Improving Perinatal Care

Project Description

Women have the right to reproductive health care that is medically safe, fits their lifestyle and recognizes and respects their individual and diverse physical, social, spiritual, psychological an economic needs. Our ultimate aim through this project is to give childbearing families confidence in their ability to give birth safely, balancing technology with sensitive, compassionate care. We will make our patients the center of care, implement the bundles, create a just culture, use common language, and document for accountability.    

Interventions

•  Standardized Induction and Augmentation and Induction Protocols have been implemented. These protocols include research-based criteria that when met have demonstrated to improve outcomes for mothers and babies.    

•  Emergency Caesarean Section Drills have been implemented. The goal is to provide each clinician with an opportunity to be able to practice the skills required to provide safe Caesarean Section delivery. Each drill is reviewed and critiqued so that improvements to our response can be identified and implemented.

•  Common Language among clinicians has been identified as a key component to ensure safe communications during the care of a mother and baby. Each clinician must complete a neonatal monitoring course where common language terms are taught. Our Obstetrical physicians have made attending this course a requirement for credentialing at Springfield Hospital.    

•  A Safety Survey is now distributed to all clinicians twice a year. The goal of this survey is to identify opportunities to improve our safety environment.

Evaluation Metrics

•  Adherence to Augmentation and Induction Protocols
•  Patient Outcomes
•  Patient Satisfaction
•  Caesarean Section Response Time
•  Caesarean Section Incision to Decision Time

Initial analysis demonstrates adherence to Augmentation and Induction Protocols. Incision to Decision time for Caesarean Section is maintained to within 30 minutes.
No compromises to Patient Outcomes have been identified and Patient Satisfaction remains high.

Next Steps

The Improving Perinatal Care Team is working to improve the safety and support environment for Emergency Caesarean Section procedures.  Debriefings are occurring following each Emergency Caesarean Section to identify and implement improvement opportunities.

Contact Information

Bob DeMarco, RN, MA, Chief of Quality and Systems Improvement
Springfield Hospital, 25 Ridgewood Road, Springfield, Vermont, 05156
Telephone: 802-885-7565; e-mail: bdemarco@springfieldhospital.org

Patient Centered Care

Project Description

As health care providers, our number one goal is to assure our patients the safest and highest quality health care.  In our Patient Centered Care environment, our patients and their families are the most important members of our health care team. Assuring their safety and quality care is everyone’s responsibility. To be fully successful this requires a team effort and it requires everyone to be engaged, ready and willing to advocate and patient for safety and quality.  

Interventions

•  Patient Centered Rounding has been implemented. The goal of Patient Centered Rounding is to provide and opportunity for each patient to meet with the clinical care provider team.  The team may include Nursing, Pharmacist, Social Service, Dietician, Physical Therapist and Physician. During rounding each patient is asked if their needs are being met and if they have any concerns or questions that we can address.  During each visit the care plan is reviewed. The goal is to develop a conversation between patients and the clinical team so that patients can make the well-informed decisions about their care.

•  Discharge Phone Calls – Upon discharge each patient is notified that they will receive a phone call within the following 24 hours to see how they are doing and to answer questions and identify further resources as needed.  This process has provided demonstrated benefit to both patients and staff in terms of overall satisfaction.   

•  White Boards are hung at each bedside.  Patients may utilize these boards to communicate their needs to staff.  These boards are also planned to be a focal point for Patient Centered Rounding.

•  A Speak Up Campaign has recently been implemented.  Speak Up is designed to urge our patients, their families and our staff to take an immediate role in preventing health care errors by being involved health care team members and speaking up at the first opportunity to ensure that safe and quality care is provided.  As health care providers, our number one goal is to assure our patients the safest and highest quality health care.  In our Patient Centered Care environment, our patients and their families are the most important members of our health care team. Assuring their safety and quality care is everyone’s responsibility. To be fully successful this requires a team effort and it requires everyone to be ready and willing to advocate and Speak Up for safety and quality.

Evaluation Metrics

Patient Centered Care is under ongoing evaluation and analysis.  Measurement Strategies include:

•  Patient and Staff Satisfaction
•  Adverse Drug Events

Next Steps

Spreading Patient Centered Care to all Clinical environments.

Contact Information:

Bob DeMarco, RN, MA, Chief of Quality and Systems Improvement
Springfield Hospital, 25 Ridgewood Road, Springfield, Vermont, 05156
Telephone: 802-885-7565; e-mail: bdemarco@springfieldhospital.org

Boards on Board

Project Description

As hospitals seek to drive rapid quality improvement, the Board of Directors has an opportunity and a significant responsibility to make better quality of care the organization’s top priority.

Interventions

• Board of Directors will spend at least 25% of their meeting time on quality and safety issues.
• Board Members will have a conversation with at least one patient (or family member of a patient) who sustained serious harm at their institution within the last year.
• The Patient Experience Team includes the Chief Executive Officer and Chairman of the Board.  This team invites former patients/families to discuss the quality of care they received and to discuss potential improvement opportunities 

Evaluation Metrics

•  Meeting Minutes
•  Active engagement of Board members in Quality Improvement Activities.
•  Patient Satisfaction

Next Steps

Continue activities to support complete integration of Boards on Board AIMS into our hospital culture. 

Contact Information: