final project - google docs
TRANSCRIPT
University of Utah Redwood Health Center Urgent Care Department ______________________________________________________________________________
Plan for the Redwood Health Center’s Urgent Care Department
______________________________________________________________________________
Final Project Performed January‐April 2016 Performed by: Tay Omana Robert Prather Jose Saucedo Lana Xaochay Xavier Blackhurst Jarre Cameron
Table of Contents: Introduction……………………………………………………………………………….. 3
About the Group…………………………………………………………………………..3
About Redwood Health Center………………………………………………………….3
The P.R.E’s………………………………………………………………………………...4
The Plan…………………………………………………………………………………...12
Target Audience…………………………………………………………………………..12
Setting of Program……………………………………………………………………….12
Goals & Objectives……………………………………………………………………...1213
Interventions……………………………………………………………………………...13
Motivation………………………………………………………………………………...14
Logic Model/Literature Search …………..…………………………………………...18
PERT Chart……………………………………………………………………………...21
Budget…………………………………………………………………………………….24
Description of the Evaluation ………………………………………………………...28
Method of Evaluation ……………………………………………………………..…...30
Instruments Used …………………………………………………………………..…..31
Addressing Stakeholders……………………………………………………….….…..36
Resources:Funding,Facilities, Equipment, Personnel…...…………………..…...37
Evaluation Design ……………………………………………………………….…...38
Comparables…………………………………………………………………….……..38
Process Evaluation ………………………………………………………….………..39
Program Impact & Evaluation Results…………………………………….……….40
Program Maintenance………………………………………………………………..40
Program Conclusion………………………………………………………………….41
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Introduction :
The University of Utah Hospitals and Clinics aims to provide exceptional care to the communities they serve. They have been ranked as one of the top 10 healthcare facilities in the nation by the U.S. News and Report for the past 6 years, and in the top 20 for the past 18 years. One of their many clinics is the Redwood Health Center which was established in 1998. This clinic has struggled to strengthen their Urgent Care Department’s Patient Satisfaction Report, which weighs heavily on the overall rankings of the organization. Each person in our group is interested in the career path of a healthcare administrator. As future administrators it would be our duty to discover and correct the issues facing this department. This report will detail the existing program, evaluate the current state of the department, and give recommendations for process remediation and improvement.
About the Group :
As a group, we have a common primary interest in Healthcare Administration. Jarrett Cameron is currently employed at the University of Utah Redwood Health Center’s Urgent Care Department as a receptionist. This gave us a unique opportunity to evaluate the Urgent Care Clinic’s triage system to determine quality, efficiency, and overall use of the system and its protocols.
About Redwood Health Center :
The Redwood Health Center serves the greater area of West Salt Lake City, Utah. This is a healthcare facility that provides care to a population with diverse cultural backgrounds, socioeconomic statuses, and varying levels of comprehension of the English language. For example, many refugees that enters into Salt Lake County are encouraged by their receiving organizations, such as the Catholic Community Services, to take their healthcare needs to this facility. Not only does this population meet all of the aforementioned characteristics, but they also often have not had health care available to them in multiple formats and, thus, are not able to determine whether they should go to the emergency room or seek medical attention from the urgent care facility.
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The P.R.E.’s P.R.E’s are factors that influence the capabilities and character of the Nurses and
Receptionists. P.R.E. stands for Predisposing, Reinforcing, and Enabling factors. After considering these factors of the staff and categorizing them into what will be the most influential in our project we have determined the top P.R.E’s are: (To view how the P.R.E.’s were determined please view them starting on the following page.)
The HighHigh P.R.E.’s
Knowledge Skills Layout/Directions
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Predisposing : Nurses & Receptionists P1 Knowledge (+)
Medical knowledge, cultural knowledge, general knowledge of staff P2 Certification (+)
What certifications do the staff hold P3 Ethnicity (+)
What Ethnicity do they belong to P4 Age (+)
What is their age P5 Culture (+)
What cultures do they belong to P6 Previous work experience (+)
Where and what have they done as previous work experience P7 Attitude (+ or )
What are their attitudes regarding medical procedures, illnesses, team work, life, patients, etc.
P8 Behavior (+ or ) What are the behaviors of the staff
P9 Language (+) What languages do the staff speak
P10 Length of Employment at Location (+) How long have they been employed here
P11 Skills (+) What are the staff’s skills
P12 Stress Management Skills (+ or ) How does the staff react to stressful situations
P13 Confidence (+ or ) How confident are the staff in their responsibilities How confident is the staff in each other
P14 Capacity to handle high workloads (+ or ) Can the staff work well in high workloads
P15 Sex/Gender (+) What sex/gender does the staff belong to
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Reinforcing R1 Regulations (+)
What regulations help the staff members R2 Internal Policies (+)
Do the policies support the staff R3 Legality (+) Legal things that support the staff in their positions R4 Managers/Supervisors (+)
Support of the managers and supervisors R5 Competition (+)
Healthy competition in responsibilities and competition for the positions R6 Accountability (+)
What accountability does the staff have R7 Family (+ or )
Does the staff member’s family support their career/position R8 Appropriate workload: overwhelming? ()
Is the workload overwhelming R9 Money (+)
Is monetary compensation sufficient for the staff R10 Language barriers ()
What language barriers do the staff have to the patients/ each other R11 Insurance Policies and Benefits (+)
How does insurance support the staff
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Enabling E1 Facilities (+)
What facilities are used E2 Funding (+)
How much funding exists E3 Continuing Education (+)
What continuing education helps the staff E4 Equipment (+)
Equipment used by staff E5 Software (+)
Software used by staff E6 Time ()
There is never enough time to finish everything E7 Transportation (+)
What transportation do the staff take for work E8 Layout/Directions (+)
Is the layout good and easy to understand, are directions understood. E9 Community Involvement (+)
How is the community involved E10 Networked Facilities (+)
What other facilities help the staff
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Data Matrix
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Literary Search of similar programs Program Examples
(1) The Trauma Report Nurse: A Trauma Triage Process Improvement Project Jelinek, L., Fahje, C., Immermann, C., & Elsbern, T. (2014, September 5). The Trauma Report Nurse: A Trauma Triage Process Improvement Project. Retrieved March 23, 2016, from http://www.sciencedirect.com/science/article/pii/S0099176713006077
Description
A process improvement strategy aimed at improving trauma triage accuracy was implemented. An innovative role, the trauma report nurse (TRN), was created and became the trauma nurse expert. The TRN was responsible for assigning a trauma triage level to all incoming adult and pediatric trauma patients. In parallel, improvements were made to the prehospital report format, increasing standardization and clarifying handoff verbiage.Undertriage rates dropped from 14% to 4.8%. Qualitative data demonstrated acceptance and support of the TRN role among physicians, nurses and nursing and ancillary staff.
Important Points to “Borrow”
1. An innovative role, the trauma report nurse (TRN), was created. This trauma nurse expert was responsible for assigning a trauma triage level to all injured adult and pediatric patients and activating the appropriate trauma team.
2. All TRNs and ED charge nurses were required to attend a 1hour course. Formal staff education was conducted utilizing several methodologies. The class covered roles, responsibilities, leveling criteria, policies, procedures, and radio etiquette. Case studies applying the knowledge were also incorporated. These case studies included the patient’s age, mechanism of injury, vital signs, and injuries found. The TRN students were then required to assign a level and provide the rationale. ED charge nurses were included because they were the designated backup in the rare case the TRN was unavailable.
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(2) Easing the Chaos in Emergency Departments: Implementation of the ‘Ask Your Nurse’ Teletriage Program
Bearden, M., Brown, T., & Kirksey, K. (n.d.). Easing the Chaos in Emergency Departments: Implementation of the ‘Ask Your Nurse’ Teletriage Program . Journal of Emergency Nursing. Accessed March 22, 2016. http://www.jenonline.org/article/S00991767(07)003236/abstract
Description
Nurses working in the emergency departments of large, metropolitan health care facilities have long experienced overcrowding in waiting and treatment rooms. The problem has only become more pervasive as individuals with nonemergent conditions inappropriately seek health care in the emergency department. In Houston, Texas, the Harris County Hospital District (HCHD) serves primarily low income and homeless persons. To address this critical situation, a communitywide telephone nurse advice center, known as “Ask Your Nurse,” was established in an attempt to reduce inappropriate emergency department use. The objective of the “Ask Your Nurse” Program was to direct callers to the appropriate level of care.
The “Ask Your Nurse” program was successful in decreasing the number of unnecessary ED visits, and the costs to patients; It provided education about health care options available to the general public, ran a greater and more organized patient flow and enhanced the quality of care for the patients
Important Points to “Borrow”
1. An RN evaluated the call for severity (eg, nonemergent vs. lifethreatening illness or injury). If the condition was deemed life threatening, the RN would immediately initiate a conference call with Emergency Medical Services (EMS). The patient’s name, address, and telephone number are the only personal data obtained at this time.
2. The Telenurse would help the patient decide where to go, whether it be to the Urgent Care or the Emergency Room.
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(3) Accuracy and interrater reliability of paediatric emergency department triage.
Allen, A. R., Spittal, M. J., Nicolas, C., Oakley, E., & Freed, G. L. (2015). Accuracy and interrater reliability of paediatric emergency department triage. Emergency Medicine Australasia, 27(5), 447452. doi:10.1111/17426723.12455. http://www.ncbi.nlm.nih.gov/pubmed/26268051
Description
Nurses in several hospitals in Melbourne, Australia were give a standard scale to use when triaging patients. Although the nurses were all using the same scale, success varied. The scale proved to be unreliable and inaccurate.
Important Points to “Borrow”
1. Although the instrument may be the same, the nurses will all interpret it
differently. Perhaps a way to fix this would be to involve training. 2. A new instrument may be a good way to streamline triage, other countries
and hospitals appear to be searching for a good way. Perhaps we need to continue searching or meet with the nurses and programmers to create a foolproof triage application.
(4) How we do it: Improving the triage process
Snyder, J. (1995, August 12). How we do it: Improving the triage process. Retrieved March 23, 2016, from http://www.sciencedirect.com/science/article/pii/S0099176705800686
Description
Staff discontent with working in the ED triage area, physician complaints about triage decisions, administrative concerns about risk management issues, and patient dissatisfaction with waiting time provided the impetus for the emergency department at Wake Medical Center in Raleigh, North Carolina, to initiate a process to improve its triage system. A seven step problemsolving process was used to identify three primary areas of need: better management of the patient volume and flow, improvement of communication between triage and the treatment areas, and increased support and recognition for the triage nurses.
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Important Points to “Borrow”
1. Improved Communication: A new course was developed and included a review of system assessment; age related developmental issues, case studies, as well as special section devoted to the vital link between communication and effective triage.
2. Increased recognition and support: A new policy that was implemented, prevented any physician or staff member from directly questioning a triage nurse’s decision regarding either patient urgency or appropriate location of treatment.
The Plan
1. Train the Nurses to have more effective and better quality triages. 2. Train the Receptionists to understand the reasons for triage and have them apply the
knowledge in roleplay to prepare them for realworld application. 3. Place a receptionist closer to the the main entrance to greet patients sooner and direct
them appropriately. Target Audience
1. Nurses 2. Receptionists
Setting of Program
1. Trainings will be in the board room for both the Receptionists and Nurses at the Redwood Health Center
2. Online Learning Modules will also be used to increase the knowledge and skills of the Nurses and Receptionists of the Redwood Health Center
Goals of Program
1. Have better trained Nurses 2. Have better trained Receptionists 3. Quicker access to necessary triage 4. Relay information to patients quicker
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Objectives 1. Train the Nurses
a. Teach them to use the thermometer more in their triages b. Get them more comfortable with the process of a triage c. Get the Nurses to the patient faster by getting triage requests to the nurses
quicker by stationing a receptionist closer to the door d. Provide an individual to whom they can refer to for questions not answered in our
trainings such as a charge nurse 2. Have better trained Receptionists
a. Teach them the proper signs and symptoms that would require a triage b. Teach them the process of how a triage works from start to finish c. Provide an individual to whom they can refer to for questions not answered in our
trainings such as a team lead 3. Quicker Access to Necessary Triage
a. This will be accomplished by placing a receptionist closer to the entrance 4. Relay information to patients quicker
a. This will be accomplished by placing a receptionist closer to the entrance b. We will also help receptionists use a TV screen to relay information to patients c. We will train the receptionists to make periodic patrols of the waiting area to
answer questions and provide information. Interventions (Policy, Engineering, Environmental, and Education)
Education 1. Training for the Nurses (see nurse training checklist)
a. A powerpoint presentation containing a depth of information regarding some of the points on the following Competency Checklist
2. Training for the Receptionists (see GRS training checklist) a. A powerpoint presentation containing a depth of information regarding
some of the points on the following Competency Checklist Policy
1. A receptionist will be manning the desk nearest the entrance to the facility all day. a. This accomplishes the goal of having information relayed to the nurses
quicker b. This will also increase the ability of the receptionists to recognize those
who need immediate aid or attention.
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2. Policy will include every employee recompleting the training every year and also having all new employees complete the training before they begin working.
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Motivation
1. Staff participating in the trainings will be able to clock in during the trainings 2. Pizza party for those who completed the trainings within the specified time frame. 3. Trainings will be organized around work hours of participants such that they are already
at the facility.
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Logic Model Title and Definion:
Plan for the Redwood Health Center’s Urgent Care Department
The knowledge and use of the triage protocols currently established at the Redwood
Health Center’s Urgent Care Department are not being ulized effecvely by the Receponists or
Nurses to the full potenal that they could be. Training is required for the nurses and
receponists to improve their abilies, knowledge, and overall performance. This report will
detail the program we will implement to correct the current issues within the department.
Influenal Factors in our program:
Educaon of staff,
What does the staff already know? How do they apply this knowledge?
What is the best way to teach the staff?
Paent Health Issues,
What are common symptoms of paents entering the Redwood Health Center? Do they
receive the correct treatment?
Paent knowledge,
Do the paents know when to come to the urgent care and when to go to the
emergency room?
Have the paents been to the Redwood Health Center before? Do they know the layout
and the procedures?
Facility Layout,
Have the paents been to the Redwood Health Center before? Do they know the layout
and the procedures?
Which desk is most effecve? Is the layout confusing?
Previous Work experience of staff,
How long has staff been employed at the Redwood Health Center?
How long has staff funconed in their job capacity? At Redwood Health Center? Overall?
What trainings and/or cerficaons does the staff have?
Time,
How long does it take paents to get to a Guest Service Representave (Receponist)?
How long does it take the receponist to determine if a triage needs to be performed?
How much me does it take for the receponist to call for a triage?
How long does it take a nurse to respond to a triage request?
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How much me does the triage take the nurse to perform?
Funding,
Where is our funding coming from?
Would the community be interested in funding the triage project?
Equipment,
What equipment is available to us?
Is the equipment we are using up to date?
Availability of staff for educaon,
When is staff available to complete trainings?
Third Party partners such as the video crew,
Video eding crew,
Human Relaons Technicians crew,
Learning Management System (LMS) modules coordinator,
Previously constructed material.
Has anyone already done a similar project?
What informaon is available to us about similar situaons?
Does the University have any protocol that we must include in our training module?
Inputs to our program:
Time
1. Time of the Receponists
2. Time of the Nurses
3. Time of the managers and trainers in our program
Funding
1. Provided by the University of Utah’s Redwood Urgent Care Department
a. Paying for the me the staff will be involved in trainings
b. Paying for the reward for those who accomplish their trainings within the first 30
days.
Equipment
1. The equipment will be In‐Kind donaons from the Redwood Facility
2. A second In‐Kind donaon will be the LMS modules by the University of Utah’s HR
Technical trainings
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Facilies
1. Redwood Health Center
Personnel
1. Receponists
2. Nurses
3. HR staff
4. Management
5. Clinical directors
Educaon
1. Learning Management System Modules
Acvies (what our program will do):
Train Nurses
Train Receponists
Improve Paent Flow
Improve Paent Outreach
Support Employees
Outputs:
Trainings for the receponists in which they are taught to understand when to call for a
triage and what paent complaints require immediate aenon.
Trainings for the Nurses in which they will learn how to perform a proper triage. They
will also learn how to cooperate in a mely fashion how to get treatment to the paent
as fast as possible.
Learning Management System (LMS) modules for the nurses and receponists. These
modules will be used to train nurses and receponists for possible years to come.
Inial Outcomes
Receponists who know when to call for a triage.
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Receponists who can idenfy possible complaints in which will require immediate
aenon.
Nurses who know how to perform a proper triage on every nature of illness and
complaint that a paent brings into the clinic.
Service will be improved as the receponists and nurses will be more competent to meet
the paent's needs.
Improved Paent Care
Intermediate Outcomes
Increased Paent Populaon
Improved Staff Performance
Improved Staff Moral/Confidence
Long‐Term Outcomes
Improved Paent Sasfacon
Improved Community Health
Financial Stability by becoming more efficient
Increased credibility in the community
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PERT Chart
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Budget
Personnel ($750)
Darv Anderson (Guest Relaons Specialist Director, U of U Hospitals & Clinics)
Darv will be clocked in during his training sessions and will be paid through the
University of Utah. The things he will contribute will be within his job
descripon.
This me will be worth $200
Heather Smith (Nurse Director, U of U Hospitals & Clinics)
Heather will be clocked in during her training sessions and will be paid through
the University of Utah. The things she will contribute will be within her job
descripon.
This me will be worth $250
Heather Wilson (Nurse Manager, Redwood facility)
Heather will be helping the nurses apply the things they learn in the Learning
Module System.
This me will be worth $300
Nurses ($400)
Nurses will be clocked in during the LMS training. This training will be done at
any me that they chose.
The cost of this me will be around $50 for each nurse. Totaling up to $400
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Receponists ($525)
Receponists will be clocked in during the LMS training. This training will be
done at any me that they chose.
The cost of this me will be around $25 for each receponist. Totaling up to
$525
Instruments
LMS Modules (Kirt Hunter, Dir. HR Analycs & Technology) (free)
Example videos of proper triage protocol for Nurse’s Role
Followed by quesons about what was done properly
Examples videos of proper triage protocol for Receponist’s Role
Followed by quesons about what was done properly
Movaonal Supplies
Pizza ‐ $400
Drinks ‐ $100
Utensils/Eang supplies ‐ $50
Terary:
Educaon Intervenons:
All Staff Complete LMS training (EDU 1)
Overseen by: Jarre and Lana
Timeline: 1/13/17 ‐ 3/20/17
Heather Wilson (Nurse Manager at Redwood) will oversee the compleon of the
LMS modules for Nurses.
Dave Larsen (Customer Service Manager at Redwood) will oversee the
compleon of the LMS modules for Receponists.
Pizza Party Reward for Compleon of LMS Modules (EDU 1)
Overseen by: Jarre and Lana
Timeline: 2/28/17
The Nurses and Receponists who complete the LMS modules within the
desired 30 day period (1/13 to 2/27) will receive a reward pizza party held at the
Redwood facility in the break room.
Failure to Complete LMS Modules ‐ Enforced Consequences (EDU 2)
Overseen by: Jarre and Lana
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Timeline: 2/28/17 ‐ 3/20/17
The Nurses and Receponists who fail to complete the LMS modules within the
desired 30 day period will be given an addional 15 days to complete the
modules. The staff members who fail to complete the modules during this 15
day period will receive a write up and immediate leave unl compleon of LMS
modules occur.
Engineering Intervenons:
Create our own original content for LMS module process (ENG 1)
Overseen by: Jose
Timeline: 5/2/16 ‐ 5/19/16
Development will begin May 2nd 2016.
We hope that this step can be accomplished in 10 days but are allong 14 days
in case mulple revisions are necessary.
Our original content will include general storyboards and important key points
that need to be addressed by the videos. They will not be in the form of the final
product but will provide a direcon in which the development team should
follow.
Approval Process
05/20/16 ‐ 07/01/16
Customer Service Director (POL 1)
Overseen by: Robert
Have the original content pre‐approved by Darv in order to ensure that the
customer service representaves’ key concerns are addressed by the training
modules.
Approval from Nurse Director (POL 2)
Overseen by: Robert
Have the original content pre‐approved by Heather in order to ensure that the
nurse’s key concerns are addressed by the training modules.
07/05/16 ‐ 07/25/16
Approval from Redwood Managers (POL 3)
Overseen by: Robert
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Have the original content pre‐approved by Customer Service Manager Dave
Newton in order to ensure that the administrave concerns are addressed by
the training modules.
Have the original content pre‐approved by Nurse Manager Wendy Barber in
order to ensure that the administrave concerns are addressed by the training
modules.
Have the original content pre‐approved by Clinic Manager Sco Hunt in order to
ensure that the administrave concerns are addressed by the training modules.
07/26/16‐09/06/16
Approval from HR (POL 4)
Overseen by: Tay
Have the original content, that has then been approved by the Redwood
managers and directors, approved by HR to avoid unnecessary revisions of the
developed modules.
09/07/16 ‐ 12/01/16
LMS Training modules developed by HR Tech team (ENG 2)
Overseen by: Jose
LMS training modules developed.
12/02/16 ‐ 01/12/17
Make Correcons to HR Tech’s Modules (ENG 3)
Overseen by: Lana and Jarre
HR Tech will need to connuously make revisions and correcons to the
modules as correcons and suggesons are made by those in the approval
process.
12/02/16 ‐ 01/12/17
Final Approval on Modules
Human Resources (POL 5)
Overseen by: Jarre and Lana
HR will need to give connual approval over revisions submied by the
individuals involved in the approval process.
Legal (POL 6)
Overseen by: Tay
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Have the original content pre‐approved by legal.
Obtain permission to use pre‐exisng triage training module creaon tools from
Kirt Hunter, Dir. HR Analycs & Technology.
Redwood Directors (POL 7)
Overseen by: Lana
Have the final product LMS modules approved by Heather.
Have the final product LMS modules approved by Darv.
Environmental Intervenons:
A receponist will be staoned at the desk nearest the front door to help paent flow
and iniate triage sooner
This will need to be approved by Receponist Supervisor Theresa Johnson, and
Customer Service Manager Dave Newton
This will take 3 days and will be commenced as soon as approved by management at Redwood.
Descripon of the Evaluaon:
Our group will evaluate the nurses at the Redwood Health Center’s Urgent Care
Department. We will be looking for improvements in knowledge of triage protocols, as well as an
increased use of that knowledge. We will accomplish the evaluaon of these two things by using
the post‐test evaluaon survey to the pre‐test evaluaon survey that we used before the
implementaon of our program. This survey is in the “ Instruments ” secon of our evaluaon.
This post‐test evaluaon survey will measure the increase in the Nurse’s knowledge of the triage
protocol. Secondly, we will be using the same “direct observaon” technique to determine if the
nurses are applying their newly increased knowledge effecvely. This direct observaon will be
done by the same individual that conducted the pre‐evaluaon. A similar checklist instrument
will be an aid to this individual to stay objecve in their evaluaon of the changes in our
program.
Our group will also be evaluang the receponists in the Redwood Health Center’s
Urgent Care Department. We will be looking for improvements in the knowledge of triage
protocols, as well as an increased use of that knowledge. We will accomplish the evaluaon of
these two things by using the post‐test evaluaon survey to the pre‐test evaluaon survey that
we used before the implementaon of our program. This survey is in the “ Instruments ” secon
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of our evaluaon report. This post‐test evaluaon survey measures the improvement in
receponist knowledge. In addion to the evaluaon of their knowledge, we want to know if the
receponists are applying this knowledge more effecvely than previously. We will measure the
improvement in the use of this knowledge by another survey. This survey will ask quesons that
will allow the receponists to self‐report their own improvement.
We will also evaluate the Greenwood Health Center and use the informaon that we get
from them to determine how our program has affected Redwood Health Center. We will use
Greenwood Health Center’s nurses and receponists as our comparable because before the
implementaon of our program these two health centers were very similar. Since the two health
centers were so similar, we will be able to determine if our program is successful over me.
The results of all these surveys and direct observaon will be compiled to represent the
total effect of our program. The report containing details of the program’s effects will be brought
to the stakeholders within the Redwood Health Center for discussion. At that me, we will
address any stakeholder concerns. Following this meeng with the stakeholders the group will
distribute the final results to the necessary stakeholders in the appropriate forms.
Why these areas of evaluaon were selected
By evaluang the knowledge within the nurses and receponists at the Redwood Health
Center we will be capable of defining one of the effects of our program. The goal of our program
is to improve the effecveness of the nurses and receponists in regards to triage protocol.
Triage protocol knowledge is essenal to being effecve at carrying out one’s dues regarding
the triage protocol. If the nurses and receponists are competent in knowledge then they should
be more capable of effecvely ulizing the triage protocol.
By evaluang the applicaon knowledge of the nurses and receponists at the Redwood
Health Center, we will be capable of defining a second effect of our program. Use of knowledge
of triage protocol is essenal to being effecve at carrying out one’s dues. If the nurses and
receponists are capable of using their knowledge effecvely then they should be more effecve
in their respecve work dues.
Furthermore, by evaluang the total amount of improvement through compiling results
of the evaluaon, we will determine the effecveness of our program. We will also be able to
report the total effect, posive or negave, our program has had on the staff at the Redwood
Health Center.
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Method of Evaluaon
Nurses
The nurses will be given a survey that will test their knowledge of the triage protocol.
The nurses will also be observed by a professional in the field of nursing. The instrument
used to aid this direct observer will help this individual be objecve in her evaluaon.
Incenves are that Nurses will be paid to do the training, pretest, post test evaluaons
and will be included in the Pizza party.
Receponists
The receponists will be given a survey that will test their knowledge of the triage
protocol.
The receponists will be given a survey that will demonstrate their effecveness in
applying their knowledge of the triage protocol. This will be a self‐reported examinaon
and, thus, may be subject to faulty informaon. However, the receponists will be
guaranteed confidenality to promote honesty without worry of repercussions.
Incenves are that receponist will be paid to do the training,pretest, post test
evaluaons and will be included in the Pizza party.
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Instruments Used in the Evaluaon of our Program
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Addressing the Stakeholders
Needs
The stakeholders in the Redwood Health Center were to:
Improve paent sasfacon
Improve staff knowledge
Improve staff’s competency to carry out their responsibilies
We have accomplished each of these needs through the implementaon of our
program. Our program was designed to improve the essenal base to each of these three needs.
That essenal part of these needs is (1) improving staff knowledge, and (2) improving the use of
staff’s knowledge. By increasing knowledge and the confidence to use that knowledge we have
successfully impacted each of the needs of the stakeholders.
Goals & Objecve
The goals and objecves of our program were to:
Have beer trained Nurses and Receponists.
Improve the triage system currently in use
We have accomplished these things in many ways. The receponists report having a
greater knowledge of the triage protocols and enables them to be more effecve and beer
trained staff members of the Redwood Health Center’s Urgent Care Department. The
receponists also show great improvements of the use of their knowledge. They are more
confident and quicker in applying and execung the protocol, which results in improved triage
response me and paent sasfacon. By improving these things we have directly addressed the
concerns and desires of the stakeholders within the Redwood Health Center.
We have also accomplished the training of nurses to have greater knowledge of the
triage protocols. The nurses are more aware of what circumstances require immediate acon
and thus we are able to report that paent sasfacon and safety have improved. Through the
direct observaon of the nurses we have noted that the nurses appear more confident in their
decisions. This is vital to treang paents in a mely and effecve fashion. By training the nurses
to be more competent in triage situaons we have also improved their moral, confidence, and
ability to make difficult decisions.
Finally, we can note that the concerns and desires of the stakeholders have been met
through evaluaon, program implementaon, and re‐evaluaon.
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Resources
The resources provided to us by the Redwood Health Center have been used efficiently
in the compleon of our program. Those resources and the jusficaon of their efficient use is as
follows:
Time
We have given parcular aenon to the complicated structure of me around
our program. Considering each of the vital secons of our program, such as the
creaon of trainings, trainings themselves, evaluaons, and direct observaons,
we have been able to complete each of these secons in a mely fashion.
Funding
We received $2,500 to complete our evaluaon and program from the clinic.
We have $300 le over from the total funds we received.
This money will be used to re‐evaluate the program’s effecveness in 6 months.
Personnel
Each of the personnel in our program have been used efficiently. Their me has
been vital to the compleon of our program and the fact that the compleon of
these parts have been accurately accomplished shows that the personnel have
been used effecvely.
Facilies
We were given the conference room of the Redwood Health Center for the pizza
party secon of our program. That has been used effecvely.
No other facilies than above menoned are required.
Equipment
We have used numerous amounts of equipment in our program. These include:
Computers for the LMS modules to be taken by staff
Surveys and Quesonnaires for the Staff to be evaluated effecvely
LMS modules from the University of Utah’s Human Relaons Technicians
The equipment needs have been used effecvely and efficiently. We have
received great support from the HR staff at the University of Utah.
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Evaluaon Design
Evaluaon of Nurses
The nurses will be evaluated by method of a quesonnaire and direct
observaon as described previously. The quesonnaires will allow us to understand if
the knowledge of the nurses has increased. The direct observaon will describe the way
the nurses are using their newly increased knowledge. These both will tell us if our
program was successful.
Evaluaon of Receponists
The Receponists will be evaluated by method of two surveys. The first survey will
determine the receponist’s new gained knowledge. This will help us understand how
well our program increased their knowledge. The second survey will help us understand
if the receponists are using their newly increased knowledge. This will help us
understand if our program was effecve.
Comparables
Receponists
In order to understand if our program was truly successful, we need to know
what the previous knowledge and use of knowledge was for both the nurses and
receponists. We have that data from our original evaluaon. In this data we report that
the receponists lacked the knowledge to call for a triage when their common sense
says to and many other circumstances. Our original surveys also found that receponists
did not call for a triage when a paent complains of shortness of breath. Our new
evaluaon of our program will determine if these things have been improved. To
determine if the program is successful we should see an increase in the knowledge of
triage protocol as well as an increase in its use. For more detailed informaon on the
success and failure of the project see the Impact and Outcome secons of this
evaluaon.
Nurses
In order to understand if our program was truly successful, we need to know
what the previous knowledge and use of knowledge was for both the nurses and
receponists. We have data that describes the previous knowledge and use of that
knowledge for the nurses. We will use that previously obtained data as a comparable to
determine the increase or decrease in knowledge and use of knowledge in the nurses.
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For more detailed informaon on the success and failure of the project see the Impact
and Outcome secons of this evaluaon.
Redwood vs. Greenwood Health Clinics
To keep track of the changes the program makes, we will also compare our
evaluaons (pre‐test and post‐test) and compare it to the an evaluaon done at the
Greenwood Health Center where they do not yet have the program. We will compare to
Greenwood during our program to evaluate our process as well as aer and a few
months in the future to evaluate the impact and outcome. Determining the success of
the program should be fairly simple, we will either noce our evaluaon scores remain
the same (the program failed), our scores will become lower than Greenwood Health
Center (the program failed), or our scores will increase in comparison to the Greenwood
Health Center which will tell us that our program has been a success.
Process Evaluaon
The evaluaon of the process for creang and implemenng our intervenonal program
to meet the nurses, receponists and stakeholder’s needs; was a long and carefully considered
process that required the involvement, cooperaon and approval of various Chairs, directors,
managers and stakeholders.
When creang and organizing our PERT chart, our meline was very significant. In the
meline we had to determine desired, reasonable and last resort but sll appropriate deadlines
for our objecves. Although all our goals and objecves were always to meet the highest
expectaons, we had the different grace periods to prepare for unplanned issues and sll fulfil
our objecves.
For our “Budget” we pre‐planned the highest possible cost but within the reasonable
limitaon of funding for each personnel member (Guest relaons Specialist Director, Nurse
Director, Nurse Manager, Nurses, Receponists). The budget was designed to pay for each
employee’s work me, during their clocked in period, while making contribuon within their job
descripon. As we implemented the training for our nurses and receponists, we did
miscalculate and exceed me paid for the Guest Relaons Specialist Director but fortunately
because every other personnel member’s budget did not exceed, there was no issue with the
general budget. The budget for the movaonal supplies was not exceeded either.
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The Compleon of the LMS training modules for our nurses and receponist was
overseen by Heather Wilson (Nurse Manager at Redwood) and Dave Larsen (Customer Service
Manager at Redwood). Although there was a successful 100% compleon of LMS modules by all
Nurses and Receponist in the 30 day objecve meline, there was sll the addional 15 days to
complete modules, that followed up with a write up and immediate leave, if failing to complete
in this 15 day grace period. No complaints and posive feedback and praise was given from
nurses, receponists and stakeholders, in regards to the LMS training program.
When planning the “Engineering Intervenons” for the content of the LMS modules the
objecve of development was 10 days with a max deadline of 14 days. Since there were
mulple revisions, 14 day max deadline, was necessary. Engineering maintenance did report
stress when approaching the 10 days and even higher levels of stress as the 14 day deadline was
approaching. Although the max deadline of 14 days was met, maintenance did complain of the
stressful meline.
The approval process was ancipated to be a long and frustrated process and required
the cooperaon of all chairs, directors, managers and stakeholders. Frustraons from all pares
included: response me, lack of one party understanding the needs, wants and barriers of the
other party, mulple pre approval and approval; and rejecon at the end from highest authority.
However all deadlines and objecves were met for the process of creang and implemenng the
intervenonal nurse and receponist program.
Impact Evaluaon (What was the impact of our program?)
As a result of the evaluaon and its training modules, both the nursing and recepon
staff exhibited improvement in their triage knowledge and use of triage knowledge. The
program did meet expectaons of the stakeholders by increasing both nursing and receponist
performance which yielded improved paent outcomes.
The training modules will be integrated into the Urgent Care Clinic’s overall training and
connuing educaon for their nursing and receponist staff. New nursing and recepon staff
will complete their respecve training modules as part of their onboarding process. In addion
to this, the course will be required every year as a refresher.
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Outcome of Evaluaon (What did we discover from our evaluaons?)
We will begin our outcome evaluaon 6 months aer all of the employees have
completed the module. This will allow us me to see how well the program has affected their
knowledge and the use of that knowledge. We will use the same instruments to evaluate the
nurses and receponists and compare their newest scores to the scores they received before
and aer taking the module. We will also be using Redwood Health Center’s paent evaluaon
forms to see if paent sasfacon and flow have improved. We predict that they will, if we are
correct and they do improve then our module will be considered effecve and successful.
Conversely if they do not, it will not mean that the program was ineffecve unless the paent
flow and sasfacon have declined. We will also evaluate at the six month mark, the use of the
module, is it being used? Are the nurses and receponist sasfied with the module? Does it
meet the needs of the major stakeholders and management? Etc. We hope to find that the
module improves confidence in the employees of protocol and that this will affect the overall
morale. Finance will be approached to determine if the funds are being used effecvely and at
what rate that funding should connue. We expect that these posive effects will have an
impact on the overall community and we expect to see an increase in our clinic’s good will. We
believe that our module will affect everyone equally and that no populaon will be le out.
Assuming that the program is a success we will implement long‐term program
maintenance and annual evaluaons, if the program is a failure then the health center will cut
the program. We will call the program a success if there is any posive improvement in the
nurses’ and receponists’ knowledge of triage protocol and use of this knowledge. We ancipate
good results and have therefore planned for program maintenance.
Program Maintenance and Annual Evaluaons
To maintain the program all new employees will be required to complete the training
before being scheduled to work. Yearly, all employees will be required to repeat the course
during their annual HIPAA training; this will be due to the fact that HIPAA training and the Triage
training use similar modules. Aer the module has been in use for six months we will begin our
outcome evaluaon to determine if the module is effecve. Aer this six month evaluaon, the
triage protocols and the triage training module will be evaluated yearly by the nurse and
receponist specialists to create updates and add anything necessary to the educaonal training
module. These annual evaluaons will determine if the triage training modules are effecve and
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if/how the program should connue. This program and data findings will be shared with the
other clinics to help improve their systems.
Program Conclusion
The enre program for improving the triage protocol and staff’s capabilies for the University of Utah’s Redwood Urgent Care Department has been a complete success. Not only is this training program replicable for the other clinical facilies throughout the enre Hospitals and Clinics side of the University. The online training programs used are perfectly efficient in giving the Receponists and Nurses the informaon they need to improve their knowledge. The training videos, as well as follow up reviews, help the nurses and receponists understand how to use their knowledge on a daily basis. The cost of the enre program from start to finish landed at under $15,000 which was well below the value of what is produced by the program. Although connuous audits are recommended for the program to be maintained and valuable, the effort is worth the cost, me, and personnel it would take. The community served by the Redwood Urgent Care Department has seen the improvements and are more likely to recommend their family, friends, and neighbors to use the services at the University of Utah’s Redwood Health Center.
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