| Primary Author: | Anthony L. D’Eramo, MSN, RN |
| Co-Principal Investigators/Collaborators: | Kim M. DeMasi, MSN, RN, CEN, LADC |
| Organization | Providence Veteran Affairs Medical Center and Rhode Island College, School of Nursing |
Abstract
Purpose
The IDPT selected their global aim to improve communication, specifically written documentation. The specific aim was to create and pilot a computerized template to document the discharge planning process.
Background
Communication among healthcare professionals is an expectation yet communication failures continue to be the number one finding of root cause analysis. At one Veterans Affairs Medical Center, insufficient interprofessional discharge planning documentation was noted by the Joint Commission as a room for improvement. Although members of the interprofessional discharge planning team (IDPT) meet daily, they did not document their communication. The IDPT was asked to address these regulatory findings. Facilitation was provided by improvement advisors trained in the Dartmouth Microsystems Curriculum (DMC). Facilitators adapted DMC methods when facilitating a system redesign improvement process.
Materials & Methods
A draft paper template of a discharge planning documentation form was created and piloted. During the pilot, the case managers (CM) were identified as primary recorders. The paper draft was revised twice before a computerized template was instituted. Every patient admitted would have the initial documentation of their discharge plan completed within a specified time frame. The computerized template was piloted, revised, and became a standardized documentation tool. A standard operating procedure was created and implemented once the pilot was completed.
Results
After implementation of the computerized template, a chart audit demonstrated 100% compliance with regulatory documentation requirements. Anecdotal team comments noted the new template improved team efficiency and team communication. A time study with the new template revealed a 50% reduction in CM admission assessment and documentation time resulting in a cost-avoidance of $21,600 annually.
Conclusion
The significance of this project was the successful implementation of the DMC, beyond a Microsystem, within an IDPT improvement project and the sustained use of a newly created discharge computerized template note. While the project outcomes were impressive, the greater benefit was in team development and easy adaptation of Microsystem tools within a system redesign project.
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© Improvement Science Research Network, 2012
The ISRN published this as received and with permission from the author(s).