Want more recognition for your critical pathways?
Want more recognition for your critical pathways?
Blow your own horn at a celebration luncheon
If you’re looking for a way to gain recognition for your work and help increase staff understanding about critical pathways, consider holding a "celebration of success" party. That’s what clinical pathway teams did at the Daniel Freeman Memorial Hospital in Inglewood, CA, earlier this year, allowing team members to profile their activities and accomplishments to administrators.
Suzanne Cannata, RN, MN, clinical pathway program director at the hospital, says she had been attempting to increase knowledge of critical pathways to team members for some time.
"I have a task force for the hospital for clinical pathway development," she explains. "I’ve been trying to think of ways to get that information down to that task force, to other team members, and to administration."
Cannata says she and another task force member had a brainstorm at the hospital’s annual Christmas party last year.
"We said it would be fun to do something like this for clinical pathways so the whole task force could hear what was going on," she notes. "From that, our idea took off. We started thinking about how we could give everyone the opportunity to get the recognition they deserved as well as imparting information to them. It would also serve as a way for people to realize their own successes."
Cannata says she began planning the luncheon for March to include task force and team members consisting of staff, physicians, and administrators.
"We thought about opening it up to the whole hospital, but because of the budget and because of space [limitations], we weren’t able to do that," she notes. "We are considering inviting the board of directors next year so they can hear everyone’s presentation. The board is very interested in what we’re doing with outcomes and quality improvement."
About 70 people attended the party, which included lunch. Seven clinical pathway teams presented:
• acute stroke;
• chest pain;
• open-heart surgery;
• orthopedics encompassing fractured hip, total hip replacement, and total knee replacement;
• perinatal;
• acute rehab for stroke and spinal-cord injuries;
• asthma.
"What we did was give them specific ideas for presentation," Cannata explains. "I asked that they present information on their pathway, their goals for the pathway, the outcomes, and/or their plans for that pathway. Some of the teams were fairly new and just had baseline information, so they could only present what they planned to do about it."
Pathway addresses chest pain
On the chest pain pathway, for example, team members presented information on the program, number of cases, length of stay (LOS), and mortality rates. (See the mortality rate chart, above.) That pathway was developed in 1994 after a multidisciplinary task force had been developed to reduce LOS in patients presenting to the emergency department (ED). Through measures such as modifying laboratory services, having pre-existing on-call cardiology teams, and cross-training respiratory therapists in the ED to administer electrocardiograms, the ED LOS for chest pain patients dropped from 4.5 hours in 1993 to three hours in 1994. It remained at three hours in 1995.
Each team had to devise a one-page document on what they were going to present. Those documents were given to participants in a packet of information. (See clinical pathway on preoperative orthopedic teaching, p. 157.)
"The orthopedic teams presented issues such as pre-op education prior to hospitalization and the actions they’d done, the processes they had developed to meet that need, and the use of DVT [deep-vein thrombosis] prophylaxis in this population," Cannata says.
She also had participants evaluate the presentation. Participants also could add their own comments, suggestions, or questions to specific teams on the evaluation.
"Overwhelmingly, the evaluations were positive," Cannata says. "[Participants] said it was an excellent way of getting information and hearing about all the work being done."
Were presentations too long?
The only complaint was the length of presentations. Because there were seven teams presenting, Cannata says she asked them to keep presentations down to no longer than 10 minutes each.
"[Next time], we’ll refine that a little bit and meet with presenters ahead of time and go through what they’re going to talk about," she explains. "Because they were so enthusiastic, they tended to talk about a lot when they could have just highlighted information."
Another suggestion Cannata has for other hospitals who would like to have similar presentations is to start several months ahead because planning takes time.
"You have to be supportive in helping people presenting information," she notes. "Many of them hadn’t done presentations before. We split assignments among the teams so that one person organized it, someone else was the speaker, someone else developed the one-page handout, and someone else developed the overheads."
In addition, she advised members to concentrate strongly on data, patient outcomes, and the actions taken to improve outcomes. She says because the next presentation will be several months before the next survey from the Joint Commission on the Accreditation of Healthcare Organizations, staff will be more prepared for surveyors’ questions.
"Come July, when Joint Commission comes, we’ll have it down pat," Cannata says. "You have everything in front of you, and every team member knows what the other has been doing."
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