Clinical and Allied Health Professions Managers Session
fromnigellumley to All Participants:
I find that as a nurse on a busy unit, a change is implememnted which always increases workload. However after a period of time it becomes absorb into the daily routine
from Charmaine Van Heerden to All Participants:
Always does, like we just adjust to the aadded responsibilities over time. But I do think we are cutting corners to absorb the extra workload
fromsheelu joy to All Participants:
i think more than the work load and routine work ,,as long as it matters for our patients safety.
from Janice McClintic to All Participants:
You get more buy in on change, if staff is involved with developing the change plan.
from Kathy Duncan to All Participants:
You are right! People who do the work - should design the work.
fromArdo Hassan to All Participants:
Yes, I agree. I also think the key word here is "adabtable".
from Kathy Duncan to All Participants:
Great! Janice just said this!
fromsheelu joy to All Participants:
time management.....
from Janice McClintic to All Participants:
also, staff needs to know why we are making a change. Then they get the "big picture"
fromsheelu joy to All Participants:
prioritize tasks....
from Charmaine Van Heerden to All Participants:
Do not think this has anything to do with time management or prioritizing. In the end of the day "ALL" work should be done and is done but not the way it should be. There are only so many hours in a shift
fromfundisamketo to All Participants:
Teamwork help each other in the change because not everybody will be on board but by using the staff to motivate each other could motivational
fromnigellumley to All Participants:
you say prioritize tasks, but as a nurse pt care always come first. Although with any change comes the paperwork which is the time consuming task of any change.
from WENDY NDHLOVU to All Participants:
Change is not always easy for the staff.but there is always benefits for making a change and I agree the staff must be involved in the process of planning a change.
from Kathy Duncan to All Participants:
these are tools to help you know the impact that change makes on the workload.
fromjuliethorpe to All Participants:
I try to include the caregivers in the input and implementation of change. I do not expect that change will always be good. It is then important to utilize the feedback by those who are most affected by it, and if something doesn't work, go a diff direction
from Laura Morgan to All Participants:
Lauren used the PDSA process, and Carl (whose name changed from Dale!) did not.
from Charmaine Van Heerden to All Participants:
:))
fromAnas raja to All Participants:
The fundemental difference is that Lauren sought input from the actual staff that were implementing the changes
from Laura Morgan to All Participants:
The interdisciplinary approach is better than just management.
fromAnas raja to All Participants:
I think that both attempted to be comprehensive and interdisciplinary, they both used hard data and evidence to support their effort.
fromsheelu joy to All Participants:
both of them work as age group and intervention
from Laura Morgan to All Participants:
Lauren integrated the use of equipment/supplies instead of just focusing on the tasks and the time they take.
fromfundisamketo to All Participants:
Need to be adopted by providers,and be aware of why is it to be done
fromnigellumley to All Participants:
we have to remember that healthcare is a 24 hour job so there should not be a blame culture of passing on a task
from April Jones to All Participants:
Lauren thought outside the box when she looked for ways to get the tasks done without adding tasks to the nurses' workload (utilizing family members).
from JINGGAY MANUEL to All Participants:
w do have a VAP bundles
fromMariamma Varghese to All Participants:
Bundle audits
from JINGGAY MANUEL to All Participants:
vap bundles, like w ned to take the head elevated, ilcer prophylaxis
from JINGGAY MANUEL to All Participants:
turning position every 2 hrs
from Laura Morgan to All Participants:
Improvde HCAHPS scores by assigning a domain to a clinical manager; brought in staff members and using PDSA.
fromnigellumley to All Participants:
VAP bundles were added in my previous hospital and a combination of allied health professionals used
from JINGGAY MANUEL to All Participants:
,oral prophylaxis, weaning of sedation and early extubations
fromnigellumley to All Participants:
fromphysio, nurses, aneathatistetc
fromsheelu joy to All Participants:
RT CAN REALLY HELP
from Matthew Hafen to All Participants:
I think the style refers to the utilization of the front line staff to drive the changes. Our projects need to be from the bottom up instead of top down.
from JINGGAY MANUEL to All Participants:
yes, i really do agree
from Laura Morgan to All Participants:
Allied health has different perspective and expertise, so they should indeed be consulted
from Shannon Freel to All Participants:
I agree
fromArdo Hassan to All Participants:
yes, as Mathew noted. Front line staff's must not be neglectd
fromAnas raja to All Participants:
I think that the more inclusive and comprehensive that the QI approach is, the more creative ideas will be found and the more the follow on effects both positive and negative will be identified
from JINGGAY MANUEL to All Participants:
rt is involved because they are responsible with the vemtilators
fromMariamma Varghese to All Participants:
Yes, Improvement results heavily depend on team work
from JINGGAY MANUEL to All Participants:
it can create a better health outcome to the patient
fromsheelu joy to All Participants:
Agree
fromArdo Hassan to All Participants:
Yes, team work can reduce workload and improve the productivity
from Matthew Hafen to All Participants:
I absoltely agree. There needs to be a certain level of support from the top that will move the changes forward as the front line staff continue to find areas for improvement. Without eachother the top nor the bottom will succeed.
fromnigellumley to All Participants:
i agree strobly with matthews comment
fromAnas raja to All Participants:
I have to agree, the focus of clinicians is on patient care, they often dont have the time to study and find improvement areas
from Laura Morgan to All Participants:
Show how the initiative actually works into the process instead of being additional work
from JINGGAY MANUEL to All Participants:
there must be a clear delegations of responsibilities with each othr
fromsheelu joy to All Participants:
True ,Team work is very important during the busiest moment,in our Job.
fromnigellumley to All Participants:
i think as long as staff are involved in any change then the changes will be implemement smoothly
fromAnas raja to All Participants:
This case study has really reminded me that often we look at concepts and QI ares and things to change, but often we forget that all the "good ideas" eventually have to be put in place by the clinicians
from Matthew Hafen to All Participants:
Utilization of cause and effect or fishbone diagrams could be used to help identify what outcomes we might find from a given change.
fromjuliethorpe to All Participants:
If there is potential for a large increase in workload, can pieces of the change be implemented instead of everything all at once
from JINGGAY MANUEL to All Participants:
i do agree with julie and mat
from Shannon Freel to All Participants:
They end up doing more with less, which in the end is not productive or sustainable
from Charmaine Van Heerden to All Participants:
More focus should be placed on the value of change
fromsheelu joy to All Participants:
we need to keep things as simple as possible and not complicate...
from Janice McClintic to All Participants:
I like the idea of small changes along the way
Quality Improvement Managers Session
from OHA Transformation Center to All Participants:
Dale was top down. Lauren talked to the staff doing the work and tested it
from Matt Hoffmann to All Participants:
Lauren had the front line staff more involved and Dale did not.
from Matt Hoffmann to All Participants:
Dale did not collect as much information as Lauren
from Penny Beattie to All Participants:
Lauren involved staff, heard the concerns and got buy-in first.
fromjihanelhadad to All Participants:
Lauren involved the front line and the Respiratort technician
from Rebecca Beckman to All Participants:
Lauren had an interdisciplinary approach
fromJulya Miner to All Participants:
getting front-line team members involved from the very beginning allows ownership to be developed. Then you don't have to get buy-in later.
from Dimple Pajwani to All Participants:
Dale did a light touch approach in engagement and then decided to roll things out
from Dimple Pajwani to All Participants:
Lauren was really on the ground experimenting with staff
from Nawal Al Tamimi to All Participants:
same thing; Lauren talked to the end users before tesing the change in contrast to Dale who went to managers to implement the change directly
from Lovell Ingham to All Participants:
Lauren incorporated tasks into existing routines
from Kelly Rowe to All Participants:
Dale's motivation appears to be an "accreditation visit on the horizon." Lauren's process evolved from an annual ojective, not spurred by a looming visit.
fromjihanelhadad to All Participants:
laurenmodle has few staffs tryed the new draft process
from Matt Hoffmann to All Participants:
To make this process work, you need the people involved in the process to give the okay. This gives them more resposibility to make the process succeed.
from Katie Moore to All Participants:
I can appreciate the difference in styles given the different deadlines (accreditation visit vs annual objective)
from Kelly Rowe to All Participants:
Lauren's approach is proactively addressing quality, where Dale seems to be reactively addressing the upcoming accrediation. This could make it harder to get buy in.
from Matt Hoffmann to All Participants:
Strengths- checklist, implementation plan
fromJulya Miner to All Participants:
If accreditation is in question, there needs to be a sense of urgency generated among the team to identify solutions
fromjihanelhadad to All Participants:
he involve the managment not the front staff
from OHA Transformation Center to All Participants:
Dale sought to modify an existing process
from Matt Hoffmann to All Participants:
Weakness- did not include front line staff, no observations
from Penny Beattie to All Participants:
Dale did create a chcecklist and training
from Rebecca Beckman to All Participants:
With upcoming accrediation, he really needed the support of leadership to work fast and he went to them first
from Kelly Rowe to All Participants:
Dale may be able to use the upcoming accreditation visit as an initial motivator, but long term adoption may require more staff input
from OHA Transformation Center to All Participants:
she anticipated additional workload upfront
from Lovell Ingham to All Participants:
multi disciplinary teamwork
from Matt Hoffmann to All Participants:
Strengths - included front line staff, conducted observations, had all the staff that affected the patient included in on the process
from Gayle Pokotylo to All Participants:
Lauren measured work flow
fromjihanelhadad to All Participants:
strength update guidlines for VAP
from Kelly Rowe to All Participants:
Lauren's process strengths include using line staff input, but also addresses the entire VAP Bundle Process-not just the addition of more work
fromjihanelhadad to All Participants:
also he provide the education required
from Nawal Al Tamimi to All Participants:
Like Lauren
fromjihanelhadad to All Participants:
i will do like Lauren involving all stickholder
from Lovell Ingham to All Participants:
include a stakeholder analysis
from Matt Hoffmann to All Participants:
I would use both styles
from Penny Beattie to All Participants:
I would do like Lauren with the additional use of the tool that we were just introduced to from Dr. Hayes
from Nawal Al Tamimi to All Participants:
But in my departemtn the leader usually act like Dale
from Kelly Rowe to All Participants:
I would have researched best practices, evaluated current rates, and provided this information to a multi-disciplinary team (inlcuding clinic staff leadership); seeking input to evaluate current protocol and revise according to input.
from Matt Hoffmann to All Participants:
We use both styles
from Diana Gehring to All Participants:
I think individual dept managers would like to use the Lauren approach, but organizationally we tend to react more like Dale...
from Chris Hayes to All Participants:
All the material and tools are available at
from Matt Hoffmann to All Participants:
Explain the why behind it
from Kelly Rowe to All Participants:
Both approaches used; depending on process/guideline
from Katie Moore to All Participants:
engage them and explain why, highlight the value behind the change
from Diana Gehring to All Participants:
Bring in frontline caregivers into the process of creating the solution
from OHA Transformation Center to All Participants:
testing the ideas
fromjihanelhadad to All Participants:
involve the stickholders and engege them with the tool analysis
from Kelly Rowe to All Participants:
Establishing champions of the process, to promote adoption
from Jessica Coyne-Lowe to All Participants:
Involvement of the staff is paramount especially in getting all the process pieces involved.
fromjihanelhadad to All Participants:
test the change and sustaion
from Rami Jabr to All Participants:
Get the feedback from all involved staff, and trying to improve