Shining the Light on St. Michael’s Best Practice Spotlight Organization Achievements This annual newsletter highlights some of St. Michael’s best practice achievements with examples of how our nursing teams are implementing, evaluating and sustaining best practice guidelines (BPGs) into standardized processes that support evidence-based nursing practice. A new e-ticket is helping ensure that when hospital inpatients are moved from an inpatient unit to diagnostic areas, their safety information is front-and-centre when they arrive. If the patient is at risk of falling, needs special equipment or extra infection-control precautions, this information is automatically pulled from the patient’s electronic medical record and highlighted in the e-ticket for transfer. “Before now, we would call Medical Imaging to make sure they had the details about the patient that we thought were of note,” said Carl Leushuis, a Registered Nurse and Best Practice Guideline (BPG) Nurse Champion in Oncology & Infectious Disease. “However, working on the project, it became clear that the information we were choosing to highlight for each patient was very subjective. What we thought was important for the Medical Imaging staff to know may not have been what they actually needed in order to do their work and keep the patient safe in their context.” Leushuis co-led a pilot of the e-ticket and associated decision-making guidelines in Hematology/Oncology, along with Registered Nurse and BPG Nurse Champion Suzanne Scotland. Nephrology and Medical Imaging also piloted the tools. The project contributed to the hospital’s implementation of the Registered Nurses’ Association of Ontario Best Practice Guideline to promote safe and effective care transitions, and builds on the successful
work to implement hospital-wide, shift-to-shift transfer of accountability. “The e-ticket doesn’t replace our telephone communication, but it guides the questions the receiving unit or area can ask,” said Scotland. “They can see all the pertinent information right away, and then use the phone call to verify it with us. I feel that this is the key to implementing a BPG. In order for it to be successful, you have to tie it into the work you already do. We weren’t reinventing the wheel, we were articulating, standardizing and improving the way we already provide care.” The pilot was part of an interprofessional and interdepartmental research, education and qualityimprovement initiative to develop and implement the e-ticket and Transfer of Accountability guidelines to ensure safe transfer of non-critical patients. The project required education, engagement and practice change amongst: Registered Nurses as well as patient-transport assistants, clinical assistants, clerical and medical imaging staff across the hospital. An ongoing, hospital-wide research project is evaluating staff perceptions of the tool and guidelines. Scotland and Leushuis’ education plan for Oncology was carefully tailored to the unit’s needs. “We knew it had to be short, convenient, and flexible,” said Scotland. “We paid attention to workload and if a day was very busy, we would cancel the inservice and wait for a better Continued on page 3
BPSO stands for Best Practice Spotlight Organization, the designation awarded by the Registered Nurses’ Association of Ontario (RNAO) to organizations upon successful implementation, evaluation and knowledge translation of established nursing best practice guidelines (BPGs). St. Michael’s has been a proud designated BPSO since 2012.