Intensified or new activities to... | More actively or new since beginning of project No. of teams (%) |
---|---|
Reduce pressure ulcers (28 teams) | Â |
1. regularly changing patient's position | 19 (68%) |
2. risk assessment for each patient | 18 (64%) |
3. patient information brochure on pressure ulcers | 16 (57%) |
4. compliance to a pressure ulcers protocol | 13 (46%) |
5. updating the pressure ulcers protocol | 12 (43%) |
6. occupational and physiotherapy | 9 (32%) |
7. sufficient anti-pressure ulcers mattresses | 6 (21%) |
8. specialised pressure ulcer nurse | 4 (14%) |
Average number of changes (out of eight) applied by pressure ulcer teams | 3.5 |
Improve medication safety (34 teams) | Â |
1. clinical lesson in pain reduction | 13 (38%) |
2. spreading a simple card with 'switch' guidelines | 12 (35%) |
3. reducing postoperative pain; pain score on linear scale <4 | 11 (32%) |
4. reduce degree of unnecessary intravenous antibiotics | 10 (29%) |
5. compliance to a medication prescription and administering protocol | 8 (24%) |
6. apply guideline to reduce unnecessary blood transfusion | 6 (18%) |
7. fixed medication times | 4 (12%) |
8. double check of all medication | 2 (6%) |
Average number of changes (out of eight) applied by medication safety teams | 2.0 |
Optimise operating theatre productivity (18 teams) | Â |
1. starting on time | 11 (61%) |
2. emergency procedures: re-definition of 'emergency' | 8 (44%) |
2. reallocate extra operating time based on the degree of utilisation | 8 (44%) |
4. tracking and solving disturbances in the operating theatre programme | 7 (39%) |
5. planning based on average surgery time | 6 (33%) |
5. reduce time between operations | 6 (33%) |
7. maintaining capacity for emergency available in the programme | 5 (28%) |
8. staff planning based on differences in surgery time of individual clinicians, differences in anaesthesiologists and assistants, and the experience of the team | 2 (11%) |
Average number of changes (out of eight) applied by operation theatre teams | 2.9 |
Reduce postoperative wound infections (18 teams) | Â |
1. limiting the number of persons in the operating theatre | 16 (89%) |
1. reducing number of door movements | 16 (89%) |
3. protocol for optimal administering of antibiotic prophylaxis | 11 (61%) |
4. participation in national wound infections surveillance network | 8 (44%) |
5. minimise refreshment of bandages | 5 (28%) |
6. staff reports (skin) infections and diarrhoea | 5 (28%) |
7. separate working tablet is used for each patient (bandages, instruments, gloves, deposit bags, etc; afterwards cleansing with alcohol) | 4 (22%) |
8. during wound care no beds are made, nor is the ward cleaned | 2 (11%) |
Average number of changes (out of eight) applied by wound infections teams | 3.6 |
Reduce throughput times (33 teams) | Â |
1. reserving slots for specific diagnosis | 20 (61%) |
1. reducing planning moments | 20 (61%) |
3. clear decision lines and division of responsibilities | 19 (58%) |
4. rational planning of demand on expected question | 18 (55%) |
5. introduction of one-stop shop | 16 (48%) |
6. admission on day of operation | 12 (36%) |
6. more flexible staff utilisation | 12 (36%) |
8. protocol for treatment groups (e.g., physiotherapy or informing patients) | 11 (33%) |
Average number of changes (out of eight) applied by process redesign teams | 3.9 |
Reduce waiting list (36 teams) | Â |
1. block agendas six or eight weeks in advance; cancellation only in case of emergency | 26 (72%) |
2. anticipate on fluctuations | 23 (64%) |
3. minimise types of consults | 21 (58%) |
3. plan patient consults not routinely but in the event of complaints | 21 (58%) |
5. perform diagnostics in fewer consults | 20 (56%) |
6. minimise vacations in busy periods | 17 (47%) |
7. increase the interval for consultations for chronic disorders | 17 (47%) |
8. plan realistically on the basis on actual consult length | 16 (44%) |
Average number of changes (out of eight) applied by waiting list teams | 4.4 |