Lutheran Senior ServicesWhy we choose Interact II Tools

2

Where we started…

Data poorHealth Care ReformGrowth of short stay rehab programMove to Evidence Based Practice

3

Tools We Are Using

Resident Transfer FormChange in condition cardsCare MapsSBAR

4

TRANSFER

ENVELOPE

5

Change in Condition Cards

6

CARE

MAPS

7

Define a ProcessClinical Guidelines for Management of LRI

Assessment / Observation standards• Review Broncho-pulmonary assessment in Optimus• Define guidelines for staff

Communication• Build Profile order set “Management of URI”

– Nursing orders Assess Bronchopulmonary status BID and prn Provide additional fluids Encourage coughing and deep breathing Encourage mobility Monitor VS and O2 Sat BID and prn

– Physician orders IV fluids Antibiotic therapy Oxygen therapy Nebulizer treatments Portable CXR CBC BMP

8

Process (cont.)

• CARE PATH: Symptoms of Lower Respiratory Infection (INTERACTII)– SBAR Communication as a guide to communication with physician

Education• Develop powerpoint education tool covering the steps defines in Assessment

and Communication• Skills training

– Completing a respiratory assessment Equipment: Lung sound recordings, Double ear stethoscope

– Understanding the findings of the assessmentMonitoring

• Track hospitalizations and review using Quality Improvement Tool (INTERACTII)

• Report quarterly and include in quality Dashboard

9

Staff Education

10

Assessing Lung Sounds

http://www.easyauscultation.com/lung-sounds.aspx http://www.wilkes.med.ucla.edu/lungintro.htm http://www.cvmbs.colostate.edu/clinsci/callan/breath_sounds.htm http://faculty.etsu.edu/arnall/www/public_html/heartlung/breathsounds/contents.html

11

Challenges and Successes

12

Data FindingsRe-Hospitalization Rates

Dec Jan Feb March April ytd0%

5%

10%

15%

20%

25%

30%

The Next Step…

Partnering with Hospitals