QUALITY IMPROVEMENT INITIATIVES  

Anticoagulant Safety

Medication safety is a top priority at Porter Hospital. Among many other safety and quality improvement initiatives, a team of Physicians, Nurses, Laboratory staff, and Pharmacists are currently working on a large project focused on Anticoagulant safety that began in 2010 and is ongoing.

Anticoagulants such as Lovenox and Warfarin are also known as “blood thinners” and are prescribed for many patients for cardiovascular conditions and other illnesses where it is necessary to prevent or treat blood clots. While these medications are safe and beneficial in most cases, they may cause adverse effects due to drug interactions, dosing changes, or non-compliance.

Based on recommendations from national organizations such as The Joint Commission and the Institute for Safe Medication Practice (ISMP), our team of clinicians has developed new processes that will reduce the risks for errors, adverse effects, drug interactions and will improve patient education for our patients taking anticoagulants. These changes will directly benefit patients at both Porter Hospital and all of the Porter Physician practices.

Marianne Visicaro, RN
Risk Management/ Performance Improvement
Porter Hospital, Inc.
(802) 382-3460

Prevention of Hospital Acquired Infections

The prevention and control of multi-drug resistant organisms, MRSA being the most well known, has received a great deal of attention in recent years. Although Porter’s infection rates have been historically low, maintaining those rates is an ongoing process.

In October 2010, a multidisciplinary team from Porter joined a statewide collaborative with a focus on the prevention and control of multi-drug resistant organisms. Through participation in this collaborative, team surveillance projects, and a review of current practices, several changes were made to further enhance our already effective infection control program. The installation of additional hand hygiene stations, staff education, and procedural changes have been among the steps taken toward preventing these infections from occurring. This project will be completed in September of 2011.

Marianne Visicaro, RN
Risk Management/ Performance Improvement
Porter Hospital, Inc.
(802) 382-3460

IHI Expedition: Advanced Techniques to Improve Your HCAHPS* Scores

In March of 2011, we joined a nationwide project led by the Institute for Healthcare Improvement (IHI) and launched an initiative that examined Quietness of the Hospital Environment at Porter. The ultimate purpose of these relatively quick, sharply focused initiatives was to shadow patients through their care to then help us identify how we can deliver exceptional patient and family-centered care experiences. As IHI states, “the key to understanding this is to view all care as an experience and through the eyes of patients and their families.”

Aware of patients’ perception that all hospital noises can be disruptive to one’s overall care experience, we first chose to shadow a patient from 9pm-1am on our medical-surgical unit. For that 4-hour period, all the noises heard were recorded. Results were then shared with nursing staff and from that discussion a multi-disciplinary team was pulled together to tackle two major sources of noise - cart wheels and several doors on the unit.

At this time, we are happy to report that all laundry cart wheels (along with a variety of other carts) have been replaced and measures are being taken to adjust the med room doors! We have become quieter! Discussion continues among team members as to how we can further reduce noise, and, in collaboration with our clinical engineer from UVM, we are also planning to do a decibel study on the unit. We hope this will help us objectively understand when our noisiest times of day are so that we can better address “quietness of the environment” which we know can have significant impact on one’s care experience. This project is ongoing.

Wayfinding

Over the past year, Porter’s Service Excellence Team embarked on a significant endeavor to improve signage throughout the facility. Starting with simple, laminated paper signs, printed on neon-colored paper, team members placed signs throughout the hospital and adjoining Collins Building in places that had been void of proper signage, full of confusing signage, etc. Feedback from employees, patients and family members was immediate and positive. Suggestions for changes, improvements, enhancements and more signs filtered in over the first few months of working on the project. Before long, employees consistently reported that they felt fewer “customers” were confused or lost.

In January, we engaged a local sign company to do a walk-through with us to assess our work and make suggestions for a cost-effective, professional, consistent way-finding system. A prototype was created for the administration to consider and evaluate, and we are excited to announce that as we prepare this report, production is complete and delivery of our new signs is imminent. We remain confident that our exhaustive efforts will result in a much-improved, professional and visually beautiful wayfinding system for Porter Hospital. We anticipate this project ending by summer of 2011.

* What is HCAHPS? This acronym stands for Hospital Consumer Assessment of Healthcare Providers and Systems. HCAHPS is “a tool to be used for public reporting of major areas of hospital performance to support consumer choice.” (CMS)

Marianne Visicaro, RN
Risk Management/ Performance Improvement
Porter Hospital, Inc.
(802) 382-3460

Return to Hospital Report Card Menu