reduction in hospital-acquired pressure injury
the fy 2018 to FY 2019
Stanford Health Care’s Wound, Ostomy, and Continence Nurses (WOCN) are an interprofessional team of specialty-trained nurses who work toward advancing the quality of life for patients with wound, ostomy, and continence needs through assessment, treatment, advocacy, and ongoing staff and patient education. As certified WOCNs, this team of nurses are a part of a professional and international nursing society with over 5,000 engaged healthcare professionals.
One of the WOCN’s impactful initiations, led by Chungmei Shih MSN, RN, CNS, CWON is the Collaborative Alliance for Nursing Outcomes (CALNOC), which is a database of nursing-sensitive quality indicators that helps nursing leaders articulate the value of the professional nursing practice. The CALNOC database, owned by Press Ganey, is used to monitor care, improve care, achieve quality and safety goals, and to conduct research.
Stanford Nursing conducts quarterly CalNOC (the Collaborative Alliance for Nursing Outcomes) study to identify the prevalence rate of hospital-acquired pressure injuries (HAPI) and restraint use on a specific date. it starts with an hour of HAPI prevention review and reinforcement while recognizing all the excellence that led to a hospital-wide reduction of HAPIs exemplifying SHC nurses’ and inter-professionals’ collaborative commitment towards patient safety and outstanding patient outcome. Study team members (40 RNs) then conduct a head-to-toe skin assessment on all patients who were admitted to ICUs, AAUs, and ED. The data collected is used for benchmarking and quality improvement purposes.
The Vascular Access Services (VAS) team is one of Stanford Health Care's team of internal experts that support interprofessional practice across the Patient Care Services. Sean Lau, MBA, RN, VA-BC, a member of the VAS team has been a leader in exemplary professional practice.
In 2019, Sean's involvement in the Association for Vascular Access (AVA) and academic achievements embolden him to advance the science of vascular access and share his expertise nationally while enhancing the professional practice environment of nursing.
Sean has been committed to educating RNs regarding current best practices in vascular access while supporting initiatives to reduce hospital-acquired Central Line-Associated Blood Stream Infections (CLABSI).
Over the past year, he spent time training nurses throughout the enterprise to insert ultrasound-guided peripheral IVs to support patients that had difficult peripheral vascular access.
"SHC’s supportive work environment empowers nurses like me to collaboratively work with clinical nurses and other disciplines in promoting outstanding patient outcomes."
Sean Lau, MBA, RN, VA-BC
Sean presented at the Association for Professionals in Infection Control (APIC) in 2019 with 5 other lead clinicians from the AVA on the subject of VEINglish. Sean’s presentation focused on addressing concerns of acute care hospitals in shifting to clinically indicated removals of peripheral vascular access devices, and the standardization of vascular access devices to minimize IV therapy administration error.
If the patient has a clinical symptom, the CAS nurses take the call, and utilize standardized clinical protocols to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may contact the on-call physician based on the clinical protocol. Nurses must be able to appropriately be trained to triage and/or escalate many different scenarios (ie. chest pain, suicide, prescription refills, oral anticoagulation clinic, UTI’s, and pediatrics). They also provide an ear to ease the patients fears.
Since August 2015, CAS has managed >700,000 calls from 97 clinical specialties.
Reporting is built into our electronic health records.
92% of patients had all of their need met.
Average 4% of the calls were escalated by CAS staff to the physician on call.
Average 5% of the patients were triaged to ED by CAS.
95% of patient adhered to care advice provided by CAS.
Also, in May 2016 CAS also began post discharge follow-up phone calls within 24-hours to patients discharged from inpatient units
Congratulations to the exceptional Stanford Health Care CAS team, we applaud your excellence!
The Utilization Review Accreditation Commission (URAC) accreditation process demonstrates a commitment to quality service and serves as a framework to improve business processes through benchmarking organizations against nationally recognized standards.
In October 2019, Clinical Advice Services (CAS) was awarded Full Accreditation
with the Utilization Review Accreditation Commission (URAC), akin to Joint Commission, and the gold-standard for health call centers meeting excellence in quality, safety, and satisfaction.
Findings note included significant attention to quality, safety, and rigor around the program, monumental strides in meeting the 30-minute callback time from an RN (a core metric), thoroughness of documentation as evidenced by substantial EPIC medical record reviews, and comprehensive interviews with Leadership, RNs, and CAs.