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© 2011 Parallon Business Solutions, LLC. Development and Management of an Adult Vascular Access Team Christopher Frith RN BSN CRNI VA-BC.

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Presentation on theme: "© 2011 Parallon Business Solutions, LLC. Development and Management of an Adult Vascular Access Team Christopher Frith RN BSN CRNI VA-BC."— Presentation transcript:

1 © 2011 Parallon Business Solutions, LLC. Development and Management of an Adult Vascular Access Team Christopher Frith RN BSN CRNI VA-BC

2 2 Parallon Workforce Management Solutions “Patients First” philosophy with a focus on quality and decreased cost Hospital operators working with other hospital operators Provide unprecedented efficiencies, performance and outcomes for our customers Dedicated to continuous process improvement through our pragmatic, impact-oriented solutions


4 4 Learning Objectives To use the S.M.A.R.T. criteria in development of a Vascular Access Team To use the D.I.S.C. model to build a High Performance Team (HPT) To highlight the importance of Data mining and how it will directly affect the sustainability of a Vascular Access Team

5 5 IV Therapy History 1628 Dr. William Harvey (1578- 1657) described how blood circulates around the body and the part the heart plays – “Anatomical Essay on the Motion of the Heart and Blood in Animals” 1657 Sir Christopher Wren was the first to perform a intravenous injection in a human

6 6 Intravenous Injection Metal pipe was first used Replaced by silver or gold tube Opium and purging medication

7 7 Modern History 1940- Nurse assigned as I.V. Therapist at Mass General Hospital (Boston, MA) Metal needle used in World War II 1945- Plastic catheter was developed 1970’s plastic containers introduced for infusates

8 8 Current Infusion Landscape Greater than 80% of hospitalized patients receive IV therapy Infusion therapy is now a sub-specialty in nursing Reduction of CLABSI/BSI are major initiative for all hospital organizations IV Nurse Specialist’s are now considered a resource to infection preventionists, etc….

9 9 Modern Vascular Access Varied procedures in toolkit Must have multi-departmental integration Track efficiencies and progress Infusion Alliance * Lynn Hadaway Associates, Inc.

10 10 Vascular Access Team Registered Nurses – Critical Care background Specially trained/certified in infusion therapy Multiple devices in tool kit Schedule flexibility Trouble shooting Education Sustainability

11 11 Inadequate Goals Goal Outcome

12 12 Smart Goals for Team Development S pecific M easurable A ttainable R easonable T ime-sensitive *Creator George T. Doran (1981)

13 13 Is this smart? Hire two IV therapy nurses to stop CLABSI’s – Subjective – Anecdotal – Has no equity – Presents significant risk

14 14 Specific Explicitly Set forth Definite Vague goals equals Vague Results Employee two IV therapy Nurses

15 15 Measurable A systematic way to assign to each suitable subset a number, intuitively interpreted as the size of the subset Quantifiable Assessable To decrease our CLABSI rate from 2%

16 16 Attainable/Achievable To gain as an objective To achieve Is it possible or idealistic To 1% overall

17 17 Realistic/Relevant A statement offered in explanation or justification Not extreme or excessive Over the next six months

18 18 Time Sensitive/Time Framed The indefinite continued progress of existence and events in the past, present, and future regarded as a whole There must be a dead line Dates are agreed-upon by all parties involved Goals without deadlines are generally never met The reduction in our facilities CLABSI rate will be noted on April 1, 2012

19 19 Final Goal Statement By employing and training two IVT therapy Nurses, over the next six months we will decrease the facilities overall CLABSI rate to 1% or less. This goal will be noted on April 1, 2012

20 20 Goal Considerations Document all performance expectations and goals Assign each goal a due date Identify how the goal will be measured Set reminder dates to review and update goals

21 Goal ProcessTeamTask

22 22 DISC Model Management D ominance I nfluence S teadiness/S ubmission C onscientiousness/ Compliance

23 23 What is the DISC model Created in 1928 by Dr. William Moulton Marston (1893–1947) at Columbia University Focus is based on – Four quadrant behavioral model Personality styles – Examines behavior within environmental situations.

24 24 William Moulton Marston Psychologist Created Lie-Detector test – Systolic blood-pressure test Feminist (Creator of Wonder Woman) Theorist Inventor

25 25 DISC Model All individuals possess all four of these behaviors – The degree of each varies – Focuses on self and others – Thinking styles – Personality typology – Personality traits

26 26 D ominance “D” Relating to control, power and assertiveness ! High D Can deal with problems and challenges – Demanding – Forceful – Energetic – Strong willed – Aggressive – Determined Dominant Driving *Donald Trump Low d Need to do more research before taking action – Conservative – Low keyed – Agreeable – Peaceful – Mild – Cooperative

27 27 I nfluence Relating to social situations and communication High I Influence others with talking and activity – Emotional – Convincing – Magnetic – Warm – Optimistic – Persuasive Inspirational Influencing *Oprah Winfrey Low i Influence by data and facts not feelings – Reflective – Factual – Calculating – Skeptical – Logical – Critical

28 28 S teadiness/ S ubmission Relating to patience, persistence, and thoughtfulness +/- High S Do not like change, like steady pace and security – Calm – Relaxed – Patient – Predictable – Deliberate – Unemotional Steady Stable * Mother Teresa Low s Like change and variety – Restless – Impatient – Demonstrative – Eager – Impulsive – Intolerant

29 29 Conscientiousness/Compliance Relates to structure and organization ? High C Adhere to rules, regulations and structure – Cheerful – Cautions – Exacting – Neat – Systematic – Tactful Competent Careful * Albert Einstein Low c Change rules and yearn for independence – Self –willed – Stubborn – Opinionated – Arbitrary – Unconcerned – Unsystematic

30 30 Circular Model Circumplex Sincerity Dependability Competency Quality Enthusiasm Relationships Action Results DI SC

31 31 Team Dynamics Typical team has varying degrees of compatibility Goal is to identify and refine gaps to increase efficiencies What motivates each individual

32 32 DISC Deployment Pre employment screening – Attitude – Hostility – Integrity – Conscientiousness – Abuse – Harassment

33 33 DISC for an Existing Team Development tool – Team Building – Coaching – Communication Insight – Succession Planning – Team Analysis

34 GoalsRolesManagementProcess Interpersonal Relationships Team Development Identify Team Issues

35 35 High Performance Team (HPT) Team "A team is a small number of people with complementary skills who are committed to a common purpose, performance goals, and approach for which they hold themselves mutually accountable" Understands the big picture Common Goals Works collaboratively

36 36 High Performance Team Develop goals Provide a mission statement – “Parallon Business Solutions is committed to transforming the business of healthcare. Our strength is our people who are experienced in executing and managing complex processes with the support of enabling technology. We are dedicated to continuous process improvement through our pragmatic, impact-oriented solutions” Positive relationships – Nonaggressive confrontation Effective problem-solving – Identify and repair

37 37 High Performance Team (HPT) Team leadership – Respond and respect leadership Provide support and action to decisions Open communication – Feedback model with Brainstorming Training and development – Leadership principles – Organizational effectiveness – Communication skills – Provide resources

38 38 Data Mining The extraction of hidden predictive information from large databases – Algorithms – Database management – Massive data collection – Reports

39 39 Electronic Health Record (EHR) Systematic collection of electronic health information about individual patients or populations The legal patient record created in hospitals and ambulatory environments as a data source Recorded in a digital format Shared across the network

40 40 Data Mining/EHR Advantages Promotes evidence based practice Cost reduction Improved quality of care Mobility Trend identification

41 41 Data Mining/HER Disadvantages Cost Time to learn new systems Privacy/Liability Legal interoperability Regulatory compliance – Health Insurance Portability and Accountability Act (HIPAA) 1996 USA – Personal Information Protection and Electronic Documents Act (PIPEDA) 2000 Canada

42 42 Vascular Access Data Patient tracking and log Infection prevention – Insertion disposition – Surveillance Occurrence reporting Productivity monitoring Device related monitoring

43 43 Sample Data Points Total insertions Procedures for a specific date range Catheter tip termination Number of attempts Total number of CVC catheter insertions Average catheter line days Total number CLABSI per proceduralist

44 44 Visual Presentation Chart types – Column – Histogram – Bar – Radar – Surface – Bubble – Pie

45 45 Sample chart

46 46 Sample Data Pivot




50 Smart Goals DISC Data Pivot Vascular Access Team


52 52 Results Decreased CLABSI/HAC Cost reduction Shorter hospital stay Increased quality and patient satisfaction

53 53

54 54 Contact Information Email

55 55 Financial Disclosures Parallon Business Solutions –

56 © 2011 Parallon Business Solutions, LLC. Q & A

57 57 References Adams J. Utilizing evidence-based practice to support the infusion alliance. J Infus Nurs. 2010; 33(5):273-277. Centenary of Hypodermic Injection. G. A. Mogey, M.B., B.Ch. Department of Pharmacology, University of Leeds Hataway, L Development of an Infusion Alliance. J Infus Nurs.2010; 33(5):278-284. Joint Commission on Accreditation of Healthcare Organizations. Comprehensive Accreditation Manual for Hospitals: The Official Handbook (CAMH). Oakbrook Terrace, IL: JCAHO; 2009. Szalados JE. Legal issues in the practice of critical care medicine: a practical approach. Crit Care Med. 2007;35(suppl 2):S44-S58.

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