CMO Message: September, 2023

September 11, 2023

Welcome to September! While some are already enjoying their pumpkin spice lattes, I am thankful for a few more mild, sunny days before the official start of Fall, the Autumn Equinox on Sept. 22-23.

Thank you for your completion of the Annual CIA Training in a timely fashion. South Puget Sound ministries and caregivers were the first areas to reach 99-100% completion across the North Division.

We have started the roll out of our new safety event reporting system, High Reliability Platform (HRP) as we close out Datix. Core leaders were assigned a brief course Sept. 8, and the deadline to move Datix events to leader sign off will be Sept. 30. HRP goes live on Oct. 3, and we lose access to Datix on Nov. 30. See attached infographic for additional information ... HRP Infographic

1) Good News!

a) We are excited to announce the start of emergent TeleNeurology (eTN) Consult Services at Providence Centralia Hospital in October. Training for nursing staff care teams has started with a tentative go live date in October 2023 (click THIS LINK for reference slides and eTN algorithms for review).

b) Our South Puget Sound Staffing, Transfer and Operations Center (STOC) stood up Aug. 29. As expected with any new process I am aware of some areas for improvement, please continue to share those with me but also be patient and understanding as we refine our processes. For Incoming Transfers and Direct Admissions: 1-866-470-4233, St. Peters Bed Placement 1-360-493-7220.

2) What to watch: Emergency Center Boarders and LOS

a) Emergency Center Boarders – This topic will require continued effort from all. We had an excellent week with the lowest number of boarders in a while (and got down to 6 boarders), but we must maintain momentum to keep the numbers low and get to zero boarders. Our goal should be that patients requiring admission in our ECs should have a reasonable timeframe to expect a bed in one of our units. Some creative things that we have tried in recent weeks are:

    • For appropriate patients, offering admission to PCH
    • Shifting patients from EC to CDU along with their nursing assets
    • Pulling patients through the system one by one, starting with our longest and/or sickest boarders, to get them ready for a bed as soon as its available on a unit – this requires accurate prediction of discharges (using EDD in EPIC) and early and efficient processing of discharges (e.g. early orders for discharge, advance coordination of DME and transportation, use of the discharge unit, etc.)

b) Our efforts are beginning to pay off! For August we saw the lowest GMLOS (Geometric Mean Length of Stay Observed to Expected) O:E across both ministries than we have seen in the last 12 months (1.40 overall with 1.47 at PSPH and 1.10 at PCH) with sustained decreases over the past 2-3 months. Our ALOS (average length of stay) and Financial LOS (length of stay) appear to have both improved for the month of August but need continued focus to drive down even lower. I am happy to share this data in more detail with your teams, just reach out to if interested. I would love to attend your departmental meetings or other events to meet your physicians and APCs, thank them, and to discuss the data in more detail.

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