No Hive Left “B” Hind

Project Topic:

Create a shared governance collaborative between the units to promote dialogue between care team members to solve direct patient care issues

Hospital, City and State:

Providence Swedish Medical Center, Seattle, Washington

Unit:

Cardiovascular Laboratory (Cath), Electrophysiology Laboratory (EP)

CSI Participants:

• Jen Griffith BSN, BA, RN, CEPS
• Nicole Picardal, BS, RCIS, RCES
• Amy Reimers BSN, RN, PCCN

Project Goals/Objectives:

1. Increase AACN Healthy Work Environment Assessment Tool (HWEAT)7 aggregate score for True Collaboration
2. Identify top 2-3 “stings” with a “Bees in Your Bonnet” survey
3. 60% participation rate
4. Create a shared intraprofessional governance council

Project Outcomes:

1. Increased HWEAT True Collaboration score from 3.04 to 3.84
2. All HWEAT standards increased
3. Created intraprofessional governance council and identified hair clipping in procedural room as an improvement need
4. Decreased procedural room hair clipping for 5 of the projects 6 months when compared to the previous year
5. Created bridges between units and built long-lasting relationships
6. Uncovered workflow standardization, and increased familiarity with resources available to unit staff

Project Overview:

Teamwork is vital to a successful perioperative patient experience. When issues arise, as they always will, it is important to have an appropriate place and time for those issues to be worked through in a thoughtful and concise manner. The CSI team identified a need for shared governance among the pre and post-procedural units.

The project kickoff was at a combined staff meeting between EP and Cath lab where surveys were released asking for staff input about the main issues between pre and postoperative units. Staff identified issues with preoperative hair clipping, which became the focus of the project. The CSI team created a meeting with the preoperative/post-operative units and held space for everyone to come together get to know each other and air grievances. The CSI team picked the patient's bathroom needs and plugged in beds upon the patient’s return to SSU that could be worked on in addition to hair clipping. The CSIs took the issues back to units and had reminders at daily huddles for patient bathroom needs, and to plug in beds when transportation of the patient back to SSU commenced.

Cath lab and EP CSIs created individual educational aides to help support education tools needed for proper patient hair clipping. Educational in-services were held as well as daily reminders at huddle boards. Hair clipping data was tracked pre-education and post-education.

The successes of this project vary in measurability. The CSIs have created many positive professional relationships along the way, which are immeasurable. A project was created, followed through, and evaluated with varying results. Although the CSIs can report there has been a decrease in the amount of hair clipping in both labs, the data shows that there was a slight increase in the amount of hair clipping done in the lab post-education.