Releasing Time to Care

The Acute Care for Elders Unit Experience

Disclosure Statement

There are no conflicts of interests noted from our team for this project or

presentation

Poll

Front Line Staff

Frustration

Repeating inefficient methods

Less direct patient care

Leadership

Not knowing where to start

Large undertaking

Under utilized resources

Releasing Time to Care

Developed by the National Health Services in 2007

Program to promote quality, safety and efficiency

Based on LEAN principles

RT2C Project Goals

What We Do As RT2C

Implement grassroots ideas from frontline staff and patients

Unit directed by frontline staff who are Ward Leads

Track data including quality indicators

RT2C for Acute Care for Elders (ACE)

ACE patients are at higher risk for: falls, hospital-acquired infections, pressure

sores, deconditioning

Have complex medical and psychosocial backgrounds

Require specialized holistic nursing care for optimal outcomes

Beginning Assumptions

RT2C is another top-down approach

Work for data gathering and interpretation

Staff resistance to change

Simple Practical Efficiency

Ice Water Trays

Reduced travel time

More efficient medication administration

Infection Control

Omnicell Stock

Reduce follow up time with pharmacy

Faster response time for sick patients (ex. Sepsis, high BP, GIB)

Better support for end of life

Making an Impact

Hand hygiene rates

Hospital Acquired Pneumonia, MRSA, C. diff, and Falls etc.

Patient and Staff Satisfaction Surveys

Activity Follows

Making an Impact

ACTIVITY FOLLOW

Direct patient care time increased by 7%

Patient flow decreased by 4%

Medicine Management decreased by 2%

Improved Hand Hygiene Rates

Improved Infection Control Rates

Making an Impact

Making an Impact

It Takes The ACE Team

It Takes a Team

Front Line Staff buy-in

Staff consensus (voting, ideas box, huddles)

Completed tasks show efficacy

Major cornerstone improving staff wellbeing

What We Are Still Struggling With

Enough hours backfilled for RT2C leads

Finding time to consistently run daily huddles

RT2C role definition

Ward Lead Burnout

Acknowledgements

Robert H.N. Ho Foundation

Langara Students Christina and Lara

Kwantlen University Nursing Students

Jen Tabamo Nurse Clinician VGH Medicine

Felicia Laing Quality and Safety

T11 Staff and Leadership Team