System Redesign with Huddle Boards at the James

System Redesign with Huddle Boards at the James A. Haley Veterans Hospital Betty Paul, DNP, APRN, FNP Purpose Recommendations 70 v To introduce and/or emphasis the huddle boards to ten acute care units at JAHVH as a standardized quality improvement measure. 50 Huddle Board Activities % v To improve the knowledge of registered nurses to use the huddle board in the acute care units at JAHVH Background v No standard methods currently exist to communicate with all the nursing staff at JAHVH regarding the improvement activities in the units. v Revise the huddle board as more user friendly and place the board in the nursing station near the tele monitors so that all the staff can participate in the daily huddle board meetings. 30 0 PRE Setting v Host site: Ten acute care units at JAHVA hospital in Tampa. v The patient population in these units include critical care, acute care, medical, surgical, cardiac, preoperative and post-operative categories. ØHelp team members better conceptualize QI ideas Ø Implement suggestions for improvement Outcome Measures ØTrack improvement process through to final outcomes. v Visited all the ten units once in a week for four weeks from January 2019 -February 2019 and completed the evaluation on what huddle board activities, the barriers, outcome of the activities and the requirement for extra training. v Huddle Boards are the best source for Idea generation and Process Improvement. v The analysis and evaluation of the data collected using the descriptive statistics. Results v This project consisted of educating registered nurses with poster boards about the use of huddle boards consistently in each unit, evaluating the knowledge acquired and to assess the perception of nurses in the use of the huddle board in ten acute care units. WEEK 2 WEEK 3 WEEK 4 Discussion v Target population: Registered Nurses in ten acute care units at JAHVH. v Huddle boards are a visual demonstration of group thinking about quality improvement and associated concerns. WEEK 1 Mean Pre and post implementation in acute care units Sample v Huddle Boards are visual displays to v PDSA model for improvement 40 10 v Focus: - Improved patient experience and staff performance to make JAHVH a five-star facility for the veterans. v Quality improvement project v Managers should develop a routine to engage with the staff on SAIL measures. 20 v Veterans Health Affairs currently uses Strategic Analytics for Improvement and Learning (SAIL) measures to evaluate quality and performance in the care provided to the veterans. (U. S. Department of Veterans Affairs, 2014). Design v Establish consistently dedicated time for staff to work on the Huddle Boards. 60 v Ten acute care units at JAHVH showed 30% improvement in the use of huddle boards consistently. v Data gathered from unit assessment visits showed improvement in the knowledge acquired by nurses in consistent use of huddle boards. v The most common barriers found are lack of dedicated huddle time and insufficient training/mentorship. University of South Florida College of Nursing Tampa, Florida v. The participants found the huddle boards to be effective mean to better intellectualize ideas by visualizing the problem, recommendations for change and plans to advance the process. v. Ongoing support and training are necessary to enhance the sustainability of regular huddling in each unit. v. The target outcomes set for this project were all met to introduce and strengthen the benefits of the use of the huddle boards in each unit. Limitations v One major limitation to the study was the lack of a control group. v Limited time for detailed assessment within units. v I would like to express my sincere gratitude to my project supervisors Dr. Marcia Johansson and Dr. Catherine Ling for their unwavering support and guidance throughout this project. v I would also like to thank Dr. Massengale & the JAHVH staff for the opportunity to conduct this project at the JAHVH facility. v Many thanks to Ms. Ugarte, DNP © for support and mentorship on the project. v Unit volunteers should continue to encourage all the staff to take the lead role daily huddling consistently in each unit to increase their knowledge and comfort level with the process and ultimately improving the patient satisfaction. v Ongoing White and yellow belt trainings would help the staff to engage more to the unit improvement projects. v Further studies should include a control group, larger staff population, and long term follow up. References Agency for Healthcare Research and Quality (2017). The CAHPS ambulatory care improvement guide: Practical strategies for improving the patient experience. Retrieved July, 2, 2018 fromhttps: //www. ahrq. gov/sites/ default/files/wysiwyg/cahps/quality improvement/improvement-guide/4 -approach qi-process/cahps-section-4 -ways-to approach qi-process. pdf Peter, D. , & Paul, K. (2015). Use the PDSA model for effective change management. Education for Primary Care, 26(4), 279 -281. U. S. Department of Veterans Affairs (2014). Strategic analytics for improvement and learning (SAIL) [Fact Sheet]. Retrieved June 19, 2018 fromhttp: //www. blogs. va. gov/ VAntage/wpcontent/uploads/2014/11/ SAILFact. Sheet. pdf