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From left: Rose Wach, Janet Gill, AnnMarie Chase, Sarah Frasure, Michelle Higgins, Emily Aaronson, Gopa Mukherjee and Michael Robinson presented their EPIP team projects last month.
As a result of the process improvement initiatives of three multidisciplinary teams from BWH's Emergency Department, the ED is well on its way to fostering a culture of continuous improvement.
Beginning last year, ED staff worked with BWH's Center for Clinical Excellence (CCE) to develop a course modeled after the successful Partners Clinical Process Improvement Leadership Program, or CPIP, in order to strengthen the ED's process improvement capability.
The new Emergency Medicine Clinical Process Improvement Leadership Program (EPIP) consisted of three teams working for more than four months to improve different aspects of care in the ED.
John Rossi, MBA, CCE senior consultant, guided the teams, along with Joshua Kosowsky, MD, clinical director of the ED, and Heidi Crim, RN, MSN, former ED nursing director.
"It was really exciting to walk this journey with the teams and to see everything come together," Rossi said. "Each team took a problem and was able to define and diagnose it. From there, they figured out and implemented changes and solutions. I'm very proud of all of them."
The three EPIP projects were:
"Communication is the Key to Success," which sought to mend the gaps and delays in clinician-to-clinician communication around plans of care. The project focused on ensuring that the ED tracking board-a computerized program that provides a view of the department and patient locations in real time-accurately reflects each patient's care team, including physician, physician assistant and primary nurse at all times.
"Decreasing Variation in Time Interval Between CT-Order and CT-Begin," which aimed to decrease variation in the time between when a CT is ordered and when the scan begins. After mapping the process in real time and collecting input from front-line staff, the team identified root causes for delay. The team created a brightly-colored form that incorporates a checklist for nurses to help them prepare the patient for the CT on one side and a sign for Central Transport on the other side, as a visual cue that patients are ready for CT.
"Knowing your Providers," which focused on helping patients identify their physicians and nurses and understand their roles. After identifying causes of confusion, the team developed and distributed laminated cards to patients, which outlined the individual roles of their care providers.
While these projects continue to be rolled out and built upon in the ED, plans are already underway for the next round of EPIP in the fall. To learn more, email firstname.lastname@example.org.