Vila Health: Creating a Culture of Evidence

You continue your work with the EBP intervention Team at St. Anthony Medical Center. Over the last three months, the organization has conducted an evidence-based intervention to address the hospital’s poor patient safety scores. Now, it’s time to review data about the results of the intervention. It’s also time to make recommendations for how the hospital can move forward to creating a culture of evidence.

You have an email from Andrea Branch, the EBP Intervention Team Lead.

EMAIL INBOX

Inbox – (1)

PDSA Cycle Outcomes – First Quarter 2018

From: Andrea Branch, EBP Intervention Team Lead

To: Kayla Stephens

Thank you so much for all of your work on the patient safety intervention. Here is a report on how the intervention went over the past 12 weeks. I pulled data from our tracking system for the first quarter of 2020 for the same indicators with poor performance in 2018 and 2019.

According to the data, it seems like we might be making a difference so far, but you will be the best judge of that. Here are the 2018 and 2019 yearly rates again, and at the bottom you will see the first quarter of 2020 rates:

2018

1. Patient Falls – Expected: 0 Observed: 3

2. Medical Errors causing patient allergic reaction – Expected: 0 Observed: 2

3. Staff member in Emergency Department (ED) needed urgent treatment for concussion = 1

2019

1. Medical Errors causing patient allergic reaction – Expected: 0 Observed: 4

2. Staff member in Emergency Department needed urgent treatment for lacerations = 1

3. Nurse on critical care unit slipped and broke her arm = 1

2020

1. Patient Falls – Expected: 0 Observed: 0

2. Medical Errors causing allergic reaction – Expected: 0 Observed: 1

I also wanted to mention that the EBP Intervention Team seems to think that staff members like the new Incident Reporting (IR) system.

Also, they heard about a couple of incidents where water was spilled in the ICU, and one of the nurses reported each of these incidents immediately. She said it was about time we had an IR system where we could see possible immediate results and make positive changes to the safety of our environment.

I also heard that the Lead Nurse in ICU had two huddles with all staff in the unit, including Environmental Services staff, on the importance of preventing slips and falls for both staff and patients and ensuring the floors in rooms and stations are clean and any spills are taken care of immediately. The Environmental Services staff members mentioned it to their supervisors and I guess their department will be adding one more round during the evening hours to help ensure floors are clean and not slippery for anyone. The Lead Nurse was even thinking about creating an educational poster on preventing falls to put up on the wall in the break room as a reminder.

Anyway, that is just what I heard. Maybe if there is another formal town hall or something like that we can all talk about everyone’s experiences and get some input on how it’s going for everyone with the implementation of the intervention using PDSA cycles.

I suggest you speak with Emilio Ramirez, the PDSA Team Director, to ask questions and gain insight on how you might write your final report and create a culture of evidence at St. Anthony Medical Center.

Again, thanks for all of your hard work.

Sincerely,

Andrea

St. Anthony Medical Center

You meet with Emilio Ramirez, the PDSA Team Director, to discuss your next steps, including how to move forward with building a culture of evidence at the hospital.

What questions do I need to be asking myself as I complete my final report?

Emilio: That’s an excellent question. One important question you should yourself is, “When do I want another report?” What kind of time frame is needed to ensure that you have the data you need. Another important question is, “How are we going to sustain this?” Going forward, do you have a plan to obtain continued buy-in by stakeholders, as well as the resources you need to continue with the intervention? Evaluating and Sustaining Change from EBP

EMAIL INBOX

Inbox – (1)

Final report

From: Jackie Sandoval, CNO

To: Kayla Stephens

I am aware of the success of the evidence-based intervention with the PDSA cycle team and with the nursing staff. This is great news! Now we need to spread this optimism about EBP throughout the organization.

As you write your final report and make recommendations to foster engagement by various stakeholders in the organization to create and sustain a culture of evidence. Please address the following:

· Differing opinions that existed within the medical staff.

· Organizational culture.

· Leadership strategies.

· Communication planning to share the results with stakeholders across the organization.

Thank you for all your hard work!

– Jackie

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