Optimizing Congestive Heart Failure (CHF) Care Through Team-Based Collaboration

Project Topic:

Optimizing congestive heart failure (CHF) care through team-based collaboration

Hospital, City and State:

Newton-Wellesley Hospital, Newton, Massachusetts

Unit:

• 4 Usen (cardiac step-down unit)

CSI Participants:

• Britney Stone-Smith, MSNc, RN
• Danielle Zoppo, BSN, RN
• Coach: Kata Conde, MSN, RN, CEN, CHSE

Project Goals/Objectives:

1. Both RNs and PCAs to capture a total of at least 3 intakes and 3 outputs per patient per day in the electronic health record system (EHR), within in a 24-hour period
2. 60% of patients on the unit will have the “Getting to Know Me” tab completed by the primary nurse in EHR
3. Standardize CHF education on admission
4. Improve Healthy Work Environment Assessment Tool (HWEAT) from baseline for both the RN and Team categories
5. Decrease burnout levels < 40="" as="" reported="" oldenburg="" burnout="" inventory="" />
6. Decrease the length of stay for patients hospitalized with CHF

Project Outcomes:

1. RNs and PCAs captured average 2.22 total intakes and outputs per patient per day
2. 70% of patients on the unit had the “Getting to Know Me” tab completed by the primary nurse
3. Standardized CHF education on admission
4. Decreased HWEAT aggregate RN score from 3.45 to 3.24
5. Decreased HWEAT Skilled Communication RN score 3.22 to 2.95
6. Decreased HWEAT True Collaboration RN score from 2.92 to 2.65
7. Increased HWEAT aggregate team score from 3.51 to 3.57
8. Increased Skilled Communication Team scores from 3.13 to 3.40
9. Increased True Collaboration Team score from 2.91 to 2.95
10. Decreased burnout levels < 40="" as="" reported="" the="" oldenberg="" burnout="" inventory="" total="" score="" from="" 43.03="" to="" />

Project Overview:

This project was initiated to address gaps in communication and inconsistent workflows amongst PCAs and RNs that affect team collaboration and the accuracy of I&O documentation on our unit. As a cardiac floor, it also focuses on standardizing readily accessible CHF patient education to help promote consistent, high-quality care to our patients. A bulletin board was created to educate staff about the project. CHF education was revised. New suction cannisters were implemented. Chart audits were completed to assess compliance with the project.