Sanford Health’s innovation unit has grown to 32 beds just over a year after opening on the eighth floor of Sanford Medical Center Fargo.
The inpatient floor, designed to test ideas before implementing them at the organization’s 45 other hospitals, opened in October 2019 and eventually grew to 18 beds on the 8A wing. It also now occupies 14 beds on the adjoining 8B wing.
“We had a good four months before the pandemic started, which threw us for a loop. But innovations prevailed throughout that,” said Ericka Wambach, BSN, RN, director of unit.
That gives the team more opportunity to expand projects to more patients, she said.
It is one of the only such units in the country to incorporate patient care innovations that may be applied to a broader patient population. The goal is to improve patient and staff experience as well as outcomes, reduce waste and increase efficiencies by evaluating new ideas.
The Fargo medical center, which opened July 2017, already includes numerous innovations that make it one of the most advanced hospitals in the region. These advancements include spaces specifically designed for care, team collaboration, private patient rooms with areas for the patient, caregivers and family members, and efficient floor plans that foster efficiency and communication while leveraging technology in new ways to improve patient care.
Ideas for innovation unit projects have come from inside and outside the organization.
One of the first ideas tested on the unit and ultimately implemented across the medical center is a white board that staff members from each unit gather around before every shift. The so-called huddle board serves as a visual communications and education tool.
Traditionally, nurses would be briefed only on the condition of the patients they were assigned to on that particular day. With the huddle board, every team member on the floor receives morning and evening updates on all patients.
“It really aligned with the high-reliability organization (HRO) training that all Sanford Health employees are undergoing and increased communication and collaboration,” Wambach said.
The effect has been a dramatic reduction in patient falls, infections and other care-related safety elements, she said.
Care rounding dashboard
Another project that also reduced such patient incidents is the care rounding dashboard.
“We do the four ‘Ps:’ pain, potty, position and personal items,” Mikayla Kath, RN, an innovation unit nurse, said in describing rounding. “Does the patient need to use the restroom? Are they in pain? Do they need to be moved from side to side? It’s just making sure they’re comfortable. And maybe they didn’t think they could push their call light because they didn’t want to bother us. But that’s what they’re there for.”
The dashboard shows green when they’ve been rounded on, yellow when it’s been 45 minutes and red when it’s been more than an hour.
“Instead of having a sheet of paper and not know who’s been rounded on, you go into a room and it’s all done digitally,” said Inno Nsengiyumva, a patient care technician on the unit.
“It’s holding us accountable because you can see how many minutes since someone was in that room,” Kath added. “Time can go by and you don’t realize it’s been two hours and you realize you haven’t been in that patient’s room, but you feel like you were just there. And it can also bring out a little bit of that competitiveness and be like, ‘Ooh, who was the top rounder today?’”
Since implementing the dashboard, the unit has reported fewer patient falls, increased patient satisfaction and reduced use of the call lights.
The team is fine-tuning the dashboard and then hopes to spread its use to other nearby floors and perhaps across the organization.
Some of the other projects tested on the innovation unit that may expand to other parts of the organization:
- Cables, cuffs and cords: This idea seeks to save money and time by better tracking and reusing cables, cords and blood pressure cuffs in patient care. Sometimes those items required in patient care aren’t in the right place at the right time. The unit partnered with central supply and environmental services to label everything and create a new workflow for the unit to try.
- Get to know me: When patients are admitted to the innovation unit, they fill out a questionnaire poster with their personal preferences, such as what they like to eat, what kind of music they like, their hobbies and other information about them. That allows all care team members get to know the patients and make them feel more comfortable.
- Lift system: The innovation unit installed a unique lift system in one of the hallways that senses a patient’s weight and movement. The lift provides weight relief that helps the patient work on activities like balance, sit-to-stand and walking up and down stairs. Only 10 hospitals in the U.S. use the hands-free technology, and the Fargo medical center is the only one in the Midwest with it, said Casey Riedberger, BSN, RN, innovation unit nursing manager. It offers patients a safe option while reducing the number of nurses required to help the person.
The innovation unit is part of a broader push by Sanford Health to tap the talent and ideas of its employees. It uses Sanford Health’s crowdsourcing platform, Ideawake, to accept, vote on and track ideas that are trialed on the unit. All Sanford Health employees may submit ideas to the innovation unit. Because it’s web-based, employees can safely and easily engage with it through their smartphone, tablet or any computer.
“It’s so important for us to get ideas from our 50,000-employee footprint because different people think differently,” Wambach said. “We could have an environmental service worker give us a different idea about patient care that maybe nursing didn’t think about. Sometimes we get stuck in our lanes and it’s hard to think outside of the box.”
The approach allows the organization to test ideas on a small scale first.
“We have lots of ideas coming at us over and over again that we roll out big bang,” Wambach said of the larger organization. “Rolling it out small on a medical surgical unit like ours gives us the opportunity for us to do some focused study and then roll out to the other areas with hopefully continued compliance.”
Even simple innovations that find efficiencies can improve patient care, Kath added.
“You may think it’s a simple little thing, but it actually can be a bigger thing. It can start on 8A-B here and end up in Sioux Falls,” she said. “When our job is easier, we’re more efficient and we can spend more time with the patients.”
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