RITE Cohort: RITE 23 Wednesdays Summer 2022
Team Members: Dolly Garay, NP, Dora Kalatzi, CNS, Clarissa Manez, RN, Samantha Nguyen, RN, Samantha Allen, NP, Tiffany Nawabi, RN, Hannah Kirsch, MD, Sherry Kirkes, RN, Michelle Ellerbee, LCSW, Heather Riis, Tovah Kohl, SPM, Cessa Heinzmann
Team Sponsor(s): Rudy Arthofer, RN, ACNO and Karen Hirsch, MD
General inpatient hospice care benefits patient, family, and hospital with better care and increased resources. We addressed the drastic decrease in GIP enrollment during the Covid-19 pandemic by working to increase GIP referrals for the neuroscience service lines.
Throughout our analysis we identified the following gaps and prioritized these key drivers:
We were able to achieve our SMART goal of patients per month before the end of the RITE cohort.
Our major asset during RITE was an enthusiastic, engaged multidisciplinary team that worked extremely well together. Each person had a clear purpose in the team and owned a piece of the project. The hospice process is complex and required intense partnership with the Mission Hospice nurses. We made a point to involve them heavily and build relationships with them. Our project leads did an absolutely phenomenal job managing follow-through via communicating with team members and ensuring all educational interventions were embedded properly. The team also did a great job pivoting throughout the project and taking all lessons learned to heart. For instance, the team was able to address in real time gaps that emerged as we iterated through interventions.
Our team did achieve our SMART goal, and we have already started the spread process to Medicine and Oncology. Though the project was a success, we did have some bumps in the road. The discharge and readmit process was tedious and had many details that needed to be considered. We also had to navigate how night shift roles would play into our process, and ensure training was completed. There was only one provider covering the entire service during night shift, and we had to re-focus our education based on their needs. We created escalation pathways with day shift in mind, but night shift proved to be more complex in part because the palliative care service does not work in house at night. A separate challenge the team will have to work through in ensuring that staff is comfortable caring for this challenging population. Our team did a fantastic job working with the staff in the Neurosciences units, but it will be a continual process.