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Adaptation of a Lean Tool Across Surgical Units to Improve Patient Experience
1Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston.
Background:
High reliability organizations (HROs) sustain consistently excellent outcomes over time. Health care systems need to eliminate major quality failures to become reliable.
Local Problem:
Practice variations, unstructured leader rounds, and unfavorable patient experience outcomes with Responsiveness of Hospital Staff prompted leaders to adopt Kamishibai cards (K-cards).
Methods:
Evidence-based practices (EBPs) such as timeliness of answering call lights, purposeful rounding, communication, and engaging patients were used to develop Responsiveness K-cards.
Interventions:
Responsiveness K-cards established standard work for staff responsiveness and audited process compliance. Findings determined what areas needed improvement, and leaders engaged frontline staff in practice changes.
Results:
Percentile rank for Responsiveness of Hospital Staff had a sustained increase. Four of 6 hospital units using Responsiveness K-cards achieved 80% rank or better in every patient experience domain for the entire fiscal year.
Conclusions:
K-cards use HRO principles to standardize practice and improve outcomes. They encourage continuous improvement, which supports the sustainability of EBPs.
Related Concept Videos
Nursing Clinical Information System
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
Types of Reports I: Hands-off Report
Following are the key components and categories of hand-off reports:
Purpose and Process:
Nursing Implementation
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
Patient-centered Care
Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...

