4/10/2012 Session Six Connections: Pain Management Kelly McCutcheon Adams, MSW, LICSW, IHI Director Barbara Balik, RN, EdD, IHI Faculty March 21, 2012 2:00 – 3:00pm EST Matt Morse Matt Morse , Institute for Healthcare Improvement (IHI), is responsible for managing and coordinating a variety of programs based on Key Processes on the IHI Improvement Map. Mr. Morse is a graduate of Northeastern University in Boston, MA and has been with the IHI for 4 years. He enjoys music, travel, cooking, and some graphic design. 2 1
4/10/2012 WebEx Quick Reference • Welcome to today’s session! • Please use Chat to “All Raise your hand Participants” for questions • For technology issues only, please Chat to “Host” • WebEx Technical Support: 866-569-3239 • Dial-in Info: Communicate / Join Teleconference (in menu) Select Chat recipient Enter Text 3 When Chatting… Please send your message to All Participants 4 2
4/10/2012 Kelly McCutcheon Adams, MSW, LICSW Kelly McCutcheon Adams, MSW, LICSW, Director, Institute for Healthcare Improvement (IHI), has served in this capacity for eight years for a variety of IHI Collaboratives and programs, particularly those focused on critical care. She is a medical social worker with experience in hospice, nursing home, sub-acute rehabilitation, emergency department, and ICU settings. She has also served as faculty for the US Department of Health and Human Services Organ Donation Collaborative and for the Gift of Life Institute. 5 Barbara Balik, RN, EdD Barbara Balik, RN, EdD, Principal, Common Fire Healthcare Consulting, is also Senior Faculty at the Institute of Healthcare Improvement. Her areas of expertise include leadership and systems for a culture of quality and safety, including patient- and family- centered care, patient experience, systems to improve transitions in care, and transforming care prior to or with optimization of an electronic health record implementation. She works with leaders to develop adaptive systems to excel and innovate in complex organizations, and to ensure sustained improvement and innovation every day. Ms. Balik's publications include the book, The Heart of Leadership , and the IHI white paper on “Achieving an Exceptional Patient and Family Experience of Inpatient Hospital Care,” among others. Previously, she served in senior leadership roles at Allina Hospitals and Clinics, United Hospital, and Minneapolis Children's Medical Center. 6 3
4/10/2012 Overall Objectives At the end of this program, participants would be able to: • Articulate key foundational elements in support of all domains of patient experience improvement • Share specific testable ideas for improving nurse communication, pain management, and cleanliness • Plan small tests of change to try during the Expedition 7 Session Agenda • Homework – We did you learn? • Patient Experience Change Package ─ Our focus today • Perspectives from Faculty: ─ Roslyn Marshall, Nurse Manager, Neuroscience Center, Medical College of Georgia Health System • Perspectives from the Field: ─ Sara Short, HCAHPS Rep, and Kimberly Chumley, Director, Mother/Baby Unit, Reston Hospital Center ─ JoAnne Cattell, CNO, St. Petersburg General Hospital • Time for Q&A 8 4
4/10/2012 Homework from prior session • Identify 1 lesson from the field in Nursing Communication to test in the next 5 days • Share what you learned from the test at the next session 9 Patient Experience Change Package: Overview Key areas for improving specific domains of patient experience: Nurse Communication, Today’s Session Cleanliness, and Pain Managem ement Staff and Physicians Connection Patient and Family Improvement/ Leadership Engagement Infrastructure Foundational Elements for Improving Patient Experience 5
4/10/2012 Our Focus Today • Why the Connection? ─ Cycle of Communication between all staff and physicians and patients/families is core to patient experience ─ Examples of where Connection shows up in HCAHPS results: Nursing Communication Cleanliness Pain Management 11 Lessons from Faculty • Roslyn Marshall, Nurse Manager, Neuroscience Center, Medical College of Georgia Health System 12 6
4/10/2012 Pain Management Key Change Concepts • Introductions and Understanding Patient Comfort Definitions ─ Process to understand patient definition of comfort preferences including light, heat, noise. Create reliable system for these definitions and preferences being shared across shifts and disciplines • Pain Management ─ Mutually develop comfort goals that include pain management, medications, environment, and activity level for hospital stay and for self-management post- hospitalization. • Shared Care Plan ─ Consider the care plan a shared document. Assure opportunities for patient input into the plan and review the care plan together • Pain Management Expertise ─ Develop or identify a specialized expert resource to consult with staff and care team regarding difficult pain management issues and train staff on current methods • Pain Management Escalation Pathway ─ Develop a policy or procedure for staff to follow when a patient has difficult pain management. Develop staff understanding of role of personal bias in addressing challenging pain issues with patients. Lessons from the Field • Sara Short, HCAHPS Rep, Mother/Baby Unit, Reston Hospital Center • Kimberly Chumley, Director, Mother/Baby Unit, Reston Hospital Center • JoAnne Cattell, CNO, St. Petersburg General Hospital 14 7
4/10/2012 Reston HCAHPS data: Top Box answers for Pain Management Domain 15 St. Petersburg HCAHPS data: Top Box answers for Pain Management Domain 16 8
4/10/2012 Pain Management Reston Hospital Center, Pilot Unit (Mother/Baby) • Implemented use of a tool that promotes clear communication between nurse and patient. • Developed script and process that requires use of tool on admission, each shift assessment, and each new complaint of pain. • Use tool during hourly rounds to proactively manage pain . • Shared Pain Assessment Tool with other inpatient units. PDSA’s encouraged to customize process to different patient populations. • Ongoing data collection regarding pain reassessment in order to give feedback to staff regarding pain management goals. Reston Hospital Center Faces Pain Scale Descriptive Words Ache Minimal Soreness Burning Numbing Stabbing Cramps Pin Pricks Throbbing Dull Pressure Tingling Heavy Sharp Vague Intermittent Shooting 9
4/10/2012 St. Petersburg General Hospital Pain Management Plan Pain Management Plan Opportunity Recognized need for improvement in educating patients regarding their pain management plan Adequate pain control for those in need Commitment All patients will be informed within 24 hours of admission. There will be a consultative process for those that are not receiving adequate comfort from the pain management plan 10
4/10/2012 Pain Management Plan Old process Fragmented Information not user- friendly Delays in receiving orders Inconsistent and limited use of the Pain Team for consults When you’re in pain nothing else matters! SPGH Pain Management Plan Education for our patients Two sided 6 X 8 in ‘Managing Your Pain’ card was developed. PDSA test cycles showed increased patient satisfaction. Consultative Services Team consists of Nursing, Pharmacy, Rehab, Anesthesiologist Anyone can make the consult Does not require a physician order Recommendations are followed up with the managing physician 11
4/10/2012 Homework for the next session • Identify 1 lesson from the field in Pain Management to test in the next 5 days • Share what you learned from the test at the next session 23 Next Call Session 7 - Cleanliness Date: Wednesday, April 4, 2012 2:00 PM - 3:00 PM Eastern US time 24 12
4/10/2012 Listserv • Patient_experience@ls.ihi.org • Send and receive questions and comments to/from faculty and participants • To be added to the listserv please email dkim@ihi.org 25 13
Recommend
More recommend
