This month’s update on the BEST Initiatives spotlights the Care Optimization workstream. The team has been hard at work designing solutions for three different priorities: Interdisciplinary Rounds (IDRs) and Care Management, Transfer Center, and Emergency Department (ED) Nursing. The solutions for each of these areas will be piloted at Highland and then modified for rollout and adoption at Alameda Hospital (AH) and San Leandro Hospital (SLH).

  • Interdisciplinary Rounds and Care Management:
    • Completed three design sessions
    • Defined roles and confirmed expectations
    • Completed facilitator training for Charge Nurses and Case Managers
    • Went live with IDR enhancements on 8ACT!
    • Care team moving from whiteboard to Epic patient list during IDRs
      • Observed improvement regarding facilitation based on AHS leadership feedback and engagement
    • IDR successes include:
      • Identified a patient who no longer met acute criteria moved the patient through the continuum of care
      • Rehab, Nursing and CM all contributed multiple times to assessing and asking for re- evaluation to see if discharge plan could change:  ARU vs. SNF; Home with services vs. SNF
      • Highlighted conservatorship issues that might not have been addressed otherwise
      • Identified many logistical discharge barriers related to lack of isolation beds for non-vaccinated patients
      • Started to inquire if test(s) could be done as an OP after acute stay
    • Future unit rollout dates are targeted for the following dates:
      • July 19 – 9ACT
      • July 26 – 7ACT
      • August 9 – 6ACT
  • Transfer Center:
    • Completed Roles and Responsibility Design Sessions
    • Centralized Staffing Office FTE and Design Work
    • Approved Transfer Process Roles and Responsibilities
    • Pre-Approved Clinical Criteria
    • Moved to “Exclusions” only list for Intra-facility Transfers
    • Removed Med/Surg/Tele and listed General and ICU/CCU
    • Approved Neurology Clinical Workflows
    • Approved Clinical Transfer Process Maps
    • Completed Emergent Transfer Workflows and Clinical Criteria
    • Determined tools for Transfer Center Policy and Processes
    • Completed House Management Design Sessions, House Management Priority Matrix and Standard Work, and House Management and Transfer Center Decision Rights
  • ED-Nursing:
    • Reviewed role clarification documentation for ED Techs in Front End with nursing and physician leadership
    • Drafted initial communication plan for proposed Front End layout changes and reviewed with nursing and physician leadership
    • Developed future state front-end role definitions – pending finalization with ED Leads​
    • Completed initial volume analysis for Staffing to Demand analysis
    • Fast Track Design Session on 7/7/22

Congratulations to the Care Optimization teams for all of their success to date!