2009 Innovation Award Nominees
Below we list nominees who garnered significant numbers of votes in the Innovation Award Program.
Working Together to Achieve Safety and Efficiency — Callahan Eye Foundation Hospital
Data retrieval prior to surgery is time intensive, often requiring substantial front-end work before treatment can begin. A phone interview and assessment prior to a scheduled surgery provides required information and allows presurgical assessment nurses to explain the upcoming procedure to patients and determine if additional lab tests are necessary.
About a quarter of surgical patients are unreachable by phone, however. The interdisciplinary team at Callahan Eye Foundation Hospital early identification process is for a presurgical assessment nurse to interview the arriving patient and coordinate data collection before the patient moves to the preprocedure area. Early identification has reduced wait times and facilitated timely referral of patients to appropriate care.
This process allows early identification of patients with elevated blood glucose or blood pressure so that the anesthesiologist can be notified and treatment initiated.
Day-of-surgery cancellation rates have dropped from about 6% to between 1% and 2%; surgical delays also have decreased.
Management Services Organization (MSO) Correspondence Workflow — Health Services Foundation
Approximately 10,000 pieces of paper flood MSO every month. This deluge includes bill review requests, subpoenas, precertification letters, and patient correspondence. Converting manual intake and organization of this business correspondence to a more efficient electronic process has improved efficiency, productivity, and better customer service.
Electronic correspondence management shortens the decision cycle, prevents document loss, ensures mail tracking, and improves communication and quality — all while satisfying Health Insurance Portability and Accountability Act regulations.
Correspondence is individually audited and immediately becomes available for reporting. Documents are scanned and indexed, routed based on document type, insurance carrier, and company division and are then placed into workbaskets for action. Once a user completes required tasks, documents move to permanent storage on the electronic system and are available for viewing by all secured users at any time.
Acute Care Clinic – The Kirklin Clinic®
The Acute care Clinic provides an alternative for UAB employees who use UABHS for medical care but who are unable to see their own physician immediately. A full-time nurse practitioner located in TKC provides same-day care to employees with acute problems, meeting their needs, and keeping inside UABHS for acute care.
The program required no additional cost.
Monitorpro/HR Solutions — The Kirklin Clinic®
The Monitorpro database documents all TKC complaints, automatically follows up all responses, and develops communication and notification templates. Information Systems Specialist William R. Bryars, in cooperation with Monitorpro, customized the system - the capabilities of which had never been utilized fully - to meet UAB Health System (UABHS) needs.
The database now produces graphs and trending information that assist the Quality Department.
Bryars also designed a tracking system to collect employee compliments and perform other tasks to assist in the upcoming Employee Recognition Program. He is continuing to develop the database for application within all UABHS entities.
Plato — The Kirklin Clinic®
Plato is an audit system Health Information Management (HIM) implemented to assist TKC and UAB Hospital in monthly medical records audits required by The Joint Commission (TJC).
Tammy S. Briscoe, manager, TKC Quality Improvement, facilitated Plato’s implementation and assisted in development of tracking systems, graphs, and more. She designed a TJC tracer tool, which enabled better preparation for monthly audits. This tool lets staff more easily conduct audits, provides immediate results, and has improved TJC tracers 10%.
Physician Report Cards – UAB Health System
Individual physician report cards were created in response to a Joint Commission mandate, which called for review of new physicians and continuous monitoring of active medical staff’s professional practices. Data from multiple sources was amassed in one repository to generate summary reports by physicians. Now, an Access database produces a recurring summary on each physician, including medical record delinquencies, compliments or complaints, behavioral issues followed by peer review, and patient safety incidents. All data is linked by physician code.
Reports have been distributed quarterly since January 2008. The physician report card effort facilitates evaluation and identifies opportunities for improved performance.
Acute Care for the Elderly (ACE) Unit – UAB Highlands
The ACE Unit uses an interdisciplinary team to provide patient-centered care, identify and treat geriatric syndromes, incorporate geriatric clinical guidelines into routine care, and begin discharge planning from the day of admission.
The ACE Unit meets financial and quality challenges that accompany care for complex older adults. It provides geriatric care protocol development, ongoing staff education on geriatric care principles, and geriatric consultation services for frail older adults.
The unit became active in July 2008 with a clinical staff that had received formal training in geriatric principles and interdisciplinary teamwork. A grant-supported geriatric advanced practice nurse proved crucial to providing continuing staff training and program development. The ACE Unit, the first of its kind in Alabama, has produced positive outcomes in professional development, clinical care, quality, finances, and marketing.
Lab Innovation Project – UAB Hospital
UAB Hospital Laboratories, after undergoing a culture change that increased supervisor and staff accountability and improved the work environment, asked its 10 labs to contribute ideas for process improvement, expense savings, and revenue increases. Last year these Innovation Project teams came up with 87 process improvements and ideas that resulted in more than $1.5 million in savings and enhanced revenue. The Innovation Project cemented departmental culture change; keys to positive results were improved staff relationships, minimized confusion and contention, and a more harmonious workplace.
Medical Emergency Team — UAB Hospital
The Medical Emergency Team (MET) responds quickly to patients with deteriorating vital signs and begins intervention to stabilize the patient and prevent a Code 10. The MET team has significantly reduced the number of Code 10 calls at UAB Hospital.
UAB Hospital’s Resuscitation Committee gathered evidence showing MET systems in teaching hospitals reduce cardiac arrest. The committee established a Resuscitation Department, providing a centralized infrastructure for ongoing review, staff education, and a team of health care professionals trained to proactively respond and prevent failure-to-rescue events.
Nursing Staff Conference Attendance — UAB Hospital
Continuing professional development is crucial to the provision of high quality patient care, but inequities in funding for nursing staff conference attendance existed among divisions. The UAB Hospital Staff Nurse Conference Committee brought together staff nurses and nurse managers from different areas in the hospital to develop a strategy for equitable allocation of conference attendance resources. The committee developed an application process, selection criteria, and guidelines for use of funds.
The process improved nurse satisfaction, alleviated the organizational burden of arbitrary staff selection, and increased return on investment.
Patient Journeys Through Perioperative Services — UAB Hospital
Perioperative Services’ implementation of Family Link, a patient tracking system communication tool has increased Press Ganey patient satisfaction survey scores in the “family information exchange” section. Family Link allows staff to provide patient location information from point of entry to discharge from the Post Anesthesia Care Unit. The system provides patient progress updates, promotes communication between clinical staff and patients’ families, and eases family members’ concerns.
Turn Down Service – UAB Hospital
Room cleanliness and staff courtesy are emphasized in this Environmental Services (EVS) Department initiative. Every evening between 5 pm and 9 pm, EVS staff collect trash, tidy bathrooms, and perform a spot check for cleanliness in patient rooms. Specialists conclude turn down services by asking every patient if they have any other needs.
Results from a 5-month pilot study showed a continual increases in room cleanliness (up 23%), staff courteousness (up 11%), and overall room scores (up 8%). EVS is implementing turn down services throughout the hospital.
Wii-Habilitation — UAB Hospital
Wii-habilitation, the use of Nintendo’s Wii system for virtual exercises and games in a rehabilitation setting, makes therapy interesting and fun for patients at UAB’S Spain Rehabilitation Center (SRC). The system gives staff another method of improving coordination, physical and communication skills, balance, range of motion, and cognitive processing skills. Patients become so engaged in games they forget they are working, and often participate in therapy for longer than they normally would, working through pain and fatigue with greater ease.
SRC is one of the first rehabilitation centers in Alabama to offer Wii-hab to its patients. The UAB Retirees Association, as part of its community service mission, raised funds and donated three of the increasingly popular Wii systems to SRC.
Electronic Medical Record (EMR) Implementation – The Valley Foundation
For the past 2 years the Valley Foundation has used EMR to document 100% of clinic encounters in five specialty practices. EMR documentation has improved practice efficiencies and facilitated research and quality improvement projects at UAB Huntsville Regional Medical Campus. A broad-based steering committee promoted stakeholder engagement in the project, which produced more balanced and efficient workflows.
After implementation, an EMR core team continued enhancing and expanding electronic records system utilization. The EMR initiative has produced improvements in patient care and service, including immediate availability of clinical information, results and tasking for verification, and correspondence and reports. EMR are now considered vital to the practices’ research and quality improvement initiatives, including diabetes and asthma care and childhood immunizations.
Family Medicine Childhood Immunization Project – The Valley Foundation
A new system sought to increase the Family Medicine Clinic’s immunization rates for underserved children (aged 19 to 35 months) to 90% within a year. A core multidisciplinary team addressed methods to overcome educational, bureaucratic, and financial barriers to immunization, as well as missed opportunities that can lead to incomplete immunization rates. Special recognition and prizes encouraged staff to increase rates.
Since the program began in September 2008 rates have increased for every type of immunization, and goals for several have already been met. The 64% of patients who were up to date on their immunizations at the project’s outset increased to 82% by March 2009. The initiative also promoted a cohesive, collaborative approach by clinic staff.
Bridging the Gap Between Customer Service and Member Retention — Viva Health
Viva Health’s efforts to further improve customer service and member retention through its internal processes led to two initiatives: the Courtesy Pay Policy and the standardization of the call documentation process. The Courtesy Pay Policy allows service representatives to recommend to members a one-time courtesy pay review on unpaid small-dollar claim denials. The policy decreases submission of formal appeals. Once approved, service representatives send members an approved payment notice and educational material to prevent future denials.
Standardizing call documentation processes among all call centers and claim processors included creating guidelines for recording information in member notes. The change led to faster, more informed responses to members.