Dryden Regional Health Centre
PROJECT TITLE: STAY UP
TEAM MEMBERS:
Marlene Ryan
Lucy Venne
Heather Fukushima
Wendy Lizzi
Sandra Ewings Patient Family Representative
March 2017
AIM STATEMENT
75% of the patients over the age of
70 will maintain or improve their
functional ability as indicated by
the Barthel score over the course
of their hospital length of stay by
January 31, 2017
MEASURES
Measures
Outcome:
• % of patients who achieve a functional improvement from admission by
discharge as evidenced by an improved Barthel Index Score
• % of patients who achieve a return to a pre-admission baseline functional
status as evidenced by achievement of Pre-admission Barthel Index Score
Process:
• 100% of all in scope patients will have the Barthel screen on admission
• 100% of all in scope patients will have the Barthel Screen upon discharge
• 75% of all in scope patients will have the Barthel Screen monthly during
hospital stay
Balancing:
• Measureable reduction in length of stay for our in scope patients
• Falls with injury reduction
CHANGES
• Barthel Screening on all patients over 70 upon
admission and weekly (June, 2016)
• Red Tray Program(December, 2016)
• Weekly Activation/Life enrichment
Programming( November, 2016)
• Nutritional screening on all admitted
patients with a dietitian assessment
for all patients identified at risk
(February, 2017)
RESULTS
Barthel Index Scores
% of Discharged Patients that Maintained or
Improved their Barthel Score from Admission to
Discharge
100
90
80
70
50
Percentage of patients over the
age of 70 that maintained or
increased the Barthel Score
40
Target of 75%
60
30
20
10
0
Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17
Results
Red Tray Program
462 Red trays prepared in January 2017
Results
Nutritional Screen Tool
2 questions are asked on admission
1. Have you lost weight in the past 6
months WITHOUT TRYING to lose this weight?
2. Have you been eating less than usual
FOR MORE THAN ONE WEEK?
Results
Nutritional Screen:
Nutrition Screening on Admission
% of patients screened determined to be high risk
33%
67%
% screened not at risk
NEXT STEPS
• Red Tray Evaluation
• Nutritional Screen evaluation
• Implementation of a new White board
template to enhance communication
• Review Patient Handbook to Assist with the
evolution in the “Sick culture” of our
senior patients
LESSONS LEARNED
• The need to schedule time monthly to work on
project
• Make sure that the projects are not too big to
achieve success
• Focus on a couple of smaller projects
• Take advantage of any and all low lying
fruit to achieve success quickly
KEY CHALLENGES
• Environmental limitations; space for
congregate dining
• Changing the Acute hospital culture requires
lots of maintenance work?
• Changing the “Patient Sick Culture”
• Human Resources for project
development and sustainability
TIPS FOR OTHER TEAMS
• Do not over extend project team with too
many projects
• Do not under estimate the time it takes to
complete projects
• Sometimes the surprise opportunities
can be your greatest success
• It is OK to delay projects until the time
is right