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Providence Nurses Get Rave Reviews for Unit Redesigns
And they aren't stopping there
Caption: Laura Whalen, a nurse at Providence Tarzana Medical Center, wades through a cluttered DOU supply room. A group of nurses and other hospital staff members mapped out a well-orchestrated plan to redesign the unit.
During the past 18 months, a team led by nurses at Providence Holy Cross Medical Center reviewed more than 200 suggestions as they redesigned the fourth-floor telemetry unit, a project devised to give nurses more time with their patients.
A similar project is under way at Providence Tarzana Medical Center, one of Providence Holy Cross’s sister hospitals. Nurses there teamed up to redesign the 36-bed Definitive Observation Unit, which, up until now, has been served by a single nurse station at one end of the elongated wing. This dated design has produced a chaotic system of chart review, poor distribution of lab results, monitoring difficulties and communication difficulties among staff.
Both hospitals formed nurse-driven teams that included physicians and other hospital staff members and, once formed, began following the Six Sigma concepts to identify ways to improve skills and processes.
Six Sigma is a business management strategy originally developed by Motorola to improve manufacturing processes and eliminate defects, but it has been successfully adopted into many industries in the past year. Within the organization are different levels of experts, such as “Black Belts” and “Green Belts,” and nursing teams at Providence Holy Cross and Providence Tarzana used the guidance of Black Belts to define areas of concern, measure severity, analyze data, identify improvement areas and institute controls.
When Providence Holy Cross received a grant from UniHealth Foundation, the 4-A Redesign Team began looking at ways to make nursing more efficient on a 20-bed telemetry unit. The group sought innovative ways to deliver care that would improve patient safety, clinical outcomes and patient satisfaction, and nearly 25 nurses from all shifts participated; some were so committed they came to meetings on their days off.
In approaching the redesign plan, the key question was: “What can we do better?” Changes ranged from creating patient advocacy packets to hanging “care boards” in patients’ rooms to better communicate daily plans with patients and their families. Work stations were redesigned and storage areas reorganized, improving efficiency and giving nurses more time with their patients.
Nurses, administrators and physicians at Providence Tarzana met with two Six Sigma Black Belts to overhaul the fifth-floor DOU, which suffered from a design that had led to an overtaxed nurses’ station. This resulted in frustrated physicians, missing charts, inefficient supply ordering and unacceptable noise levels. The nurse-driven team organized the area by reducing the number of fax machines and printers and moving patient charts and lab reports to a central location. Additional layout changes are under way, and, once completed, will mark the sixth project this dedicated group has finished.
“The team had great chemistry,” said Connie Pamintuan, director of nursing. “It worked as a unit, shared ideas and unanimously supported changes. The team was able to remove clutter, enhance systems and generate creative ideas that lead to improved patient care.”
The effectiveness of these and other Six Sigma projects at Providence Health & Services, California, is evident. The Catholic not-for-profit organization received two top awards last month at Six Sigma’s annual global awards program: the Platinum Award for Organizational Business Improvement and the award for Best Achievement of Organizational Business Improvement in Health Care.
For more information:
Providence Holy Cross Medical Center & Providence Tarzana Medical Center
Beth Duggan is the editor of Working Nurse. Special thanks to Patricia Aidem of Providence Health & Services for her contributions to these article.