Perioperative team, Fox Chase Cancer Center, Philadelphia
The Fox Chase Cancer Center perioperative team noticed delays in getting patients to surgery. After investigating, the team realized that blood wasn’t getting to the operating room (OR) fast enough to start the case on time. They collaborated with pre-admission testing to complete blood type and screening at presurgical testing (for procedures that require transfusions). The preoperative staff now orders the predetermined units of blood the night before, and on the morning of surgery, preop communicates with the blood bank to ensure that the blood units are ready before dispatching transport for retrieval. Delays caused by blood being unavailable in the OR refrigerator decreased significantly.
Cardiac stepdown unit, Geisinger Wyoming Valley Medical Center, Wilkes Barre, PA
The most significant outcome of the cardiac stepdown unit at Geisinger Wyoming Valley was a 58-year-old woman who was admitted with an ejection fraction of 9% after cardiac arrest postcoronary artery bypass grafting. She received a left-ventricular assist device as destination therapy. After weeks of therapy, the patient was evaluated for transplant. She was on and off the transplant list because of a fractured femur and hospitalization for pancreatitis secondary to gallbladder disease. After recovering from a cholecystectomy, the patient received her transplant. The team will always remember her and how she touched their lives.
Heartingale Squad, Lakeland Regional Health, Lakeland, FL
The Heartingale Squad at Lakeland Regional Health presented its quality improvement mobility project, “Pre- and postoperative noninvasive nursing interventions to decrease pulmonary complication in the acute care setting,” at the March 2018 American Nurses Association Quality and Innovation Conference. The outcomes of the project include decreased incidence of pneumonia, oxygen dependency, acute respiratory distress requiring higher-level care, and decreased readmission rates within 30 days of discharge due to pulmonary complications.
Scalp Cooling Task Force, Memorial Sloan Kettering, New York City
This team designed a program to bring scalp cooling to clinicians and patients throughout Memorial Sloan Kettering. Scalp cooling limits chemotherapy-induced alopecia. In March 2017, the team successfully launched scalp cooling services across all outpatient units treating women who have breast cancer. And in December 2017, the team switched vendors for a more streamlined process that also saves patients money.
Charge nurse team, Moses Cone Surgery Center, Greensboro, NC
This team rose to the challenge when its assistant director was out for several months because of illness. Some nurses created the staffing schedule and approved vacation and time-off requests. Others became more involved in the hiring process, interviewing applicants and making job offers. They collaborated with the executive director (who approved the temporary leadership transitions) to ensure that the center remained focused and able to offer exceptional care to patients and physicians. Everyone on the team has a renewed appreciation for the assistant director’s leadership contributions to the center, and the challenge strengthened and united an already robust team of nurses.
Surgical oncology team, New York-Presbyterian/Columbia University Irving Medical Center, New York City
In collaboration with the unit council, manager, clinical nurse specialist, and patient services administrator, this surgical oncology team made huge strides in improving its quality outcomes and patient experience. They set goals in January 2017 to improve their quality scores and executed them throughout the year. From 2016 to 2017, the team saw a 90% decrease in cases of Clostridium difficile, a 53% reduction in falls, a 60% reduction in catheter-associated urinary tract infections, and a 32% decrease in average length of stay.
