The Scarborough Hospital (TSH) has successfully reduced its rate of hospital-acquired pressure ulcers by more than half, which has resulted in improved care and safety, as well as a cost savings of more than $350,000.
This success was achieved through a series of co-ordinated organizational improvements in process, systems and structures including: LEAN Rapid Improvement Events (RIE) used to redesign processes; moving patient assessment forms into an electronic documentation format; broad staff engagement through local discussions; and problem solving in unit-level improvement huddles.
“TSH looked at the pan Canada rate for facility-acquired pressure ulcers and saw the number was 11 per cent,” says Nurallah Rahim, Patient Care Director, Surgical Services, Orthopaedics and Rehabilitation at TSH. “Together, the team decided to set our target below the 7.4 per cent benchmark, and we are happy to report that following the RIE, our rate is now 2.94 per cent.”
The need to address pressure ulcer prevention stemmed from a best practice standard at TSH around ulcer prevention and skin assessment, which has not always been consistent.
“We want to ensure our patients receive the highest quality of care,” says Jackie Baptiste-Savoie, Clinical Nurse Specialist at TSH. “To do that, we must have a consistent process in place and support our staff by providing access to education and tools.”
Jackie adds that it’s also important to consistently report whether or not patients arrive at the hospital with pressure ulcers, so for benchmarking purposes TSH can accurately track the actual number of pressure ulcers that were acquired onsite.
“RIEs are meant to encourage staff to challenge the status quo and identify inefficiencies in routine practices. I am really impressed with the focus the team had and their willingness to challenge themselves even if meant stepping out of their comfort zones,” says Alfred Ng, Director, Innovation and Performance Improvement Office at TSH. “It’s a great example of what these events are meant to do.”
The RIE process aims at affecting positive change by adding value to the patient experience and increasing patient satisfaction, and TSH has achieved significant success in many areas throughout the hospital since implementing performance improvement initiatives. The hospital is committed to expanding these initiatives, which will build on current success, as well as develop best practices to enhance care for continued excellence in the future.