Triumphs on the Road to
Quality Improvement
Urology Service NRH
Bernie Lee, Kelley Lennon &
Eva Wallace
The Team
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Risk Management
Urology Consultant
Urology Nurses
Clinical Specialist
Ultrasonographer
• Phlebotomy
• Xray
• Urology Administration
IHI Model for Improvement
• What are we trying to accomplish
• How will we know that a change is
an improvement
• What changes can we make that
will result in an improvement
Primary drivers
Secondary drivers
Challenges and Successes
Successes
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Challenges:
– Reduction in Nursing Staff Ratio
– Delays in scheduling due to Admin
training
– Number of unexpected processes
that needed improvement.
Baseline Data Collection
Swim Lane – Process Map – Patient Flow
at the Clinic
Use of Rapid PDSA Cycles, displayed
using Run Charts
Digital Dictation – “just do it”
Communication Frameworks ISBAR
Patient Registration - 78% of patients now go
through registration on arrival at the clinic in
comparison with pre QI of <33%
ISBAR Communication
Framework
All documentation in urology is
now completed using the ISBAR
framework
Introduction / identification
Situation
Background
Assessment
Recommendations
• No matter how good you get you
can always get better and that’s
the exciting part
Tiger Woods