QUALITY IMPROVEMENT INITIATIVES

Project Name: Brattleboro Memorial Hospital Patient Safety Initiative: Interdisciplinary Care Coordination (ICC) Rounds

Time Frame: November 2005 and ongoing

Aim Statement:
Brattleboro Memorial Hospital endeavors to improve outcomes and ensure the quality of care our patients receive with an emphasis on safety. It is our goal to provide safe, quality evidence-based care to our patients throughout the continuum of care.

Description
The purpose of the Joint Commission’s National Patient Safety Goals is to promote specific improvements in patient safety. The Joint Commission’s Patient Safety Goals highlight problematic areas in health care and describe evidence and expert-based solutions to these problems. Sound system design is intrinsic to the delivery of safe, high quality health care, the Joint Commission’s Patient Safety Goals focus on system-wide solutions, wherever possible. Brattleboro Memorial Hospital support and commit to implementation of the Joint Commission’s Patient Safety Goals

One of these goals is:
To improve the effectiveness of communication among caregivers

Goals and Measures

Communication failures have been identified as a root cause of unanticipated
adverse events. The Interdisciplinary Care Coordination (ICC) Rounds is a collaborative performance improvement initiative BMH has instituted to overcome this failure and achieve this safety goal. ICC rounds are conducted every Monday, Wednesday, and Friday. The health care team meets to discuss every patient with a focus on specific patient’s goals: achievements of these goals, barriers to goal achievement, how to break down these barriers, and to identify who is accountable to ensure resolution of the barrier. ICC rounds encompass the following long-term goals:

• To coordinate clinical care to improve quality and efficiency
• To reduce length of stay and unnecessary resource utilization
• To assure a safe and timely discharge and appropriate continuation of care
• To improve patient, family, physician and staff satisfaction
• To improve communication among health care team and to act as a forum for enhancing clinical knowledge

This Initiative has positively affected length of stay (LOS), BMH’S core measure compliance and other quality indicators. It has enhanced communication among the health care team to positively affect patient outcomes. Additional action step is to institute ICC rounds Tuesday and Thursday on identified high risk, complicated patients. BMH continues to monitor effectiveness of ICC Rounds.

Discharge Instruction Measures reviewed include:

• activity level (what you can and can’t do)
• diet (what you should, and shouldn’t eat or drink)
• medications
• follow-up appointment
• watching your daily weight
• what to do if your symptoms get worse

In accordance with the recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC), and to decrease morbidity and mortality from pneumoccocal disease, a policy to routinely screen and offer and pneumococcal (PPV) vaccination to adult inpatients has been adopted by Brattleboro Memorial Hospital.

Contact

Quality Management Department
Brattleboro Memorial Hospital
17 Belmont Avenue
Brattleboro, VT 05301
Mary L. Morgan RN
VP Quality Patient/Safety
mmorgan@bmhvt.org
802-257-8355 (phone)
802-257-8813 (fax)