Message from Melissa Grant, Chief Medical Officer
Welcome to the first edition of Medical Staff News
SOUTH PUGET SOUND – I am excited to join the team here at Providence Swedish South Puget Sound, and for the opportunity to work with this skilled medical staff team. We will be sending this newsletter the first week of every month. I look forward to using this platform to communicate with you and elevate some of the prestigious work of our medical staff.
See below for some key points which are most important to me for this month.
- Communication and Feedback:
First Medical Director’s Leadership Forum will be in April/early May. Look for invite coming soon. The intent of this forum is to provide a scheduled opportunity for medical staff leadership and hospital administration to enhance communication. This meeting will provide a platform to vet and discuss changes, new ideas, and initiatives with an opportunity to translate what is going on at the system level and how it applies to us.
- What to watch:
Length of Stay (LOS) and LOS O/E (observed to expected). Our contract/agency costs continue to be high, and our emergency departments are full of boarders needing beds. Our nursing leadership is implementing several initiatives to hire the nurses we need and to improve patient flow. In order to more efficiently move patients through our systems we need to decrease our average LOS and get our O/E down as close to 1 as possible (or even lower for some patients). Our current ALOS is 5.66 days as of February 2023, and our GMLOS (geometric mean LOS) is 1.48 O/E. Please continue to think on how we as providers can contribute to this work and more efficiently get patients dispositioned quickly to the right location when it's medically appropriate. As you identify barriers, let me know so that we can work to remove them. Some that we are already working on include scheduling outpatient follow-up at discharge, discharge planning early in the course of admission, pursuing placement options early in the admission, and increasing knowledge of general inpatient care (GIP) and palliative care options.
- Quality Matters:
We are in the window for our Joint Commission Survey at St. Peter Hospital. Based on prior trends, the below list are prior findings that are refreshers for providers to brush up on:
Brief Op Note – brief op note must be completed prior to transfer to the next level of care.
TIME OUT – all activities must be suspended (to the extent possible without compromising patient safety) to focus on the communication and confirmation using the checklist.
Informed Consent – must be signed, dated, timed, witnessed, NO ABBREVIATIONS.
Infection Prevention – hand washing required before putting on gloves and between changes and between patients.
Medication Management – Use order sets when possible (be sure to watch CAREFULLY for updates to your favorites and update accordingly); Review preference list to ensure all PRN pain medication orders have all required parameters.
Restraints – Must have face to face within 1hr of the application of restraint, evaluate 24hrs after continuous restraint or seclusion to determine need to continue or before continuing.
Communication is a high priority for me. I am here to listen and receive feedback. If you have suggestions for future content in the newsletter, email email@example.com. Email firstname.lastname@example.org if you wish to have some time with me in the near future. And always feel free to reach out to me directly at: email@example.com.
Melissa Grant, MD
Chief Medical Officer
Providence Centralia and St. Peter Hospitals