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Concept Application Project: Information and

Healthcare Technology Improvement in the


Healthcare Delivery System
❧ ❧
Brandon Gin, Samantha Bishop, Susanna Scheidt, Jordan Staab, and Miguel Nava

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Overview of Patient Care Delivery System

❧ Carondelet St. Joseph’s Hospital


❧ Medical Intensive Care Unit
❧ Focus:
o Improving information technology, specifically
regarding the lab delivery system to:
• Improve the rate at which lab results come back.
• Prevent time spent away from direct patient care.

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Microsystem Model:
Leadership
❧ Servant leadership involves keeping an open mind, thinking
before reacting, and using foresight and intuition (Marquis &
Huston, 2017).

❧ Charge nurse supportive for staff members & student nurses.


❧ Charge nurse present/leads huddle for day and night shift.
❧ Eager to include students in education opportunities.

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and
application (9th ed. p. 65). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
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Microsystem Mode
Organizational Culture and Support
❧ “In planning and organizing, leader-managers attempt to establish an
environment that is conducive to getting work done” (Marquis & Huston, p.
465, 2017).

❧ Huddle with charge nurse before every shift.


❧ Clinical leader and manager meetings.
❧ Hospital-wide meetings with administration.
❧ Tenet: Large corporation.
❧ St. Joseph’s: Large 486-bed hospital.
❧ Rapid Response Team, Code Blue team and Code Grey team.
❧ Charge nurse supportive and a team player.
❧ Understaffed.
❧ Faith-based
Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and 4
application (9th ed. p. 465). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Microsystem Model:
Patient Focus & Staff Focus
❧ Patient Focus: “...care should be organized first and
foremost around the needs of patients. Thus, it
humanitizes, personalizes, and demystifies the patient
experience.” (Marquis & Huston, p. 364, 2017).

❧ Staff Focus: “organizations that incorporate lifelong


learning as a major part of of their philosophy will be
more successful” (Marquis & Huston, p. 408, 2017).
Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing:
Theory and application (9th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams &
Wilkins. 5
Microsystem Model:
Interdependence of Care Team
❧ “All members of work groups should be assisted with
role clarification and productive group dynamics”
(Marquis & Huston, p. 516, 2017).

❧ Interdisciplinary Meetings
❧ Culture
❧ Charge nurse not in ratio
❧ Lack of Nurse Manager presence on night shift
❧ Large Volume of Travel Nurses
❧ Close proximity of provider and nursing stations
Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and
application (9th ed. p. 516). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
6
Microsystem Model:
Use of Information and Healthcare Technology
❧ Technology facilitates mobility and interactions and will be
increasingly used in high-functioning organizations (Marquis &
Huston, 2017)
❧ Use of both electronic and paper charting
❧ Cerner is utilized as the electronic health record database
❧ Access to online systems (i.e. Micromedex)
❧ Single-colored call light
❧ No technological button for code situations
❧ Staff nurses do not carry own phones on unit

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and
application (9th ed. p. 164). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. 7
Microsystem Model:
Process for Healthcare Delivery Improvement
❧ “Although outcomes are an important measure of quality care,
it is dangerous to use them as the only criteria for quality
measurement” (Marquis & Huston, p. 614, 2017).

❧ Staff meetings done during day shift.


❧ Line inspection by nurse regularly.
❧ Education/JCAHO.
❧ Competencies.
❧ Benchmarking and quality metrics.
Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and
application (9th ed. p. 614). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
8
Microsystem Model:
Staff Performance Patterns
❧ “Performance appraisal can be one of the greatest tools an organization
has to develop and motivate staff. It can also encourage staff and
increase retention and productivity” (Marquis & Huston, p. 647, 2017).

❧ Methods:
o Patient/Peer Recognition
o Annual Performance Appraisal
o The DAISY Award
o Charting audits

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory
and application (9th ed. p. 647). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
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Specific Aspect Targeted for Improvement

● What? Improving laboratory result times and specimen delivery


by the installation of a pneumatic tube delivery system.

● Positive-impact on patient-centered care:


○ Current system takes the nurse away from direct patient care
○ Reduced Staff workload
○ Reduced laboratory turnaround time
○ Quicker turnaround laboratory results.

Guss, D. A., Chan, T. C., & Killeen, J. P. (2008). The impact of a pneumatic tube and computerized
physician order management on laboratory turnaround time. Annals of Emergency Medicine, 51(2), 181-
185. doi: S0196-0644(07)00370-8 10
Leading the Plan for Healthcare Delivery
Improvement
❧ Presentation to staff: show evidence of time difference between nurses
carrying specimens to lab vs. pneumatic tube system delivery.
❧ Timeline: over the course of ~1 year

Month Months Months


1 4-7 10-12

Provide a resource
Introduce plan to Hospital approves,
individual to help staff
hospital board Months installation of tube system
Months become accustomed to new
2-3 begins
8-9 system

Arrange for Pevco Testing of new system for


contractor to give estimate accuracy/effectiveness
on cost (1 week trial period)

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References

❧ The Daisy Foundation. (2018). DAISY Award Honorees. Retrieved from


https://www.daisyfoundation.org/daisy-award/daisy-
nurses?field_first_name_value=&field_last_name_value=&field_program_name_value=c
arondelet&field_award_date_value_2%5Bvalue%5D%5Byear%5D=2017&province=AZ&c
ountry=us&page=0

❧ Guss, D. A., Chan, T. C., & Killeen, J. P. (2008). The impact of a pneumatic tube and
computerized physician order management on laboratory turnaround time. Annals of
Emergency Medicine, 51(2), 181-185. doi: S0196-0644(07)00370-8

❧ Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in
nursing: Theory and application (9th ed.). Philadelphia: Wolters Kluwer Health/Lippincott
Williams & Wilkins.

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