It’s a common theme in most hospitals: the EOC team conducts their Environment of Care rounds, Nursing conducts Patient Satisfaction rounds, the Pharmacy has their own Medication Management checklists, and the C-Suite/Executive Leadership performs its own rounding duties.
To the point, we all mostly agree that it is important to check for quality, patient safety and patient experience. (High Reliability anyone?). So there are usually multiple forms of rounding being utilized throughout the hospital. Another common thread is that many hospitals are starting to discover that their out-dated, often paper-based processes don’t cut it when it comes to performance improvement or efficiency. So what’s the solution?
Implementing new department- or hospital-wide processes in an effort to improve a score, improve efficiency, or maintain continuous compliance with an accrediting body is tough, to say the least. Not to mention, there will be those curmudgeons that may kick and scream, “We’ve always done it this way.” Let’s not give those folks any ammunition and make sure we take the following into consideration when implementing digital checklists.
1. A Streamlined Process – Simply put, avoid duplicative effort. You absolutely do not want your staff thinking this new process is another layer in an already overwhelming stack. If you have other digital programs or are considering utilizing multiple tools or formats – don’t. Your staff will be more efficient with a similar tool for all of their checklists. Consolidating all data to a single platform will significantly reduce hospital-wide time spent on producing, conducting and analyzing data along with improving the overall integrity of the process.
2. Must Be Easy to Use and Intuitive - Ensure your solution is universally intuitive. A nurse conducting a CAUTI checklist should feel as comfortable as a Pharmacy tech conducting a Medication Management safety check.
3. The Process Must Be Sustainable - With the pressure on IT resources, management effort, and the extreme complexity of data-gathering (often well in excess of 300,000 annual quality observations), it is likely that you will want to use “off the shelf” programs. Shift your operational focus to conducting the rounds, correcting failing items, and launching performance improvement efforts. (By the way, if you’re not conducting checklists for reasons of performance improvement, then why are you conducting them at all?)
4. Must Be Flexible - When buying “off the shelf,” ensure that there are well-developed templates to support every performance area. Ensure they are easily customizable to your local conditions. A word of caution about customization: if you have selected the right system, the pre-built templates will meet the vast majority of your needs.
5. Follow-up Must Be Managed Automatically - Effective, closed-loop follow-up is worth a 1 to 2-point improvement in patient safety, quality of care, and patient experience. The checklist must be properly designed to manage, notify, and escalate items that need correction. Frequency must be customizable. A patient request needs immediate action, while a Human Resources file audit doesn’t have the same urgency. Ensure your operational management is not overloaded by the system. This is also a key issue in ensuring you have a single system for managers to correct items from a variety of sources.
6. Questions Must Link to Regulatory Standards - While regulatory compliance will be a simple by-product of high reliability, insist that all appropriate template questions are linked to The Joint Commission / CMS / HFAP / DNV standards. Ensure this linking is available for any custom questions.
If you would like more information or have questions on what to consider when implementing digital checklists at your hospital, feel free to reach out to the Readiness Rounds team. Also feel free to comment below!