1. How unit-based teams are getting results Examples of operational success April 1, 2013

2. Team improves nutrition service while cutting waste FEATURED TEAM Food and Nutrition department WHAT THEY DID This San Jose Medical Center team identified ways to prevent costly food waste, where unused formula, supplements and food end up in the garbage. Small tests of change included: Conducting a “wasted meal study” to learn how much money was being lost to unused meals ($16,000 a year) Improving communication with unit assistants about patients’ eating patterns and discharge data Paying closer attention to expiration dates on supplements and adjusting the ordering accordingly Visit LMPartnership.org for ideas and tools for your team. RESULTS Monthly food expenses cut by 10 percent

3. Medication reconciliation keeps patients safe FEATURED TEAM Infectious Disease/Oncology UBT WHAT THEY DID To reduce duplicate medications listed in patient records, members of this team at the Cumberland Medical Office Building in Atlanta started by manually cleaning up patient charts. Then they instituted a new process for checking medications: Licensed practical nurses and medical assistants ask patients to bring their medications to office visits MAs and LPNs review patient medications and note on member’s chart which ones the patient is or is not taking Providers confirm medications with the member and remove the duplicate oncology medication from the patient’s record MA prints out the patient’s medications and gives the list to the nurse practitioner who, with the clinical pharmacist, reviews it and removes expired medications Visit LMPartnership.org for ideas and tools for your team. RESULTS Percent of duplicate medications per office visit

4. Standing together to prevent patient falls FEATURED TEAM Ortho/Neuro Surgical UBT WHAT THEY DID To radically reduce the number of patients who fall, the team at Fontana Medical Center (Southern California) conducted several tests of change including: Calendar posts to make problems known to all when they occur, whether day shift or night shift Daily huddles include a patient safety briefing to air concerns or potential problems Blame-free debriefings after a fall to discuss what happened and how to prevent it Quick response to bed alarms indicating that a patient has gotten up Visit LMPartnership.org for ideas and tools for your team. RESULTS Patient falls decreased by nearly 40 percent

5. Wait times down, courtesy scores up FEATURED TEAM Laboratory WHAT THEY DID To cut wait times that could sometimes exceed 45 minutes, the Mt. Scott Medical Office lab in the Northwest moved to a one-on-one model in which: A technician stays with each patient from check-in to blood draw The technician returns to the check-in desk to take the next patient More team members are freed up to reduce the queue, rather than having a dedicated member working the computer Visit LMPartnership.org for ideas and tools for your team. RESULTS Improved patient satisfaction and an unexpected jump in technician courtesy scores

6. Assigning ownership of surgical instruments saves thousands FEATURED TEAM Head and Neck Surgery WHAT THEY DO To reduce the number of surgical instruments lost before and after surgeries, nurses in this Franklin Medical Office UBT in Colorado now “own” a set instruments. They are responsible for counting the instruments at the beginning and the end of the day, similar to reconciling a cash box in a retail environment. Visit LMPartnership.org for ideas and tools for your team. RESULTS The number of lost or broken instruments

7. UBT helps new members navigate KP FEATURED TEAM Adult Primary Care WHAT THEY DID To improve member retention and help Kaiser Permanente grow, members of this UBT in Falls Church, Va., have: Involved Spanish-speaking staff in welcoming 3,200 new Spanish-speaking members Used the New Member Identifier tool in KP HealthConnect ™ so staff can help familiarize new members, or those who haven’t been in for a while, with KP Called new members to set up appointments, help refill prescriptions and address other needs Sent welcome letters and a road map on how to get started as a Kaiser Permanente member and patient Passed out a new member kit with contact numbers Visit LMPartnership.org for ideas and tools for your team. RESULTS Favorable patient satisfaction scores