Message from the CEO
Embrace Innovation
In these challenging economic times UAB Health System (UABHS) is embracing innovation to promote creative thinking and original programs that increase efficiency and productivity and help advance our primary mission — to provide the highest quality patient care possible.
The UABHS Innovation Awards acknowledge novel and inventive programs, policies, ideas, and processes implemented in the last 2 years that have led to significant, measurable improvements in patient care, operational efficiency, or both. The awards recognize best practices in UABHS entities and affiliates, with a goal of promoting wide-spread adoption of exceptional programs and ideas.
In this first year of the award program, the UABHS CEO Council reviewed 36 nominations and selected three winners in each of two categories: Impact, for programs that have had the greatest positive effects on patient care or operations, and Creativity, for programs that demonstrate exceptional vision and imagination.
I am fortunate to see all the innovation going on throughout our health system, but most people only see the great things going on in their own institution. We wanted to share these ideas so we can all gain from the creativity of others. I was impressed with this first year’s submissions as I am sure you will be. Additional nominations will be posted by June 1 at www.uabhealth.org/synopsis.
—Will Ferniany, PhD
Creativity Awards
First place: Synergistic Medical and Resource Team Training (SMART Training), Baptist Health
A team at Baptist Health created SMART training to improve patient safety by enhancing communication and teamwork among clinical care teams. Patient safety leaders believed improved understanding of underlying principles of patient safety practices among caregivers would create positive culture change and transform care.
SMART training combines evidence-based practice, aviation crew resource management, high-fidelity simulation, and purpose-based decision making.
SMART training began 2 years ago. More than 1200 health care professionals have received training, which is now a part of general orientation. As result of widespread SMART training, Baptist Health has undergone a culture change that has resulted in a positive, measurable impact on patient outcomes.
Primary program collaborators were Baptist Health Chief Patient Safety Officer Randy Johnson, PhD, who also is professor of aviation at Auburn University; COO Robin Barca, RN, MS; and Institute for Patient Safety and Medical Simulation Director Judi Miller, RN, MSN.
Second place: The Ambassador Program, UAB Health System
The Ambassador Program gives referring physicians a complete picture of their patients’ visit to the UAB Health System, allowing them secure online access to clinic documentation, lab results, pathology results, and hospital documents.
The program offers physicians many benefits, including timely and complete access to patient records, improved continuity of care, elimination of redundant and costly paperwork, and increased overall satisfaction.
Health System Information Services (HSIS) Directors Donald G. Fast and Geoffrey D. Gordon developed the concept and designed the system with the help of Chief Information Officer Joan Hicks and The Kirklin Clinic and Physician Services staffs.
Mary Gibson, RN, BSN, and Kimberly D. Hummel, RN, MSN, of Physician Services traveled throughout the state to introduce this system to our referring physicians. More than 600 physicians have enrolled, accessing information on more than 5000 patients.
Third place: UAB Bereavement Program, UAB Hospital
The Family Support and Bereavement Program was developed to improve support for families who lose a loved one at UAB and provide resources for care teams who experience the death of a patient.
The program began with the creation of a family support coordinator position to provide increased emotional support and counseling to families of patients who die during hospitalization.
The Bereavement Program expanded quickly and now offers families seven points of contact during the first year after death. Contacts include sympathy cards and booklets on coping with death. Families can opt out of the program or add more family members to the mailing list.
The seventh point of contact is an invitation to a memorial service. UAB’s second service was held in April. More than 370 family members and caregivers attended.
Since the program began in November 2007, more than 1800 family members have received materials. Their response has been overwhelmingly positive.
The Bereavement Program also includes a caregiver survey. Results show “access to the family support coordinator” was the domain most highly correlated with overall satisfaction. Family Support Coordinator Wendy B. Walters, LCSW, OSW-C, made more than 730 consult visits to patients and their families in 2008.
The program was designed and is overseen by Walters and Assistant Vice President Deborah McGrew, Transplant and Ambulatory Services.
Impact Awards
First place: CareAdvisor Program, Baptist Health
Baptist Health developed the CareAdvisor Program to find cost-effective methods for provision of high-quality care. Program goals were to open bed capacity, reduce readmission rates, and improve outcomes for the recently discharged as well as the health and wellness of patients in the Baptist Health community.
The CareAdvisor patient management team includes two nurse case managers, a social worker, a health resource coordinator, a primary care residency program, a 24/7 Nurse Advice Line, and a retail pharmacy. Nurses work closely with each patient’s health care provider and offer self-care education to patients and their caregivers. Patient services are provided at no cost for 1 year.
Early findings show CareAdvisor has reduced average patient costs for those enrolled in the program. CareAdvisor also has decreased costs per encounter for emergency department care. The program has produced a 1.37:1 return on investment (ROI) during its first 4 months. After start-up costs are accounted for, leadership expects ROI to be closer to 2.06:1.
Second place: Ensuring a Safe, Consistent Blood Supply for UAB and the State, UAB Hospital
Faced with a constant shortfall in critical blood supplies, Sherry R. Polhill, administrative director for Hospital Laboratories, worked with Hospital Administration to ensure a safe, consistent blood supply. Program goals were conserving resources and increasing local collections to limit the need for blood imported from outside Alabama. A second approach focused on decreased utilization, as medical evidence has shown conservative blood transfusion policies improve outcomes.
Frequent hospital-wide blood drives were promoted on campus and closely tied to programs designed to increase employee participation and keep them involved in donation. Closer monitoring of blood units also has led to better utilization.
Results are impressive. Compared with FY08, first quarter FY09 showed a 125% increase in collections, while blood product utilization decreased 19%. Annual hospital blood costs also sharply decreased. In FY07, annual blood costs topped out at $10,895,693. The projected cost savings for FY09 blood products is $1,876,557. Since 2006 the hospital has saved $2.6 million dollars.
Third place: Reduced Documentation Time with Electronic Medical Records (EMR), UAB Hospital
UAB Hospital’s implementation of EMR has increased electronic documentation requirements substantially. To reduce time spent documenting while maintaining a complete and accurate EMR, UAB Hospital partnered with the IMPACT system vendor to improve methods for gathering patient data. Project goals were to increase patient safety and workflow efficiency for clinicians.
The project includes monitors, ventilators, IV pumps, fetal monitors, and collaboration from several departments, including Biomedical and Clinical Engineering, Nursing, Respiratory Therapy, and HSIS.
As of March 1 there were 146 monitored beds sending data into IMPACT. The CICU also sends ventilator data into the system.
Time saved by implementing electronic data gathering versus manual entry is considerable. Nursing time savings for documentation are more than 5 million minutes per year, and the average time to document vital signs has dropped from 4 minutes to 20 seconds.
Click here to view the 2009 Innovation Award nominees.