemic Therapy Clinic and provide a better patient experience, by performing an end to end process review. How We Know it Worked Wait times decreased for service within many steps of the process resulting in patient satisfaction.