1. Clinical Practice Council Increasing Quality Nursing Time at the Bedside Results of August 2011 Assessment

2. The Tool Institute for Healthcare Improvement’s Transforming Care at the Bedside Time Study Tool 306 observations made in 4 hour blocks covering 24 hrs Observations made between 8/15 and 9/5 of 2011

3. Time in Direct Care “Direct Care” 33.3% of Med/Surg Nurses’ Time was spent in Direct Care Bedside Procedure Vitals Wound/Skin Care Incontinence ADLs Administering Meds Assessment Emergency Teaching (in pt room) Care Rounds Delivering Ice/Food/Beverage Escorting Patient off Unit

4. % Waste “Waste” 6.2% of time is wasted on system delays, or searching for things Waiting Delays Looking for Equipment Looking for Supplies Looking for Info Looking for Person Retrieving Supplies Retrieving Equipment

8. Documentation: All documentation activities Computer data entry Med Activity: Administer Meds Med Activity Care Coordination: Communication w/ Care Team Report Care Conference Paging Caregiver Calling Ancillary Dept. Care Rounds Team Doc Monitoring/Assessment: Vital Signs Assessment Monitor Patient Personal Care: Incontinence ADLs Delivering Food Ice/Beverage Hunting/Gathering: Look for Supplies Look for Equipment Look for Person Look for Information Retrieve Supplies Deliver Supplies Primary Activity Domains Other: Miscellaneous activities such as hand hygiene, relieving 1:1, downtime

9. What does the data tell us? (diagnosis) What opportunities do you see? What categories should be priority? Which items add value to the patient’s care? Which items do not add value to the patient’s care? Over which items do we have high control? Moderate control? Influence only? No influence?

10. Where do we want to be? Any “aha’s” or surprises? How good do we want to be, by when? We will increase the % of time spent in _____ care from 33.6% to X% by (date) ◦How will we get there?