![]() It was part of their clinical routine, and when necessary, they knew patients could begin treatment and slow the spread of the disease. The staff at the Radiation Oncology department at the Los Angeles Medical Center knew well the importance of identifying cancer early. “Within a few weeks, we had everyone on board and our tubing project took off.” “At first it was a little difficult to change the habits of the nursing staff,” Fought says. She attributes the success to the leadership of the team and notes that since the team has advanced to a Level 4 on the Path to Performance, team members have more camaraderie and are more engaged. Heidi Rolf, the department manager and the UBT’s management co-lead, is proud of the work the team has accomplished. “The team realized this was such a great idea and wondered, ‘Why haven’t we been doing this all along?’” Greater camaraderie ![]() “This was such an easy tweak-we just needed to think outside of the box,” says Lacey Anderson, RN, the Infusion Team Lead and a member of OFNHP, who was involved in the project. If every Kaiser Permanente oncology infusion department adopted this practice, the savings would be dramatic. This team alone was able to save $25,000 a year. “I had no idea that we would be saving the unit that much money by conforming the tubing,” Fought says. The costs add up if primary tubing is used when it’s not necessary. Primary tubing is $4.10 per unit, short tubing is $3.65 and secondary tubing is 65 cents. These types of tubing are appropriate when the medication has a low potential for a negative reaction. In this situation, if the valve is closed, more medication is in the line and will flow into the patient until the tube is empty. When the short tubing or secondary tubing is used, the valve to stop the flow of medication is farther from the patient. Appropriate times for less expensive options If the drugs being used have a high potential for an adverse reaction, it’s essential to use primary tubing, so that if there is an emergency and the line has to be shut, only a very little additional medication reaches the patient. When primary tubing is used, the valve to stop the flow of medication is very close to the patient’s body. When patients come in for chemotherapy or other infusion medications, the drugs are administered via an IV: The bag holding the medication is hung on a pole, with a line that goes into the patient’s vein. That prompted the department’s unit-based team to start an improvement project that wound up saving $25,000 a year. Why, he wondered, was primary tubing used for low-reaction drugs instead of the less-expensive short or secondary tubing? It started with a question from Oncology RN Tom Fought, a member of the Oregon Federation of Nurses and Health Professionals (OFNHP), at the Interstate Medical Office in the Northwest. “Our providers are very invested,” she says. You won’t find doctors who think UBTs are just for clinic staff on this team, says Baxter. Getting physicians involved also has been part of this UBT’s success. Now the team is taking on more complex cross-departmental initiatives, such as trying to make available online the big packet of paperwork patients need to complete before a first Ob-Gyn visit. “Small wins help develop confidence,” says Baxter. ![]() “These are important to KP, and they helped us gel as a team,” says Baillie. “From that alone, you have all the data you need.”įor instance, the Alpharetta team’s first efforts were to improve clinic start time and get a second blood pressure test for patients with high initial readings. “KP makes no secret about what is important to it,” says Baillie. “You don’t need to reach for the stars right out of the box.” Pick your projects wiselyĪnd, says Baillie, there’s no need to look any further than Kaiser Permanente’s organization-wide and regional priorities to find plenty of ideas for performance improvement projects-and a wealth of data that is being collected regularly. “We started with the low-hanging fruit,” says Baillie, RN, a member of UFCW Local 1996. “We knew the steps in the process and what to expect,” says Baxter, the department’s charge nurse.įledgling teams should begin with small performance improvement projects, they say. They both drew on their experiences to guide their new team when they became co-leads at Alpharetta. Jane Baxter and Ingrid Baillie had been UBT co-leads at two different clinics when they each got a new job with the Alpharetta Ob-Gyn department. That’s what happened when the Alpharetta Ob-Gyn UBT in Georgia zoomed from Level 1 to Level 4 in just 10 months after two nurses from two different high-performing UBTs transferred there at the same time. Sometimes the best way to spread effective practices is to spread experienced people. ![]()
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