Please ensure when working in the Gulf Coast Division Facilities the following Discharge Expectations are being met:

- 30 Minute Acknowledgement of Discharge Orders

-120 Minute Discharge Goal

Thank you for all your hard work and dedication to patient care!

Enhancement: HCA is dedicated to fostering a culture that supports a patient’s right to be free from restraint. Restraint use will be limited to clinically justified situations, and the least restrictive restraint will be used with the goal of reducing, and ultimately eliminating, the use of restraints or seclusion. Identifying areas of opportunity for improvement through data is important to improve patient outcomes which aligns with delivery of safe patient care.

The following KPI's (Key Process Indicators) will be available to facilities.

Please review to ensure accurate patient care documentation.

KPI: Documentation of Second Tier Review

• A Second Tier Review is required after every Restraint Start Application. A Second Tier Review is not required for Restraint Renewals. Applies to all age groups, locations, and restraint types.
• A Second Tier Review is performed after every Restraint Start Application.
• All 9 questions on the Second Tier Review screen must be answered (not null)

KPI: Timeliness of 2 Hour Nursing Assessments

• A RN Assessment is required every two hours after the start application of a restraint until the restraints are removed. Applies to all age groups, locations, and restraint types.
• The time frame for the two hour check is dependent on the start application timestamp or the timestamp of the last RN Assess documentation.
• If any of the required 2 Hour RN Assessment questions are answered with “No”, the record needs to be flagged as needing review. Except for the following three questions: “Meets criteria for release”, “Response to restraint”, and “Level of consciousness”.

KPI: Patients Restrained

• This metric will be measured at the enterprise, division, market, facility, and department levels.
• Calculation All patients restrained (the distinct count of patients derived from the "Restraints Documentation" screen) divided by total patients (ADT-Admission, discharge, transfers) Exclusions Behavioral health restraints

CHG Bathing – EPIC Data As of Wednesday July 3rd facilities that are on the EPIC EMR will now be able to track their CHG Bathing compliance.

Please comment with questions or concerns.

Thank you for your dedication to Patient Care!

As reminder to all Mobile Heartbeat users, please make sure you are updating your unit and facility based on working assignment. This update can be done thru your dashboard. There is an educational course available in HealthStream Titled :Mobile Heartbeat MHCURE 19.1 Clinical User Tutorial - Test. The second module of this learning course reviews how to change the unit and facility. This course is available for self-enrollment at leisure.

Please comment below with questions or concerns.

Thank you for all you DO!

As a reminder to all, please review provided education on controlled substance practices. Please comment with any additional questions and/or concerns.

Thank you each for your dedication to patient care.

Controlled Substance Education

Please review included education regarding restraint documentation:

Restraint orders must be renewed by the end of the calendar day (2359).This prevents restraining without an order while awaiting a new order.

Safety/Rights/Dignity status is documented with the other restraint component every 2 hours with the attestation that is was done 3 times per hour. Done now is used to document observation in real time and time stamps just one assessment complete.

Please comment with questions.

Have a great week!

Restraint Documentation

I have attached an educational PowerPoint on core measure education provided by Kingwood Medical Center in the Gulf Coast Division. Please review the education and comment with questions. Have a great week!

Core Measures

As a friendly reminder, please make sure you are scanning the patient armband prior to medication administration.  If the armband is no longer scanning, please replace the armband utilizing the patient identifiers. Scanning a patient label in lieu of the armband is a violation or policy and jeopardizes patient safety.

Thank you for all you do and your dedication to patient safety.

Please comment below with questions.

Included are two very helpful educational resources supporting the HCA initiative of Patient Experience

White Boards-Defines the purpose of white boards, includes tips for better communication, and provides a visual example of a white board.

Patient Experience Pre-Round and Nurse Leader Rounding-Defines the expectations of pre-rounds (questions the nurse leader will ask the clinician) and beside validation/observation by Nurse Leader.

Please review and comment with any additional questions.

Thank you for all that you do and your commitment to patient care.

White Boards

Pre-Rounds/NLR: Patient Experience

BCMA Scanning Tip: Some medications may have a double bar code for scanning, upper and lower. In this scenario, the lower bar code is the bar code that should be scanned. Make sure to cover the upper bar code with something when scanning as it has been found that even though it looks as if you are scanning the lower bar code, the scanner has been picking up the upper bar code in some cases.

If the scanner picks up the upper bar code if will look like a scan did not occur.

Best Practice: Double check all medication documentation after scanning to ensure documentation accuracy.

Please review the attachments regarding education that is live in East Florida as of 2/19/2019. The education will be included in leadership rounding and compliance will be monitored. Please comment with additional questions or concerns. There will be additional communication regarding a HealthStream course for self-enrollment.  Thank you for all you do!

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