November 18, 2013

Unit for Neurosciences Nursing demonstrates AMC21 quality pillar goal

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UAB Medicine is devoted to becoming the Preferred Academic Medical Center of the 21st Century (AMC21) through the achievement of its pillar goals and commitment to outstanding research, education, and clinical care. One key area of focus at UAB is the quality of care provided to patients.

ccrnWhen it comes to quality, the Unit for Neurosciences Nursing (UNSN) has continued to improve their performance by enacting the Reaching for Excellence principles into their routine. Nurse Manager Elizabeth Toomey (pictured, right) attributes her team's success to their commitment to holding each other accountable to these daily practices, whether it is hourly rounding, hand washing, or other common practices to improve quality for patients.

"I expect people to do their jobs, and we hold each other accountable if they don't," Toomey states.

For example, Toomey's unit took it upon themselves to reduce the number of  patient falls, and began to brainstorm on ways to reduce them. Advanced Nursing Coordinator Dorri Bierley (pictured, left) initiated different practices, such as daily safety huddles, staff education, and documentation audits. The daily safety huddles between Registered Nurses (RNs) and Patient Care Technicians (PCTs) are used to discuss which patients are at risk for falling and those who have particular issues the staff needs to be aware of in order to best serve the patient. Bierley states that maintaining a high level of quality care begins with staff awareness of quality issues that need to be addressed daily.

"Everything is incorporated into the safety huddles every morning because good quality is what our patients expect of us," explains Toomey.

UNSN also began hourly rounding with patients, as recommended by Reaching for Excellence, as evidence demonstrates that this practice reduces the number of times patients call for assistance with their ‘call lights.' Since hardwiring this behavior into their routine, UNSN has seen a decrease in these calls and a significant decrease in their patient fall rate.

Bierley adds that Toomey always stresses to their team to treat patients as if they are family members in the hospital. "There is a direct correlation to quality when you treat patients like family members, everything goes up from there."

Toomey attributes their success to the staff's longevity and dedication to the unit; little staff turnover makes it easier to create a stable environment. Plus, they maintain a sense of team, always willing to help if someone needs it. Bierley acknowledges that the recognition of staff members' performance is a contributing factor to the lack of turnover, praising Toomey for her dedication to acknowledge a nurse who goes above and beyond.

"If a patient tells me someone has done a great job, I will call their names out in staff meetings and give them a ‘Fantastic Five' card to reward them," says Toomey.

Fantastic Five cards are $5 cards that can be used in cafeterias and coffee shops throughout UAB. Toomey noted that residents and unit secretaries are also honored for going above and beyond the call of duty.

The main challenges facing UNSN now are the changes in health care and keeping nurses educated about new policies. It is a test for their unit because they experienced positive results from the old policies, but Toomey assures that her team will maintain their devotion to the highest quality.

"Our staff is very open to changing and adapting to handle things," says Toomey.

Chief Quality Officer for Inpatient Services, Ben Taylor, M.D., M.P.H., reiterates this dedication to quality throughout UAB and points out that UAB's quality measures are the highest they've ever been, in the context of a continually changing health care environment. UAB has to continue to work and evaluate practices in order to keep quality results high. "The whole point is to do more of what works and less of what doesn't, which sounds simple, but can be really hard in a big complex place like ours." 

Toomey cannot give her team enough praise for their hard work over the last 3 years to improve quality. She praises their devotion to their patients and teamwork as their keys to success and states it best: quality and patient satisfaction go hand in hand.

Click here for more information on how to improve quality metrics with UAB's Reaching for Excellence.