Download - Safer Healthcare Now!
Safer Healthcare Now!
Cape Breton Regional AMI Collaborative
Dawn Hollohan & Sharon MacLeod
Cape Breton Regional Hospital
The Beginnings
GOAL:
Door to Thrombolytic within 30mins for 90% of patients
presenting with AMI by March 30th 2010
Change Ideas
Education re AMI collaborative (posters, email, in-service)
Syncing of Clocks to EKG machine
Data collection FORM (staff engagement …FUN initiative)
Recommendations from industrial engineer re process improvement
We mapped the process.
Change Ideas
Changed phone in triage room to a Speed dial & educated the nursing staff to use same
White board outside triage room Improving EKG Pt room identification.
Place and an EKG machine within the dept.
Change Ideas
Sharing the 10minsER owns 4 mins EKG dept owns 6mins
Change to Delegated Medical Function (DMF)
Now EKG is 1st priority
Data collection sheet
Bonus…there was help with data collection!
Atlantic AMI Virtual Collaborative - Individual AMI Patient Data Sheet
Name of Healthcare OrganizationOctober 2009
BASELINE DATA
Patient MRN1st
medical contact
Arrived ED
1st ECGDiagnostic ECG done
Diagnostic ECG Read by MD
Thrombolytics Started
COMMENTS
1 CB295114 21:07 21:07 21:25 21:25 21:27 21:35
2 CB40581 19:50 19:50 19:52 19:52 20:30 20:35
3 C B97923 12:05 12:05 12:07 12:07 12:08 12:10
4 CB109589 14:00 14:00 14:11 14:11 14:15 14:28
5 CB58127 12:46 12:46 12:48 12:48 12:48 12:50
6 CB00113381 12:36 12:36 15:11 15:11 15:15 15:45
7 CB313381 10:20 10:20 10:24 10:24 10:27 10:40
8 CB127849 15:27 16:00 16:12 16:12 16:15 16:53 EHS
9 CB203175 21:47 22:55 21:50 21:50 21:55 22:25 EHS
10 CB320465 4:42 4:42 4:46 4:46 4:47 4:49
11 CB34646 6:28 6:28 6:40 6:40 6:42 6:46
12 CB67665 10:26 10:26 10:33 10:33 10:37 10:40
13 CB263621 19:35 20:30 19:43 19:43 19:47 20:02 EHS
14
Cape Breton Regional HospitalMonth and Year of Data Collection
Enter ALL time data using a 24 hour clock i.e. 8:30pm = 20:30. Be sure to include a colon(:) between the hours and minutes.
TIME OF...
Analysis tab of the tally sheet…
Atlantic AMI Virtual Collaborative - Individual AMI Patient Data Sheet
Name of Healthcare Organization
October 2009
Patient MRN1st Medical Contact
to 1st ECGArrived ED to
1st ECGDiagnostic ECG Done
to Read by MDDiagnostic ECG Read by MD
to Thrombolytics Started
1st EHS Contact to Thrombolytics
Started
Arrival ED to Thrombolytics
Started
Thrombolytics w/i 30 minutes of Arrival in
ED or 1st Medical Contact
1 CB295114 0:18 0:18 0:02 0:08 0:28 0:28 12 CB40581 0:02 0:02 0:38 0:05 0:45 0:45 03 C B97923 0:02 0:02 0:01 0:02 0:05 0:05 14 CB109589 0:11 0:11 0:04 0:13 0:28 0:28 15 CB58127 0:02 0:02 0:00 0:02 0:04 0:04 16 CB00113381 2:35 2:35 0:04 0:30 3:09 3:09 07 CB313381 0:04 0:04 0:03 0:13 0:20 0:20 18 CB127849 0:45 0:12 0:03 0:38 1:26 0:53 09 CB203175 0:03 NA 0:05 0:30 0:38 NA BY EMS or NO Data
10 CB320465 0:04 0:04 0:01 0:02 0:07 0:07 111 CB34646 0:12 0:12 0:02 0:04 0:18 0:18 112 CB67665 0:07 0:07 0:04 0:03 0:14 0:14 113 CB263621 0:08 NA 0:04 0:15 0:27 NA BY EMS or NO Data
TOTAL Count ECG w/i 10 mins 8 TOTAL Count Lytics w/i 30 mins 8TOTAL Count ECG NOT w/i 10 mins 5 TOTAL Count Lytics NOT w/i 30 mins 3
Month and Year of Data Collection
Cape Breton Regional Hospital
Data on this worksheet will automatically be calculated from the information entered on the "Individual Times" worksheet
TIME To...
Why change it?
Why does 10 minutes pass so quickly? Who was using up all the time? (Triage or
ECG?) How close are we to the goal? Is the mean time to ECG helpful?
Would the median be better? Does the time of day matter? Was sampling the best method for the
team?
The data informs the team
Name of Healthcare Organization
July 2010
Patient # CB#1st Medical Contact
Transferred from another site? Time Period
1st Medical Contact by EHS
Time ECG Called
1st ECG Time
1st ECG-1st Medical Contact
1st ECG - Time ECG Called
ECG Within 10 minutes?
ECG Within 13 minutes?
1st ECG - Time ECG Called
15 21098 1:58 No 5 No 2:01 2:06 0:08 0:05 Yes Yes 0:0516 259264 5:28 No 1 No 5:30 5:37 0:09 0:07 Yes Yes 0:0717 259245 9:30 No 1 No 9:38 9:40 0:10 0:02 Yes Yes 0:0218 33958 8:00 No 1 No 8:05 8:13 0:13 0:08 No Yes 0:0819 325598 1:32 No 1 Yes 1:30 1:30 ############## 0:00 Yes Yes 0:0020 288829 8:07 No 1 No 8:09 8:15 0:08 0:06 Yes Yes 0:0621 64702 18:57 No 4 No 18:57 19:02 0:05 0:05 Yes Yes 0:0522 105338 21:58 No 4 No 21:58 22:02 0:04 0:04 Yes Yes 0:0423 96767 23:08 No 5 No 23:14 23:15 0:07 0:01 Yes Yes 0:0124 17198 13:30 No 3 No 13:35 13:39 0:09 0:04 Yes Yes 0:0425 13724 10:07 No 1 No 10:10 10:14 0:07 0:04 Yes Yes 0:0426 63063 23:03 No 5 No 23:05 23:10 0:07 0:05 Yes Yes 0:0527 298085 20:52 No 4 No 20:53 21:02 0:10 0:09 No Yes 0:0928 66186 13:45 No 3 No 13:46 13:53 0:08 0:07 Yes Yes 0:0729 191295 11:50 No 2 No 11:56 11:57 0:07 0:01 Yes Yes 0:0130 23309 7:42 No 1 No 7:44 7:53 0:11 0:09 No Yes 0:0931 48337 11:22 No 2 No 11:24 11:32 0:10 0:08 Yes Yes 0:08
Enter ALL time data using a 24 hour clock i.e. 8:30pm = 20:30. Be sure to include a colon(:) between the hours and minutes.
Atlantic AMI Virtual Collaborative - Individual AMI Patient Data Sheet
Month and Year of Data CollectionCape Breton Regional
Changes are made based on the data
Count % Count % Period Range Count Yes No % within 10 Yes within 13 Yes 60 74.07% 3 100.00% 1 07:00 - 10:59 12 5 7 41.67% 9No 21 25.93% 0 0.00% 2 11:00 - 14:59 19 14 5 73.68% 17Total 81 3 3 15:00 - 18:59 19 13 6 68.42% 14
4 19:00 - 22:59 19 17 2 89.47% 175 22:59 - 06:59 12 11 1 91.67% 12
Total 81 60 21 74.07% 69
Mean 0:10:07Median 0:08:00
Mean 0:06:10Median 0:05:00
Within 10 min 74Within 7 min 59
1st Medical Contact to ECG
Time ECG Called to ECG
ECG called to 1st ECG
ECG within 10 minutes ECG Within 10 Minutes by Time PeriodLytic within 30 minutes
1st Contact to ECG and Thromobolytics
0%10%20%30%40%50%60%70%80%90%
100%
1
ECG within 10 minutes
Lytic within 30 minutes
In Conclusion
We cannot forget EHS !!! RESTORE Program
Our Stats
We may do hundreds of Normal EKGs but it is the ONE abnormal that we need to catch... This is our message...
Thank you.
Any questions?
Contact information:Dawn Hollohan902 [email protected]
Sharon MacLeod902 [email protected]
