Our Commitment to Caring
Our colleagues continuously develop and implement programs designed to improve the quality of care we provide. Below is a list of just some of these programs at UNC Health Care.
- TeamSTEPPS™: TeamSTEPPS™ is a teamwork system designed to improve quality, safety, and efficiency of health care. The Department of Defense Patient Safety Program developed this program in collaboration with the Agency for Healthcare Research and Quality. Read about TeamSTEPPS™ activities in the N.C. Children's Hospital here or visit the Department of Defense and AHRQ TeamSTEPPS™ page here. If you are interested in seeing TeamSTEPPS™ in action at UNC Healthcare, please click here to view videos of some of the tools.
- Meaningful Use: The HITECH Act and the Affordable Care Act, two critical federal legislations, have several provisions that focus on improving quality and safety through information technology. Meaningful Use requires eligible hospitals and professionals to demonstrate that they are using a certified EHR technology in ways that meet specified utilization and quality measures. UNC Hospitals has recently successfully attested to Meaningful Use stage 1 and is working on Stage 2 attestation. For more information about Meaningful Use at UNC Health Care, click here.
- The North Carolina Children's Center for Clinical Excellence: NC Children’s Center for Excellence (NC CCE) was formed in May 2008 to provide a sustainable quality improvement (QI) infrastructure. Many faculty and staff from the Children's Hospital have been, and continue to be, local and national leaders in QI. The Center aims to harness this expertise and offer a more comprehensive and coordinated approach to QI within the Children's Hospital. As a Center, faculty and staff will be able to share learning experiences, effective use of resources, and synchronization of goals that will ultimately improve care for all children that are served in the Children's Hospital. To learn more about NC CCE, please click here.
National Patient Safety Goals: UNC Health Care strives to provide outstanding care in all areas highlighted by The Joint Commission. The National Patient Safety Goals aim to improve patient safety by addressing ways to solve problem areas. Click here to read about work on the 2012 National Patient Safety Goals.
- Rapid Response Teams: These teams support a patient's primary inpatient physician and nurse by bringing additional consultative expertise (ICU physician, ICU nurse, and respiratory therapist) to the bedside when, in the view of a physician, nurse, or family member, the patient’s condition is acutely changed. Additional information about the Pediatric Rapid Response System, which was one of the first in North Carolina, can be found here.
- Project TICKER: The aim of Project TICKER (Teamwork to Improve Cardiac Kids' End Results) is to implement a patient-centered and family‐centered safe practice infrastructure incorporating teamwork training and integrated clinical pathways for pediatric congenital heart disease patients at N.C. Children’s Hospital. The project involves a partnership among the service units, ancillary support team, medical teams and pediatric congenital heart disease patients and their families. Click here for more information about Project TICKER.
- Transitions of Care Team: The Transitions of Care team is a readmissions action group comprising of clinical care managers and representatives from the emergency, pharmacy, and home health departments. Its focus is to ensure that the chronic disease patients, those most at risk for readmission, are adequately prepared for the transition in care and have the support and educational tools they need to manage their health after discharge.
- Commitment to Caring Teams: Several multidisciplinary teams represented by leadership, inpatient, ambulatory, nursing, medical staff, quality and other areas review opportunities and priorities as they relate to the pillars of our foundation: people (staff and patients), service, quality, finance, innovation, and growth.
- Lean Six Sigma Improvement Teams: Lean Six Sigma (LSS) is set of complementary methodologies to improve how we lead, teach and care. While Lean focuses on speed, elimination of waste, standardization, and flexibility/responsiveness, Six Sigma seeks to verify root causes of current performance and to examine and eliminate variation. Both seek to continually improve the quality of care we deliver to our patients. In a phrase, “Get rid of what you don’t need and improve what’s left!” The goal of the LSS deployment at UNC Health Care is to train all employees as Yellow Belts – those who can assist with improvement projects. All employees with interest and aptitude are encouraged to pursue further training to become Purple Belts (who focus on Lean projects), Green Belts (who focus on Six Sigma projects) and Blue Belts (manager-level and above who sponsor projects).
- The Division of General Medicine Initiatives: In order to achieve our goal of improving the health status of North Carolinians, the University of North Carolina at Chapel Hill Division of General Internal Medicine and Clinical Epidemiology is dedicated to promoting an environment supportive of continuous quality improvement. We aim to improve patient care by identifying barriers to patient satisfaction and quality patient care. We utilize continuous quality improvement methods to approach an issue in a systematic way and we encourage faculty, residents, students and staff to lead and participate in the projects. We dedicate time and resources for clinic staff to work as teams on various clinic quality improvement topics twice a month. Learn more about the division's quality improvement work here.
- Ambulatory Care Excellence Operations Improvement: Ambulatory Care Excellence Operations Improvement (ACE OI) combines the Model for Improvement Methodology with Lean concepts and tools to support access and smooth operational flow in UNC’s outpatient clinics and service areas. The intensive, collaborative approach ACE OI takes to improvement has resulted in better patient flow, reduced wait times for appointments, improved provider schedule use, increased visit volumes and enhanced revenue opportunity. ACE OI has established and continues to develop best practice processes that can be applied across UNC’s outpatient clinic and service areas, positioning them to consistently provide excellent service for our patients and their families.
- ACE OI began working in the GI Medicine Clinic during the summer of 2009, with a focus on the referral and new patient scheduling process. At that time, the clinic’s wait time was greater than one month for a new appointment, appointment utilization (how well schedules were filling) was around 65%, the cancellation rate was 18% and the no-show rate was 24%. ACE OI worked with the clinic to redesign the referral process, removing steps that created waste and delay and ensuring that the patient was always involved in the scheduling process. By March 2010, the metrics had proven that the intervention was an improvement – appointment utilization had reached >90%, cancellations decreased to 7% and the no-show rate decreased to below 10%. These gains have been sustained since that time, and the clinic has been able to increase their overall visit volumes through more efficient schedule utilization and reduced wait times.
- ACE OI has also been able to improve clinic throughput and the patient experience by evaluating patient flow and developing alternatives that reduce steps and smooth flow. In the Dermatology clinic, ACE OI Reengineering Specialists worked to redesign the flow for laser clinic patients. This redesigned process reduced the number of nurses needed to manage the Laser clinic, decreased the number of rooms that needed to be turned over from 2 to 1, and reduced the number of unnecessary steps in the process for patients. Furthermore, the clinic has been able to reduce new patient cycle time by 18% and return patient cycle time by 25%.
- STEMI Team: We have a multi-disciplinary team that successfully improved compliance in meeting Door-to-Device time targets for STEMI patients from 60% to >90%. Comprised of ED, Cath Lab, Cardiology, ICU and PI champions, as well as members of EMS teams within our community, this team has implemented: STEMI pager, early contact with EMS, reduced ED times, laminated reminder cards, house staff education, improved documentation, concurrent and monthly review of all cases – including root cause analysis of cases that do not meet standard timing elements. As recent recipients of multiple prestigious awards, UNC’s team proves teamwork improves care.
- Partnering with Patients & Families: The Partnering with Patients and Families committee is an example of how we incorporate patient-centered and family-centered care. Collaboration between patients, their families, and caregivers is essential to improving patient safety, reducing medical errors, promoting adherence to treatment, and increasing satisfaction. These partnerships involve patients and their families in care decisions as well as quality improvement projects, advisory boards, and committees.
- Annual Quality Expo: The Annual Quality Expo highlights performance improvement activities across the institution and allows departments to share success stories. Clinical as well as administrative projects demonstrate how organizational goals are driven by departmental success. Often these projects consist of an interdisciplinary team that is driven by front line staff. Many of these success stories have been shared as best practice across the organization. More than 100 posters were displayed at each of the last two Expos. The Quality Expo 2012 will be held on October 16th and 17th this year. To see a video from the 2010 Quality Expo, please click here.
- Institute for Healthcare Quality Improvement (IHQI): The mission of IHQI is to catalyze healthcare improvement, spread and culture change by engaging providers in improvement projects, training and research. IHQI strives to promote the development of experience and expertise in improvement, expand and enhance training in improvement techniques, using the Lean Six Sigma approach, and develop of robust program of externally-funded research. To learn more, visit the IHQI website here.