Fundamental of a Successful Team Environmental Services and Patient Transport Best Practices

Transcription

1 Fundamental of a Successful Team Environmental Services and Patient Transport Best Practices September 29, 2010 Tangee B. Kizer, BSM Executive Director Environmental and Guest Services Carolinas HealthCare System

2 Carolinas Medical Center and Levine Children s Hospital

3 Carolinas Medical Center and Levine Children s Hospital Carolinas Medical Center is the flagship hospital of Carolinas Healthcare System. The 800 bed Tertiary / Quaternary Care facility cares for the largest number of critically ill patients in both North and South Carolina. On the campus of Carolinas Medical Center, Levine Children s; which is a 280 bed state of the art Hospital and the largest Children s Hospital in the region open

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5 Facility Group Snapshot Total Licensed Beds 6,000 More than 2,000 physician Over 475 health care delivery sites Facility management in 24 NC/SC counties 29 Affiliated Hospitals (owned or managed) Employs more than 48,000 employees

6 Environmental Services and Patient Transport Best Practices Objectives-upon completion of presentation attendees will have a more in depth understanding of the following: Required skill set for the Environmental Services Aide and the Patient Transporter to ensure highest level of performance Industry Standards related to Patient Transport response times and Environmental bed turn times and how they work hand in hand to improve patient throughput and satisfaction Team approach to improve hospital cleanliness, customer service and wait times Equipment cleaning and storage (shared space) Safe patient handling and ergonomics Leadership tips for managing large a diverse team

7 Environmental Services and Patient Transport Best Practices Hospital are expected to maintain a clean and safe environment for their patients, visitors and staff. This cannot not be achieved without the dedicated men and women who make up our Environmental Services Departments. General Duties Preparing and maintaining patient and non-patient rooms in a clean and sanitary condition Cleaning maintaining offices, bathrooms, classrooms Removing trash and soiled linen Special Duties Floor Crew; stripping and waxing floors Material Handler; moving furniture, curtains, supplies Linen Distribution throughout the hospital

8 Environmental Services and Patient Transport Best Practices Hospital patient transporters are a central part of a hospital s healthcare system. Transporters may be responsible for transporting services, collecting services, greeting services and mailing services. General Duties Taking patients to and from medical/treatment areas Admission and discharge Special Duties Assisting clinical staff with transporting ICU patients Connecting and disconnecting patients traveling on oxygen Transporting patients to and from Specialty Areas

9 Environmental Services and Patient Transport Best Practices Collecting Duties Laboratory specimens Patient charts and paperwork Equipment such as stretchers, wheelchairs, carts Less Common Duties Greeters Receptionist-patient information Mailroom services

10 Environmental Services and Patient Transport Best Practices Physical Requirements for both Environmental Aides and Patient Transporters Continuous walking, bending, stooping Ability to lift 50 pounds Pushing, pulling reaching, climbing Contact with hazard chemicals and bioharzardous waste Ability to move heavy equipment Educational Requirement High School Diploma GED Note: In most cases job descriptions for Environmental Service Aide states High School/GED preferred

11 Environmental Services and Patient Transport Best Practices Communication Skills The environmental service aide and patient transporter must be able to communicate effectively with patients, their families and hospital staff Must be able to communicate in both verbal and written form Patient Population Served Neonate Infant Child Adolescent Adult Older Adult

12 Environmental Services and Patient Transport Best Practices On the Job Training Preparing a patient s room Infection Control Procedures Appropriate body mechanics and lifting techniques Chemical usage Preparing floors-stripping and waxing Appropriate use of equipment Career Development

13 Environmental Services and Patient Transport Best Practices Customer Services Training AIDET Training (acknowledge, introduce, duration, explain and thank-you) Key words at Key Time Managing up other departments 5/10 Rule Assisting lost patients and visitors

14 2009 Environmental Services Performance Snapshot Number of beds Total number of non-management FTEs 242 Total number of beds turned 101,768 Average response time 27 minutes Average clean time 31 minutes Average turn time 58 minutes Industry standard for bed turn time 60 minutes

15 Environmental Services Courtesy and Helpfulness of Environmental Service Aide 90.6 Percent of Excellence/Goal 80 th Percent

16 Environmental Services Inpatient Cleanliness 84.6 Percent of Excellence/Goal 80 th Percent

17 2009 Patient Transport Performance Snapshot Number of Beds 800 Total Department FTE s Number of Patient Transport FTE s Patient Transports 223,063 Average Minutes to Dispatch 10 minutes Average Response Time 22 minutes Average Completion Time 31 minutes Patient Discharges 47,289 ( 80% of total patient discharges are done by Guest Services) Discharges are 21% of Total Patient Transports Industry standard for average completion time 30 minutes

18 Patient Transport Discharge Process 70.5 Percent of Excellence/Goal 80 th Percent

19 2010 YTD Patient Transport Discharge Process 84.2 Percent of Excellence/Goal 80 th Percent

20 Patient Transport Overall Quality of Care 86.7 Percent of Excellence/Goal 80 th Percent

21 Environmental Services and Patient Transport Best Practices Team approach to improve patient satisfaction Environmental Services, Patient Transport and Bed Management use same vendor software for bed assignment, bed cleaning and patient transport The systems talk to each other allowing for better communication during crunch bed times Both Environmental and Patient Transport participate in daily Bed Huddles with Nursing Administration to prepare for discharges and admissions (10am daily) Opening Support Call Center for Environmental and Patient Transport-Fall 10 Combined training on Services Excellence tools such as AIDET, Key Words at Key Times Combined training on Body Mechanics and Respiratory Fit Training Both areas have unit based governance teams Patient transport employee monitor public restrooms and log calls to EVS for cleaning Purchased sweeper to maintain cleanliness of all lobby areas Patient transporters on light duty are assigned to EVS to clean furniture and make beds

22 Environmental Services and Patient Transport Best Practices Equipment Storage and Cleaning Combined policy for equipment retrieval was created to better assist clinical staff with who to call when equipment and furniture is left on the unit For bed, stretcher, wheelchair and furniture pick up clinical staff are instructed to call Patient Transport Dispatch for assistance/after hours they call Environmental On-Call Supervisor Patient Transport retrieves all stretchers and wheelchairs Patient Transport calls Environmental Services for retrieval of all beds and other furniture left on the nursing units Environmental Services and Patient Transport work together in the cleaning of all Patient Transport Equipment. In addition to daily and monthly cleaning Environmental Services provides through use of an outside vendor once a year deep cleaning for patient transport equipment Environmental Services and Patient Transport share equipment storage space

23 Best Practices in Safe Patient Handling and Ergonomics for Environmental Services and Patient Transport Patient Transporters are at a great risk when lifting patients out of bed. If the lift is not done properly, the worker can severely injury his neck or back. The transporter not only risk endangering themselves, but runs the risk of mishandling, dropping and injuring their patient.

24 Patient Care Ergonomics for Environmental Services and Patient Transporters Ergonomics is the science of fitting the job to the worker When there is a mismatch between the physical requirements of the job and the physical capacity of the worker; work-related injures can result (back, neck, rotator cuff) Manually lifting and transferring patients are high risk activities, both for the transporter and the patient Employee injuries lead to increased cost, turnover, staffing shortages

25 Patient Care Ergonomics for Environmental Services and Patient Transporters Safe Patient Handling Tips Train staff on appropriate body mechanics and transferring lifting techniques Ask for help if it does not feel right do not do it or use appropriate lifting devices Minimize the distance traveled when transferring a patient Place wheelchair and stretcher close to bed Lock wheelchairs and stretchers before transferring patient Ensure you have a clear path for transporting Give short and simple instructions to the patient

26 Patient Care Ergonomics for Environmental Services and Patient Transporters Proper Body Mechanics Maintain natural curves of your spine When you need to lend forward, bend at your knees not at your waist Get as close as possible; the farther the patient is from you the greater the stress on your back Avoid having the patient hold on to you Adjust bed height so you can get one knee on bed

27 Patient Care Ergonomics for Environmental Services and Patient Transporters Proper Body Mechanics Step or pivot with your feet to turn your body as a unit Arm and hand position: Use and elbow in, palms up position Use pads or linen to make a handle by rolling the linen or pad and griping with your palms

28 Patient Care Ergonomics for Environmental Services and Patient Transporters Proper Body Mechanics Use a wide and staggered base of support at least a shoulder-width; this will protect the employee while moving from side to side A staggered base one foot slightly in front of the other also helps protect the employee when doing front-to-back movements Use your body weight and bend knees Use the muscles of your legs and buttocks

29 Patient Care Ergonomics for Environmental Services and Patient Transporters Lifting and Repositioning Equipment Devices Gait Belts use for transferring from sitting to standing position Sliding Boards use for transferring patients with weakness in lower extremities Mechanical Lift - lifts patients unable to transfer safely using 1 to 2 people Transfer Chairs stretchers/recliners/chairs designed to allow for lateral transfers Mechanical Stand Assist Lift device that assists patients who are able to bear weight and transfer between seated surfaces Motorized Beds for all patient transport movement; except wheelchairs

30 Leaders Tips for Managing a Diverse Team Invest in Management Training for your Leaders Peer Interviewing Conflict Management Time Management Effective Communication Establishing Partnerships Team Building Delegation Coaching for Improved Performance High/Middle/Low Performer Conversations Set Smart Goals (specific, measurable, achievable, realistic and time specific Peer Interviewing Orienting The New Employee roll out the welcome mat

31 Leaders Tips for Managing a Diverse Team Combine Customer Service Training to ensure that both departments receive same level of training AIDET Managing up other Departments Rounding for Outcomes Defining High, Middle, Low Performers High, Middle, Low Performer Conversations Recurrent Training Continued Education Service Recovery

32 Leaders Tips for Managing a Diverse Team Create Unit based Governance Teams and empower them to make decisions that impact their areas of responsibility Invest in their career development Invest in new employee orientation and recurrent training Reward and recognize their accomplishments Send Thank-You Notes Get to know your employees and let them know that you care and value them as an employee Round on your leaders on a monthly basis

33 Environmental Services and Patient Transport Best Practices Let s review our objectives Required skill set for the Environmental Services Aide and the Patient Transporter to ensure highest level of performance Industry Standards related to Patient Transport response times and Environmental bed turn times and how they work hand in hand to improve patient throughput and satisfaction Team approach to improve hospital cleanliness, customer service and wait times Equipment cleaning and storage (shared space) Safe patient handling and ergonomics Leadership tips for managing large a diverse team

34 Environmental Services and Patient Transport Best Practices Where the objectives meet?

35 Thank You, Tangee B. Kizer, Executive Director Environmental and Guest Services