1. SNAPSHOTS OF CHANGE UBTs are getting results Examples of operational success December 2012

2. SNAPSHOTS OF CHANGE Lab hailed as it cuts taxi costs WHAT THEY DID Members of this team at the North Lancaster Medical Office in the Northwest reduced the number of stat specimens—those needing urgent processing—that are delivered via taxicab by working with Kaiser Permanente’s own transportation couriers. Visit LMPartnership.org for ideas and tools for your team. Laboratory, North Lancaster, Northwest

3. SNAPSHOTS OF CHANGE Team cuts overdue meds by half WHAT THEY DO To reduce the number of medications being given late to patients, this Redwood City (Northern California) team now: Posts laminated cards at each med station listing where medications are delivered and which drugs are typically stored at each location Delivers medications to med-surg departments 15 minutes before they are scheduled to be administered, allowing more time for drug preparation Receives daily fax of on-shift nurses’ cell phones, allowing pharmacy staff to call when a patient’s new medication is ready for pick up Uses color-coded bins to distinguish between newly prescribed medications and drugs physicians have discontinued for that patient Visit LMPartnership.org for ideas and tools for your team. Redwood City Inpatient Pharmacy

4. SNAPSHOTS OF CHANGE Medication record-check keeps patients safe WHAT THEY DO Dissatisfied with the high percentage of patient records in KP HealthConnect that had duplicate medications listed, the team did a manual cleanup of patient charts. Over a three month period team members would: Call patients and ask them to bring their medications to the next appointment Review and confirm prescription orders with the patient, nurse practitioner and clinical pharmacist Remove duplicate medications Expand the review to include infusion and one-time- only medications 31 points (from 46% to 15%) 31 points (from 46% to 15%) $90,000 Drop in duplicate medications on file Savings from avoided hospital admissions Visit LMPartnership.org for ideas and tools for your team. Infectious Disease/Oncology, Cumberland Medical Offices, Georgia

5. SNAPSHOTS OF CHANGE New printers lead to shorter lines WHAT THEY DID Members of this team in Colorado were frustrated with an ongoing printer issue: repeat paper jams and frustrating delays for patients and staff. Using a simple tick sheet, staff members tracked how often the printer was jammed, how much paper was thrown away and toner wasted, time spent with IT getting printers working again, and most importantly, patient wait times. The UBT took its findings to the purchasing department and had new printers within a week. Visit LMPartnership.org for ideas and tools for your team. Patient Registration, Franklin Medical Office, Colorado

6. SNAPSHOTS OF CHANGE Team nets $10 million in Medicare reimbursement WHAT THEY DID Members of this UBT discovered a technical issue with Kaiser Permanente’s partner hospitals in the region that resulted in incomplete physician signatures on patient charts. This glitch prevented KP from submitting bills for hospital stays and procedures to Medicare for reimbursement. After the error was corrected, the team reviewed 26,000 hospital inpatient notes for 2010. Since then, the team has captured more than $10 million in reimbursements. The team attributes its ongoing success to: quick huddles, holding each other accountable and transparent communication. Visit LMPartnership.org for ideas and tools for your team. Medicare Risk Business Services, Colorado

7. SNAPSHOTS OF CHANGE Optical team making fewer corrections to glasses WHAT THEY DID To curb the growing number of times that members’ prescription glasses needed to be fixed or replaced, staff members at the Optical Center in Redlands now: Log each redo in a tracking book. Troubleshoot service gaps and address them with a newly created “redo monitor” and lead optician taking primary responsibility. Use KP HealthConnect to identify possible factors contributing to vision problems. Collaborate with optometry and ophthalmology units in problem solving. Counsel patients on eye health and manufacturing warranty limits. Visit LMPartnership.org for ideas and tools for your team. Vision Essentials Optical Center, Southern California

8. SNAPSHOTS OF CHANGE Supply team cuts annual linen costs WHAT THEY DID Members of this Panorama City, Calif., team reduced annual linen costs in the Maternal Child Health department by educating other hospital staff about the true costs of buying and washing linens. The team created and used storyboards, which provided a confidence-boosting roadmap for staff members who are inexperienced at public speaking. Visit LMPartnership.org for ideas and tools for your team. Materials Management, Southern California

9. SNAPSHOTS OF CHANGE “Shot nurse” takes the pain out of waiting WHAT THEY DID Members of this team at the Honolulu Clinic shortened the average wait time for injections by: Designating a “shot nurse,” whose main duty for the day is to give patients injections. Using a whiteboard to communicate who is the day’s shot nurse and who is the floor nurse (who directs patients to the shot nurse and helps with shots when needed). Using Lotus Notes Sametime instant messaging to alert clinic nurses when a patient checks in. Visit LMPartnership.org for ideas and tools for your team. Obstetrics and Gynecology, Hawaii

10. SNAPSHOTS OF CHANGE Improved label printing saves money WHAT THEY DID Pharmacy technicians in Cumberland, Ga., now get the medication off the shelf before typing in the prescription or passing the prescription on to a pharmacist. This helps them select the right product from the National Drug Code database and increases the likelihood that labels will not need reprinting. They also found a way to clearly identify which prescription drug containers have been opened, improving inventory control and preventing delays. Visit LMPartnership.org for ideas and tools for your team. Clinic Pharmacy, Georgia

11. SNAPSHOTS OF CHANGE Collaboration gets teams top patient satisfaction WHAT THEY DID UBTs in two Sunnyside Medical Center departments — Labor & Delivery and Women & Newborn Care—worked together on the same service goals. They focused on key drivers of overall satisfaction, including hospital quiet and good communication. As a result: Nurses try to respond to all call lights within three dings, regardless of which nurse is assigned to the patient. Use of the Nurse Knowledge Exchange and patient rounding have minimized interruptions, reduced noise levels and improved communication. The unit’s report rooms, where staff noise levels tend to be higher, now have doors that close automatically. Visit LMPartnership.org for ideas and tools for your team. Women and Newborn Care, Northwest 57%