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Batcheller said another idea that worked was the implementation of quiet zones in areas where medications were being put together. Reducing noise led to fewer mistakes and better care for patients. Yet another change has been the practice of nurses making rounds with physicians (an old practice that is being reborn). She said the physician, nurse, and patient discuss five key issues.

Issues covered are results from the previous day, updates on previous problems, patient issues and questions, plans for the day, and progress toward discharge. The result has been better progress, better communication, fewer calls to physicians, and better patient satisfaction, Batcheller said.

Patient-centered care is one of the project’s overall missions. The care should honor the whole person and family members and respect individual values and choices, according to a project mission statement. Other major components of the mission are to ensure that care is safe, reliable, effective, and equitable and that it be administered in a joyful and supportive environment that nurtures professional development.

Another major component of the overall mission is to ensure that all care is free of waste and promotes a continuous flow. More measurable goals are to increase the amount of time nurses spend with patients from 35% to 70% and to reduce time spent on paperwork by half.

Rutherford said nurses spent too much time “hunting and gathering” for supplies, which takes them away from patients. She said helping nurses increase the amount of time doing things that motivated them to go to nursing school in the first place will improve morale and, ultimately, patient care.

Phase 1 of the project took place between August 2003 and March. The second phase, which began in June and will continue through March 2006, is being conducted at 13 hospitals across the country, including Seton Northwest. Staff at these hospitals will continue to innovate and implement comprehensive changes on a designated medical or surgical unit as well as at the organizational level. The changes must result in improved levels of care for patients and families and an improved work environment for staff.

Viney said Phase 2 will seek to measure the improvements being made in regard to patient outcomes, satisfaction levels, staff retention, and the ability to recruit nurses.

“If it worked on one shift, we stopped there and now our job is to go back and think about those things that worked well and [that] we need to implement on all shifts or with all doctors,” she said.

Seton Northwest will work with experts from the Institute for Healthcare Improvement to report on findings weekly and monthly. And they will continue to work with support departments internally to reduce test cycle time, decrease patient waiting, and increase efficiency.

Batcheller said nurses felt valued because it was their ideas that were being researched.

“They have the answers,” she said, referring to the frontline health care providers. “I just don’t think we necessarily ask and listen to what they’re telling us. Staff can see that the changes they’re making are making a difference and the resistance to making changes is less because they can see the results.”

Phase 3 of the project will disseminate successful changes on a widespread basis. Batcheller said the project has proved so successful at Seton Northwest that three other Seton hospitals are considering starting similar teams.

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