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CS176
Reclaiming Our Priorities: Using Innovation And Creative Solutions On A Progressive Care Unit
By: K. Dalesandro, D.Lovasik, M. McCaw, & C. Scholle; University of Pittsburgh Medical Center; PA
For further information, please contact: dalesandroka@upmc.edu
Purpose: The Abdominal Transplant Progressive Care Unit developed a process that empowered the nursing staff to remove barriers to care, control the environment, and manage patient care. An additional goal was to decrease voluntary nurse turnover, decrease the cost of orientation and retain specialty nurses.
Description: Following a 2-year period of increased voluntary RN turnover (16.45%) and orientation costs to the unit of approximately $640,000, the nursing staff on this unit was challenged to explore work redesign and creative solutions to increase staff, physician, patient and family satisfaction. Additional goals were to promote staff comfort level with multiple transplant service lines (kidney, pancreas, liver, small bowel, and multi-visceral), decrease nursing staff frustration generated by high acuity workload in low acuity support system, and increase physician confidence through staff development. Recent projects include noise reduction through the scheduling of "Quiet Time", using a "Yacker Tracker" to measure noise levels, and changing telemetry batteries daily to decrease nuisance alarms. Patient discharge planning expanded to include discharge classes, nurse-supervised daily self-medication and a "ring of knowledge" for common transplant medications. As unit problems are identified, the nursing staff begins to "Plan, Do, Study, and Act" to use creative solutions to resolve patient and unit issues.
Evaluation and Outcomes: Voluntary nurse turnover decreased to 5.9% (2006) and 7.8% (2007) through the redesign of work processes. Orientation costs decreased to approximately $280,000 - a savings of $360,000. This unit continues to be designated as an “innovative unit” where “tests of change” are evaluated.
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