October 2012

Your hosts: Jody Rothe, MetaStar Stephanie Sobczak, WHA

Thank you to these organizations for sponsoring this webinar series:

A special thank you to the Wisconsin Clinical Resource Center for serving as the home base for recorded webinars and materials related to the INTERACT II collaborative

July Overview & Case Review Tools

August Communication ToolsSeptember Early Warning ToolsOctober Change in Condition

ToolsNovember Resident Transfer ToolsDecember Continuous Improvement

Tools

Share experiences with the Stop and Watch Tool

Overview of the change in condition indicators

Review the File Card examples Review the Care Paths examples Implementing the Change in Condition Tools

through small tests with staff. 30 day Action Items

Please share your experiences with the Stop and Watch tool.

What did you learn from the small tests?

Did you make any changes in order to use the Stop and Watch tool?

Why this is so important:

For the frail elderly population, status can change very rapidly.

Many times, there are early signs that would indicate something has changed

Staff are the first “line of defense”!

Any symptom, sign or apparent discomfort that is:

Sudden – in onset

A Significant change – more severe in relation to usual symptoms and signs

Unrelieved – by measures already prescribed

F157 – Notification of Physician of Change of Condition

AMDA Guidelines (see WCRC) for a standard of practices related to this.

Appendix 7 and 8 for AMDA Guidelines for notification of physician with acute changes of condition.

An INTERACT II Tool set that matches signs or symptoms and what would be noticed for a status of:

ImmediateNon-ImmediateRoutine

These tools are intended to be used by front-line staff for immediate reference as well as education.

INTERACT II – Change in Condition Cards

INTERACT II – Change in Condition Cards

INTERACT II – Change in Condition Cards - From A

INTERACT II – Change in Condition Cards - to W

Print your set of Change in Condition File cards and review with your team:

How would staff access these? What procedures would you need to put in

place for using these? Case study using these (either real-time or

review a chart) – what does the team learn as a result?

A Care Path is a document standard approach to various clinical conditions

Hospital have used care pathways successfully to reduce variation in patient care.

Also an important education tool.

An immediate resource for staff encountering one of the conditions.

Should be led by staff nurse, but include CNA and others from the interdisciplinary care team.

Tie in with the other INTERACT tools in use (Stop & Watch, Early Warning Signs)

Utilize SBAR for physician contact when the care pathway indicates.

YES

Who will try out the tool?

How many staff should try the tool?

Does this tool align with current procedure or policy (if not, consider changing)

Teach staff how to use the tool.

Test Change in Condition File Cards

Test Use of Care Paths

Test Use of Stop & Watch Tool

Try testing these tools in parallel with different groups of staff

What percent of staff should have had a chance to test and give feedback before formally adopting a tool?

Around 10%25%HalfMore than halfAlmost everyone

How would you approach getting more staff involved in testing both the Change in Condition cards and Care Paths ?

Review the Change in Condition Tools with Staff Review Care Paths with Nursing Staff Have 2 different groups of volunteers test the

Change in Condition Cards and Care Paths through small tests.

Evaluate the tests and Decide to adapt/adopt/abandon based on results

Submit data

An on-line Feedback Tool will be sent after November 7th to assess your progress on these tasks.

Thank you!

See you next month

Next month: Resident Transfer Tools