AMI Improvement Charter ( Draft 1)
Intervention
Team:
Improved Care
for AMI
Team Sponsor:
Martha McLean, Director fo Critical Care & Emergency Services
Date
Team Leader(s):
Anne Buchanan & Sharon MacLeod
WHAT ARE WE TRYING TO ACCOMPLISH?
Core Team Members:
Rose Flood, EKG tech – Kelly MacNeil, EHS- Victor Mathews,ED RN –Trevor MacKinnon, ED ward clerk –
Jen Gillis, Dr. Tom Currie
Ad Hoc:Anne MacIntyre,Dawn Hollahan, CCU Rep,4A Rep, Dr. Paul MacDonald
Purpose
To Improve AMI Care by completing ECG within 10 minutes of first medical contact and
reliably administering thrombolytic agents within 30 minutes of hospital arrival by March 2010.
Scope & Boundaries
Will include all patients presenting to Emergency with diagnosis of with STEMI or new LBBB
confirmed by ECG.
Will exclude patients who received a lytic in ambulance; were transferred from another acute
care facility; or are under 18 years of age.
Improvement Objectives
1. 90 % STEMI or new LBBB will receive thrombolytic within 30 minutes of arrival at ED
2. 90 % of patients presenting to ED with chest pain presentation will receive an ECG within 10
minutes of arrival at ED.
.
AMI Virtual Learning Collaborative 533582098
Page 1
Current
Performance(baseline)
HOW WILL WE KNOW A CHANGE IS AN
IMPROVEMENT?
Measures
Goals
4.0-A % STEMI or new LBBB who
received thrombolytic within 30
minutes of arrival at ED.
4.0-A 90 % STEMI or new LBBB
who received thrombolytic within 30
minutes of arrival at ED
10.0 % STEMI or new LBBB who
received an ECG within 10 minutes
of arrival at ED.
10.0 90 % STEMI or new LBBB who
received an ECG within 10 minutes of
arrival at ED
AMI Virtual Learning Collaborative 533582098
Page 2
Change Concepts and Ideas to Test:
1. Clock sync
2. Numbering Thrombolytic boxes
3. Thrombolytic pac
4.Data collection sheet developed & readily avaliable
WHAT CHANGES CAN WE MAKE THAT WILL RESULT IN IMPROVEMENT?
5.Data collection – using draw for gift certificate weekly to obtain current data.
6. Process mapping with key players
7. Awareness & promotion ( posters with staff pictures displayed in dept with key messages)
AMI Virtual Learning Collaborative 533582098
Page 3
HOW WILL WE MANAGE THE IMPROVEMENT PROJECT?
Roles & Responsibilities of team members:
Principles for working together
 Mutual respect
 Regular meetings : Needed, productive and available by video or tele conf as appropriate
 Communication plan: Minutes to reflect issues, discussion points, action steps,
responsibilities
 Sharing the workload
 Looking for the opportunities and the keys to success rather than focusing on the
limitations.
 Engaging KOC when barriers to implementation are beyond core team’s ability to address
on their own
 Sharing successes with each other, the organization, and the Communities of Practice
 Including other interested partners as identified
 Consult with Atlantic Node proactively and as needed (before team gets overwhelmed)
Roles and Responsibilities:
Team Sponsor






Clarifying the improvement mandate and aligning it within the organizations strategic and operational
objectives
Connecting and communicating with appropriate stakeholders
Initiating the team charter
Allowing time and other resources
Establishing an accountability mechanism
Facilitating the work of the team within the larger organization.
Engaging a team leader and a coach.

Team Leader




Completing and clarifying the team charter in a manner that ensures the support of team members and
team sponsor.
Organizing and running effective meetings and maintaining team records i.e. minutes, correspondence,
improvement data
Facilitating work within the team and ensuring participation at and between meetings
Communicate about the improvement work with the sponsor, team members, stakeholders and the
larger organization.
Team Coach





Facilitating the use of improvement tools and techniques
Monitoring and facilitating healthy team behaviors
Providing technical expertise and guidance focusing on team process
Supporting the team leader to plan effective team meetings
Assisting with measurement for improvement e.g. data collection, analyzers and display.
Team Members






Sharing context knowledge, still and experience
Communicating and developing a shared understanding within the team of the wash process to be
improved or changed.
Testing change ideas within the team and in the real work context
Leading and supporting coworkers to adapt the new process
Completing tasks or assignments within and between meetings
Establishing two-way communication with their colleagues and the team
AMI Virtual Learning Collaborative 533582098
Page 4
Meeting Schedule:
Review Schedule
 Regular huddles with Day to Day leaders and staff (daily/weekly prn)
 1 hour, bi –weekly scheduled meetings x 3 months, then monthly, reassess frequency after
6 months
Key Dates:
Learning Sessions: January 06-10; February 10-10; March 25-10
Team Calls/WebEx: January 20 -09 February 24-10 March 10-10
Date: November 26,2009
AMI Virtual Learning Collaborative 533582098
Revised:
Page 5