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Banner UMC Medical Intensive Care Unit

Improvement Project

Sandrine Loko, Alyssa Pato, Abbey Brodeur, Sydney Narvaez, and Kelly Morrison
04/19/2017

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Overview of Banner UMC MICU

Objective: Improve the Interdependence


Process of the Healthcare Team in the MICU.

The MICU at Banner hospital provides care for


patients in critical conditions that need high level
of care and close observation and monitoring

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Microsystem Model:
Leadership

Authoritarian

Leaders maintain constancy of purpose,


establish clear goals and expectations, and
foster a respectful positive culture. Leaders take
time to build knowledge, review and reflect, and
take action about microsystems and the larger
organization.

Marquis, B.L., & Huston, C.J. (2015). Leadership roles and management functions in nursing theory and application (8th ed., pp. 40). Philadelphia, PA: Wolters
Kluwer Health/Lippincott Williams & Wilkins.

Institute for Healthcare Improvement.(2015). Clinical microsystem assessment tool. Retrieved from
http://www.ihi.org/resources/pages/tools/clinicalmicrosystemassessmenttool.aspx
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Microsystem Mode
Organizational Culture and Support
Organizational Culture: total of an organizations
values, languages, traditions, customs
o Currently undergoing organizational culture change

Organizational Support: Larger organization looks for


ways to support the work of the microsystem and
coordinate the hand-offs between microsystems
o Inconsistent in providing the recognition, information,
and resources needed to enhance their work
Institute for Healthcare Improvement.(2015). Clinical microsystem assessment tool. Retrieved from
http://www.ihi.org/resources/pages/tools/clinicalmicrosystemassessmenttool.aspx

Marquis, B.L., & Huston, C.J. (2015). Leadership roles and management functions in nursing theory and application (8th ed., pp. 274). Philadelphia, PA: Wolters
Kluwer Health/Lippincott Williams & Wilkins.
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Microsystem Model:
Patient Focus & Staff Focus
Patient Focus: caring, listening, educating, and
responding to special requests, innovating to meet
patient needs, and smooth service flow
o Patient Centered Care

Staff Focus: selective hiring of the right kind of


people
o Promotes continuing education and professional
growth

Institute for Healthcare Improvement.(2015). Clinical microsystem assessment tool. Retrieved from
http://www.ihi.org/resources/pages/tools/clinicalmicrosystemassessmenttool.aspx

Marquis, B.L., & Huston, C.J. (2015). Leadership roles and management functions in nursing theory and application (8th ed., pp. 266 ). Philadelphia, PA: Wolters
Kluwer Health/Lippincott Williams & Wilkins. 5
Microsystem Model:
Interdependence of Care Team

The interaction of staff is characterized by trust,


collaboration, willingness to help each other,
appreciation of complementary roles, respect and
recognition that all contribute individually to a shared
purpose.

Banner UMCs MICU staff does not work as an


effective interdisciplinary team
o Nurses, Physicians, Therapists, Pharmacists

Institute for Healthcare Improvement.(2015). Clinical microsystem assessment tool. Retrieved from
http://www.ihi.org/resources/pages/tools/clinicalmicrosystemassessmenttool.aspx
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Microsystem Model:
Use of Information and Healthcare Technology

Information is THE connector- staff to patients,


staff to staff, needs with actions to meet needs

Technology facilitates effective communication


and multiple formal and informal channels are
used to keep everyone informed all the time,
listen to everyones ideas, and ensure that
everyone is connected on important topics

Marquis, B.L., & Huston, C.J. (2015). Leadership roles and management functions in nursing theory and application (8th ed., pp. 452). Philadelphia, PA: Wolters
Kluwer Health/Lippincott Williams & Wilkins.

Institute for Healthcare Improvement.(2015). Clinical microsystem assessment tool. Retrieved from
http://www.ihi.org/resources/pages/tools/clinicalmicrosystemassessmenttool.aspx 7
Microsystem Model:
Process for Healthcare Delivery Improvement

An audit is a systematic and official examination of a


record, process, structure, environment, or account to
evaluate performance.

Different audits present throughout hospital


o Curos caps

Bias, B. (2017). Quality and safety concepts in nursing [Powerpoint slides]. Retrieved from
https://d2l.arizona.edu/d2l/le/content/553876/viewContent/4610891/View

Marquis, B. L. & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application (8th ed., pp. 551-552). Philadelphia, PA:
Wolters Kluwer Health/Lippincott Williams & Wilkins.
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Microsystem Model:
Staff Performance Patterns

Due to the use of audits, staff members in the Banner


MICU perform safely for patients.

The units structure along with nurses that work well as a


team may also contribute to the units success and safe
practice.
o Decentralized staffing
o Patient acuity tools
o Rare shortage of nurses on this unit

Marquis, B. L. & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application (8th ed., pp. 390-402). Philadelphia, PA:
Wolters Kluwer Health/Lippincott Williams & Wilkins.
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Specific Aspect Targeted for Improvement

Banner MICU needs improved interdependence


of health care team
Current problems
o No discussion among team members
o Tasks completed independently
o Decreased respect for collaboration

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Specific Aspect Targeted for Improvement
(cont.)

Research states that improved teamwork and


collaboration improves quality of care
Positive impacts
o Overall improved quality of patient care
o Reduction of medication errors
o Improved role clarity

Marquis, B.L., & Huston, C.J. (2015). Leadership roles and management functions in nursing theory and application (8th ed., pp. 165-166). Philadelphia, PA:
Wolters Kluwer Health/Lippincott Williams & Wilkins.

Kilpatrick, K., Lavoie-Tremblay, M., Ritchie, J. A., & Lamothe, L. (2014). Advanced practice nursing, health care teams, and perceptions of team effectiveness.
Journal of Trauma Nursing, 21(6), 291-299. doi: 10.1097/JTN.0000000000000090 11
Leading the Plan for Healthcare Delivery
Improvement

Change Theory by Kurt Lewin


Educational meeting for all staff
Literature: improvement will improve patient outcomes
18 month plan

Timeline of events

Assess Inform Educate Impleme Evaluat Expand


nt e

Month 1 Month 2 Months 3-5 Month 6 Month 12


Month 18

Marquis, B.L., & Huston, C.J. (2015). Leadership roles and management functions in nursing theory and application (8th ed.,, pp. 165-166). Philadelphia, PA:
Wolters Kluwer Health/Lippincott Williams & Wilkins.
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References

Banner Health. (2017). Mybanner/mychart patient portal. Retrieved from


https://www.bannerhealth.com/patients/mybanner-patient-portal
Bias, B. (2017). Quality and safety concepts in nursing [Powerpoint slides]. Retrieved from
https://d2l.arizona.edu/d2l/le/content/553876/viewContent/4610891/View
Institute for Healthcare Improvement.(2015). Clinical microsystem assessment tool. Retrieved
from http://www.ihi.org/resources/pages/tools/clinicalmicrosystemassessmenttool.aspx
Kilpatrick, K., Lavoie-Tremblay, M., Ritchie, J. A., & Lamothe, L. (2014). Advanced practice
nursing, health care teams, and perceptions of team effectiveness. Journal of Trauma Nursing,
21(6), 291-299. doi: 10.1097/JTN.0000000000000090
Liu, W., Gerdtz, M., & Manias E. (2016). Creating opportunities for interdisciplinary
collaboration and patient-centered care: How nurses, doctors, pharmacists and patients use
communication strategies when managing medications in an acute hospital setting. Journal of
Clinical Nursing, 25(20), 2943-2957. doi: 10.1111/jocn.13360
Marquis, B.L., & Huston, C.J. (2015). Leadership roles and management functions in nursing
theory and application (8th ed., pp. 40, pp. 165-166, pp. 274, pp. 366, pp. 452). Philadelphia,
PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.

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