LAUNCH ROUNDSLittleton Adventist Hospital

Centura’s 10th Annual EBP & Research Conference

November 10, 2017

LAUNCH ROUNDS – LEAN A3

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COMMUNICATION CIRCLE

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REASON FOR ACTION:

“Teamwork, efficient processes, and

seamless communication can mean the

difference between a good day and a

bad one. Multidisciplinary work rounds

are a proven method for cementing

these elements into our daily practice

and are a contributing factor to great

patient care and professional satisfaction.”

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LAUNCH ROUNDS – LIFT OFF

April 4, 20164N, 5N, 6N

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LAUNCH ROUNDS

GUIDE

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LAUNCH ROUNDS PROCESS

▪ Required Participants:

▪ LIP (Hospitalist/LIP)

▪ PCN (Patient Care Nurse)

▪ ANM (Assistant Nurse Manager)

▪ CM (Case Manager)

▪ Rx (Pharmacist)

▪ PT/OT (Physical/Occupational Therapy)

▪ PRN Participants:

▪ SLP (Speech Language Pathologist)

▪ RT (Respiratory Therapy)

▪ Palliative Care

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LAUNCH ROUNDS PROCESS

▪ 7 days/week with modifiedteam on Saturday &Sunday

▪ Begin at 0930 with firstroom on unit & work insequential order byhospitalist group

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LAUNCH ROUNDS PROCESS

1. Brief discussion outside the

room (less than 60 sec)▪ Family dynamics and/or concerns

▪ “Anything I’m walking into?”

▪ Don’t discuss anything outside the room that

will need to be repeated inside the room

▪ Knock, request permission to enter. Foam in.

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2. Inside the room (goal: 5-7minutes)

▪ LIP & PCN: Enter room first for physicalassessment.

▪ LIP acknowledges patient and introducesself.

▪ “We are here for our team rounds. We willexamine you privately and then invite therest of the team in.”

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LAUNCH ROUNDS PROCESS

LAUNCH ROUNDS PROCESS

2. Inside the room, cont.▪ Rest of team is invited in the room by LIP

▪ LIP introduces team by role, then statespurpose: “We are rounding as a team on allpatients to launch the day. Our few minutestogether now help ensure coordination ofyour care.”

▪ ANM has patient EMR open on WOW andenters orders as verbalized.

▪ LIP briefly presents the patient, then calls oneach discipline to provide their updates.

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LAUNCH ROUNDS PROCESS

2. Inside the room, cont.▪ PCN – Brief update on any change in status and last

shift review

▪ PT/OT – Assist level and functional status, dispositionrecommendation, discharge needs

▪ CM – Med prior authorization needs, insurancelimitations, clarify discharge date, transportationneeds

▪ Rx – Has EMR open and addresses antibioticstewardship, VTE prophylaxis, anticoagulation needs,IV to PO, therapeutic duplication

▪ LIP – Concludes rounds with safety checklist andthanks the patient for their time and opportunity tocare for them.

▪ TEAM foams out. 12

SAFETY CHECKLIST

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LAUNCH ROUNDS PROCESS

3. Immediately outside the

room, after patient visit▪ LIP, ANM, Rx – clarify any orders entered

▪ TEAM – verbal confirmation of action/follow-

up items and clarification of any questions

▪ ANM – directs team to next room

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VIDEO

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DATA REVIEW &

ACCOMPLISHMENTS –

TELE DAYS

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720

832

655

733723

718 731

613

662

766

581

723

500

550

600

650

700

750

800

850Tele Days - 4N, 5N, 6N

# of Tele Days Launch Rounds Begin 4.4.16

DATA REVIEW &

ACCOMPLISHMENTS –

CATHETER DEVICE UTILIZATION RATE

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0.180.17

0.21

0.15

0.140.16

0.160.15

0.130.13

0.13 0.110.13

0.150.14

0.13

0.00

0.05

0.10

0.15

0.20

0.25

Oc

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6

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6

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r-1

6

Ap

r-1

6

Ma

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6

Ju

n-1

6

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l-16

Au

g-1

6

Se

p-1

6

Oc

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7

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Acute Care Catheter Device Utilization Rate- 4N,5N,6N

Catheter Device Utilization Rate Launch Rounds

DATA REVIEW &

ACCOMPLISHMENTS –

PHYSICIAN COMMUNICATION

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66.70%68.20%

71.50%

65.70%

69.20%71.70%

74.80%77.10%75.60%

78.20%77.00%

78.70%

60%62%64%66%68%70%72%74%76%78%80%82%84%86%88%90%

HCAHPS Physician Communication (4N,

5N,6N)

% Top Box Linear (% Top Box)Launch Rounds begin

DATA REVIEW &

ACCOMPLISHMENTS –

RN COMMUNICATION

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86.70%

76.60%

83.40%

73.40%

76.30%

73.30%

77.70%

80.20%79.30%

84.80%

78.40%

82.70%

60%

62%

64%

66%

68%

70%

72%

74%

76%

78%

80%

82%

84%

86%

88%

90%HCAHPS Nurse Communication (4N,

5N,6N)

% Top Box Launch Rounds Begin

DATA REVIEW &

ACCOMPLISHMENTS –

READMISSIONS

▪ Overall 7 Day Readmission Rate

(Not risk adjusted) - Medicare /

Overall – Goal = 2.7%

▪ FY16 2.9%

▪ FY17 2.4%

▪ 12 month rolling 2.4%

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DATA REVIEW &

ACCOMPLISHMENTS –

MORTALITY

▪ Mortality rate overall (O/E) –

Goal = 0.9

▪ FY16 0.86

▪ FY17 0.76

▪ 12 month rolling 0.76

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DATA REVIEW &

ACCOMPLISHMENTS –

MORTALITY

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DATA REVIEW &

ACCOMPLISHMENTS –

CASE MIX INDEX

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DATA REVIEW &

ACCOMPLISHMENTS –

LENGTH OF STAY

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DATA REVIEW &

ACCOMPLISHMENTS –

LENGTH OF STAY

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DATA REVIEW &

ACCOMPLISHMENTS –

STAFF SATISFACTION

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DATA REVIEW &

ACCOMPLISHMENTS –

STAFF SATISFACTION

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THANK YOU!

QUESTIONS???

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