Saskatoon Health Region has made many improvements over the past 12 months to help us become better, every day. Many of these changes are the result of the Region’s 14 Day Challenge and 90-day initiatives, Safer Every Day and Ready Every Day, which focused on improving safety and patient flow respectively.
How exactly have things changed?
A year ago, there was no predictive model to tell the Region when surges in demand for admitted patients are expected. This year, there is one, and it has transformed how the Region does business. Built and maintained internally, the model is fully automated and available on the external website and mobile devices, and continues to function at over 94% accuracy.
As part of the foundational work for the predictive model, the Region also created a current capacity snapshot that provides information, in real time, on how many beds are available on every unit at all three urban facilities, allowing for better planning.
The snapshot also shows how many alternate level of care (ALC) patients – those who remain in hospital but no longer need the intensity of care found there – are currently in our system. This is important information, as these are individuals who can be better served in a community setting, such as long-term care, home care or palliative care. An electronic ALC database was created to identify these patients.
Highlights of just some of the improvements we’ve made include:
- Expansion of the Safety Alert System to all three acute care sites in Saskatoon
The Safety Alert System is now live at all three of the Region’s Saskatoon-based hospitals. The system has made it easier for physicians, employees, volunteers, patients and their families to report a concern and receive the appropriate response.
- Application of a Risk Matrix to patient safety events
A Safer Every Day team implemented a risk matrix – intended to be used across the province – to triage safety events on three surgical units at St. Paul’s Hospital.
- Launch of Team STEPPS
Team STEPPS (Strategies and Tools to Enhance Patient and Performance Safety) was launched on the Acute Care Pediatrics unit at Royal University Hospital in November. This evidence-based teamwork system is aimed at optimizing patient care by improving communication and teamwork skills among healthcare professionals, including frontline staff.
- Creation of a Mortality Review process
The work of the Mortality Review team has allowed for timely review of each death at St. Paul’s Hospital since October 19, 2015, to facilitate learning from the information collected. A multi-professional review team is being put together to ensure consistent, timely review, and to inform care improvement.
- Development of a Peer-to-Peer Support System
A Safer Every Day team plans to launch a one year pilot of a peer-to-peer support program in 2016 to improve the psychological safety of staff in the Royal University Hospital emergency department.
- Creation and rollout of a sepsis identification tool
The Safer Every Day Clinical Process Improvement team has started using a bundle of best practices for early recognition of sepsis and initial response, and a variety of educational components have been created to train staff. Early identification of sepsis saves lives and reduces the time patients need to spend in hospital.
- Opening of a Stroke Unit at Royal University Hospital
A dream for almost 20 years, a dedicated 16-bed stroke unit opened at Royal University Hospital in June as a result of Ready Every Day. In its first six months, the unit has seen a reduction in the average length of stay for patients and improved outcomes for those patients.
- Expansion of the Home IV Therapy program
The program makes it possible for patients to manage their intravenous therapy in the comfort of their own homes rather than in the hospital. Increased referrals to the program went from from an average of 40 per month to an average of 55 per month, with an all-time high of 64 in October 2015.
- Expansion of the Direct Client Funding program
Clients like Dennis Anderson and Phyllis McLeod are given monthly funding that can be used to hire services to provide for their care needs at home rather than in a long-term care facility. The Region expanded the Direct Client Funding program from 45 to 55 clients.
- Pilot of a Community Paramedicine program in Saskatoon
The Region launched a pilot in April to deliver enhanced non-emergency and emergency medical services on site to residents at Luther Special Care Home and Porteous Lodge. The pilot has since been expanded to Central Haven and Sherbrooke, Brightwater Personal Care Home, Parkville Manor, Preston Park I, Preston Park II, Samaritan Place, Cheshire Home and Baraka Care Home.
- Adoption of Region-wide staffing principles
Staffing principles were designed to guide managers toward ensuring a consistent and fair approach to master rotation development, shift relief management and vacation planning within units, so relief and vacation is treated the same regardless of the unit staff work on.
- Adoption of cascading huddles
What was once thought impossible has become possible – by 9:30 a.m., the senior leadership team knows the daily pulse of our organization thanks to cascading calls. The calls are attended by all levels, including managers, directors and senior leaders who report on the capacity of their areas and safety concerns.
- Pilot of Cellular model
This system of onsite supports for managers is meant to allow managers to spend less time on administrative tasks and more time supporting patients and staff, and improving care and the work environment. It’s also meant to reduce internal turnover, overtime, and sick time costs. In this pilot, human resource and scheduling support were placed directly in several trial patient care units to provide on-site assistance to managers. The results of these trials have been overwhelmingly positive, with overtime coming down significantly, vacancies being managed, better staff satisfaction with scheduling and managers’ time being spent more appropriately.
- Grand opening of Sanctum
The Region collaborated with community partners to launch Saskatchewan’s first HIV transitional care home and hospice, a ten-bed facility for people living with HIV who require specialized assistance in managing their symptoms due to homelessness, poverty, addictions and/or mental health issues.
- Expansion of Sunrise Clinical Manager system
Sunrise Clinical Manager (SCM) by Allscripts is the Saskatoon Health Region’s platform for our Electronic Health Record in acute care. The system had already provided caregivers with patient demographics and visit history information, lab results, medical imaging reports, and transcribed or dictated reports. It has now expanded to include discharge summaries on the Clinical Teaching Unit at RUH, and eDocumentation in the three Emergency Departments in Saskatoon. With the majority of ED nursing and physician documentation completed electronically, it provides clinicians with real-time (and anytime) access to this information.
Visit the Region Reporter website for a comprehensive look at the Region’s improvements in 2015.