Triumphs on the Road to Quality Improvement Urology Service NRH Bernie Lee, Kelley Lennon & Eva Wallace

The Team Risk Management Urology Consultant Urology Nurses Clinical Specialist Ultrasonographer Phlebotomy Xray Urology Administration

IHI Model for Improvement What are we trying to accomplish How will we know that a change is an improvement What changes can we make that will result in an improvement

Primary drivers Secondary drivers

Challenges and Successes Baseline Data Collection Swim Lane – Process Map – Patient Flow at the Clinic Use of Rapid PDSA Cycles, displayed using Run Charts Digital Dictation – “just do it” Communication Frameworks ISBAR Challenges: –Reduction in Nursing Staff Ratio –Delays in scheduling due to Admin training –Number of unexpected processes that needed improvement. Successes

Patient Registration - 78% of patients now go through registration on arrival at the clinic in comparison with pre QI of <33%

ISBAR Communication Framework All documentation in urology is now completed using the ISBAR framework Introduction / identification Situation Background Assessment Recommendations

No matter how good you get you can always get better and that’s the exciting part Tiger Woods