retuRN to Care R2C & TCAB

ARMC Nursing RetreatAnnelle Beall & James Shrum

August 28, 2008

retuRN to CareTM

aka R2C

OverviewAnnelle Beall

August 28, 2008

Focused work speeds implementation of leading practices that:

• improve medical-surgical patient care • improve nursing and patient

satisfaction• increase the time that nurses have for

direct patient care resulting in better patient outcomes

What is retuRN to Care™?

Our Goal with retuRN to Care:

Make medical – surgical inpatient care safer, more reliable, and more focused on the patient.

VHA identifies the best way to deliver care and replicates it five thousand times.

A VHA Rapid Adoption Network…8 Steps Make a Difference

Participation in a VHA RAN

• It must be supported by the CEO to assure senior leadership support• All CEOs in VHA Ga. have signed off on R2C• Mr. Drew in full support

• RetuRN to Care must have CNO support-- VHA Ga. CNO Council supported at January 2008 meeting-- Here today!

• A Blueprint is available on the Leading Practice Portal (LPP).-- ARMC selects a model.

• A Gap Analysis exists on the LPP to determine improvement priorities. ARMC will have to do the gap analysis.

• In addition to Blueprint info, hospital specific CORE Measure or National Patient Safety Goal addressed. These are available now.

Return to Care™ Components aligned with VHA national clinical

strategy

Access Blueprints on Portal, Work Independently

Participate in Educational Series and National Coaching Calls, Work Independently

Participate in a Rapid Adoption Network for Sharing, Work Collaboratively

Access to the Leading Practice Portal Blueprints

Internet networking capability on the LPP

Linkage to National Experts

Online Forum for Peer Interaction

Online Benchmarking of Quarterly Performance Indicators

Gap Analysis

VHA TV Series – no additional costs

Pre Consult with Hospital

Face to Face Fact Finding Meeting

Coaching Calls

Action Planning

Performance Measurement

Customized reports

Member to member blended studies

Member to member networking/sharing

Collaborate for improvement

Return to Care™ VHA TV Series& Conference CallsThe Business Case for Nursing

Wednesday, March 26 12:30 – 1:30 p.m. ET

Return to Care™: Leadership and Culture Better Practices

Tuesday, April 15 12:30 – 1:30 p.m. ET

Return to Care™: Med-Surg Better Practices

Wednesday, May 28 12:30 – 1:30 p.m. ET

Return to Care™ Straight Talk call #1

Wednesday, June 11 12:30 – 1:30 p.m. ET

Return to Care™: Patient Satisfaction

Wednesday, August 20 12:30 – 1:30 p.m. ET

Facilitating Change at the Bedside: Making it Happen

Wednesday, September 24 12:30 – 1:30 p.m. ETReturn to Care™ Straight Talk call #3

Wednesday, October 1 12:30 – 1:30 p.m. ET

Leading practices with proven results for enhancing medical-surgical nursing care:

The Blueprints

Relationship-Based Care• Relationship-Based Care is a delivery system in

which the patient and family are the central focus.

• The nurse and other members of the health care team strive to understand what is most important to the individual patient, and actively engage them in all aspects of care

• It is a culture that supports caring & healing• Based on PRIMARY Nursing (not simply “total

patient care”)

R2C Top EnablersFront Line Staff Drive Change ●●●●●●●●●●●

Overarching Quality Strategic Plan ●●●●●●

Hourly Nursing Rounds ●●●●

MD/RN Unit Team Collaboration ●●●

Streamlined Documentation ●●●

Quality Process is Multi-Disciplinary e.g. IT, HR, Finance, Facilities, Nursing, Ancillary Areas ●●

Nurses Realize More Time With the Patient Reduces Adverse Events ●●

Cell Phones for Physician Callbacks ●

Organization Pushes Envelope For Quality ●

Relentless Attention to Patient Care ●

Strong Medical Leadership & Code of Conduct Enforced ●

Shared Governance ●

Ownership & Accountability at the Front Line Level ●

Implementation

Selection of model Pilot the model on Nephrology unit VHA Georgia planning meeting in November

– units throughout the state come together

PDAs used to collect data from nurses– Each nurse carries PDA that alarms at pre-

determined intervals– Nurse selects what function is being done at that

moment

Implementation (continued)

Data collected for one year– Sustainability demonstrated

Rolls out to other med/surg units– No time line for implementation throughout

the Med/Surg service line

Thank You

Lillee Gelinas RN, MSN, FAAN Vice President and Chief

Nursing Officer, VHA Inc.

Karen Dunn RN, MBA

Are you ready to make a difference in medical surgical care?