QUALITY IMPROVEMENT INITIATIVES
Improving Communication
Porter Hospital
The optimum safe healthcare experience should include a strong communication system. At Porter Hospital, that system includes the patient, patient’s family and nursing staff.
In order to facilitate an opportunity for patient’s to be more involved in their care. Porter Hospital’s Medical/Surgical unit has developed a positive process change in the way that communication happens at the end of each shift.
Historically, at the end of each shift, nurses gather behind a closed door and gave report to the oncoming shift. It was recognized this communication would better serve the patient and nursing staff to share information at the bedside including the patient and their families. Bedside report was implemented the first quarter of 2008.
This new way to communicate is done after obtaining patient approval. Then, the nurse with patient’s input, explains events that took place during the last shift to the oncoming nurse. The communication could include information regarding goals, medications, upcoming diagnostic tests or procedures. This process presents an opportunity for patients to add their perspective, question and learn about there healthcare issues. We have seen the feedback from patient satisfaction surveys related to recommending Porter Hospital to family or friends increase. The average 92% positive response was achieved for the period of June 2008 through March 2009.
Our belief remains that an informed patient will take a more active role in achieving their goals toward recovery.
Diane Haughney, Perf. Improvement/Risk Mgt. Department
Porter Hospital
115 Porter Drive
Middlebury, VT 05753
802 388-5609
Improved Safety of Anticoagulation Therapy
Anticoagulants (blood thinners) are medications such as warfarin (Coumadin), enoxaparin (Lovenox) and heparin which are given to patients in order to prevent and/or treat blood clots. They are commonly given to hospitalized patients who have undergone surgery or are immobile due to their illness.
The dosing of these medications is an important factor in reducing the risk of adverse effects such as bleeding. In an effort to assure safe delivery of anticoagulation therapy at Porter Hospital, beginning in November 2008 we have implemented safety protocols with a multidisciplinary team of clinical staff including Physicians, Pharmacists, and Nurses. These safety protocols were developed based on national “Best Practices” recommendations.
These efforts have resulted in an increased the number of patients receiving preventative blood clot therapy and reporting no poor outcomes related to the use of anticoagulation therapy. Monitoring of use of anticoagulation therapy will continue to ensure continued success.
Our Anticoagulant Safety Team is also partnered with Physicians from Porter Practice Management to develop similar safety protocols for the outpatient population.
Diane Haughney, RN
Perform. Improvement/Risk Mgt Department
Porter Hospital
115 Porter Drive
Middlebury, VT 05753
802 388-5609
Safety in Diabetes Managment
Elevated blood suger (Hyperglycemia) is a common problem in hospitalized patients. National studies have demonstrated that hyperglycemia in the hospitalized patient population may extend recovery time and increase the risk for complications such as wound infection, sepsis and pneumonia.
Porter Hospital recognizes the importance of improved glycemic control in our patients and recently began utilizing insulin pens to improve the safety of insulin products and facilitate patient teaching. Most recently, in the first quarter of 2009, Porter Hospital has assembled a multidisciplinary team that includes Physicians, Nurses and Pharmacists to develop standardized order forms to streamline diabetes detection and management and improve patient outcomes.
Our expectation is by August 2009 that these diabetes order forms will improve glycemic control in hospitalized patients and will also lead to hightened awareness related to detection and treatment of diabetes in the outpatient setting as well. We will monitor these protocol and their effects to evaluate the success of this project in the last quarter of 2009.
Diane Haughney, RN,
Perform. Improvement/Risk Mgt Department
Porter Hospital
115 Porter Drive
Middlebury, VT 05753
802 388-5609
Quality Improvement Contact Information
Diane Haughney, Perf. Improvement/Risk Mgt. Department
Porter Hospital
115 Porter Drive
Middlebury, VT 05753
802 388-5609
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