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003			PILC
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022			_a0361-929X
040			_cMANILA TYTANA COLLEGES LIBRARY
100			_aBell, Ashley M.
245			_aProcess improvement to enhance quality in a large volume labor and birth unit / _cAshley M. Bell, Jessica Bohannon, Lisa Porthouse, Heather Thompson, Tony Vago
260			_cNovember-December 2016
336			_atext
337			_aunmediated
338			_avolume
440			_aMCN : The American Journal of Maternal/Child Nursing _n41 : 6, page 340-348
520	3		_aBackground: The goal of the perinatal team at Mercy Hospital St. Louis is to provide a quality patient experience during labor and birth. After the move to a new labor and birth unit in 2013, the team recognized many of the routines and practices needed to be modified based on different demands. Methods: The Lean process was used to plan and implement required changes. This technique was chosen because it is based on feedback from clinicians, teamwork, strategizing, and immediate evaluation and implementation of common sense solutions. Through rapid improvement events, presence of leaders in the work environment, and daily huddles, team member engagement and communication were enhanced. The process allowed for team members to offer ideas, test these ideas, and evaluate results, all within a rapid time frame. For 9 months, frontline clinicians met monthly for a weeklong rapid improvement event to create better experiences for childbearing women and those who provide their care, using Lean concepts. At the end of each week, an implementation plan and metrics were developed to help ensure sustainment. The issues that were the focus of these process improvements included on-time initiation of scheduled cases such as induction of labor and cesarean birth, timely and efficient assessment and triage disposition, postanesthesia care and immediate newborn care completed within approximately 2 hours, transfer from the labor unit to the mother baby unit, and emergency transfers to the main operating room and intensive care unit. Results: On-time case initiation for labor induction and cesarean birth improved, length of stay in obstetric triage decreased, postanesthesia recovery care was reorganized to be completed within the expected 2-hour standard time frame, and emergency transfers to the main hospital operating room and intensive care units were standardized and enhanced for efficiency and safety. Participants were pleased with the process improvements and quality outcomes. Clinical Implications: Working together as a team using the Lean process, frontline clinicians identified areas that needed improvement, developed and implemented successful strategies that addressed each gap, and enhanced the quality and safety of care for a large volume perinatal service.
521			_aNursing
650			_aHospitals _xMaternity services.
942			_cA _2lcc
998			_c80972 _d139335
999			_c77972 _d77972