Interim ICU leadership enables decreased infection rates and LOS with process improvement in healthcare
A 17-bed ICU of a not-for-profit community hospital was struggling with high length of stay (LOS) and infection rates, staff turnover, and an inability to implement sustainable change.
They looked to Philips Blue Jay Consulting to provide a long-term interim ICU leader and help reduce LOS and infection rates, implement performance improvement initiatives, improve staff retention.
Results* of the client engagement included:
A strategic approach with hands-on implementation
Assessment
As the interim ICU Manager, our consultant made immediate progress to increase staff morale and recommended an overall operational assessment of the ICU. All key stakeholders – including ICU staff, leaders, and providers – were interviewed and observed to document observations of processes, patient and staff flow, and areas of concern. Data was analyzed to assess the flow and environment and identify insights for improvement opportunities. The ICU had inconsistent criteria for intensivist consult which contributed to the high LOS.
Approach
Based on the assessment as well as national leading practices and evidenced-based literature, a list of prioritized recommendations was created and new unit goals were agreed upon. Next, a process improvement implementation plan with supporting leadership structure was developed. Four assistant supervisors were hired and participated in a weekly training and development program to support the new goals of the unit and the organization. A unit based practice council was established; the first of its kind in the organization. A list of practice issues were prioritized by this group and action plans developed to be reviewed every two weeks with the Chief Nursing Officer (CNO) and the interim leader.
Implementation
During the 55-week engagement, several initiatives were implemented including:
Results
At the end of the engagement, results* included:
In addition, AHRQ (Agency for Healthcare Research and Quality) Patient Safety Survey results specific to the ICU included:
Meet our team
Dawn Lombardo
Senior Consultant
Philips Blue Jay ConsultingDawn brings expertise across ED operations and inpatient settings. She has been instrumental in redesigning nursing leadership structures. She has helped plan a freestanding ED, a new hospital, and various unit renovations and hospital additions. She has led teams to improve ED performance, obtain TJC stroke certification, improve patient satisfaction, and obtain Magnet re-designations. Dawn holds an MBA, a BS in nursing, has completed a Fellowship in Patient Safety Leadership, and has a green belt certification in Six Sigma.
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* Results are rates measured prior to this engagement compared to rates measured at the end or after the engagement was completed. Results from case studies are not predictive of results in other cases. Results in other cases may vary.
1 The Joint Commission Hand Hygiene tst Program, link.
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