A Mayo team is finding it pays to sweat the small stuff when it comes to patient safety.
Employees on Mary Brigh 5D and 5E at Mayo Clinic Hospital — Rochester, Saint Marys Campus, are addressing the minor obstacles in their daily workflow, and, as a result, have increased their stress recognition from 35 to 48 percent since 2013. High stress recognition — the ability to recognize and respond to stress — reduces the likelihood of patient safety incidents.
The unit began using the Team-based Engagement Model (TEM) in 2014 as part of Mayo’s Commitment to Safety program. A TEM committee was formed to include all roles on the 36-bed progressive care unit, which cares for vascular surgery and medical patients. These roles include nursing staff, vascular surgeons, medical providers, health unit coordinators, pharmacists, respiratory therapists and environmental services employees.
At the outset of TEM, an employee safety attitudes questionnaire revealed stress recognition as a top improvement opportunity. The TEM committee examined the feedback and determined that small, everyday hassles in the workflow were adding up to heightened stress levels.
Mark Fleming, M.D., Vascular Surgery, is a member of the committee. “Mayo has a system in place for things that lead to immediate patient safety issues, but not for some of those minor annoyances that happen in our jobs. When we talk about a key on a keyboard sticking or supplies that are delayed, they’re minor. But, they add up throughout the day, because the normal workflow is interrupted.”
The committee decided to create “hassle boxes” for employees to submit issues on paper. The scope is limited to minor obstacles, and submitters include their names and details about how the issues impact their work. A designated team triages the submissions for follow-up.
To date, employees have brought forward more than 200 hassles that have led to improvements, such as:
- A process to identify patients coming from the postanesthesia care unit with minimal anesthesia
- Text pagers for nurses to communicate patient needs to nurse practitioners
- Slow-closing doors on patient shower rooms, so that patient care assistants no longer struggle to keep the doors from closing on patients
- A whiteboard that lists patients and their respective physicians and surgeons to reduce the number of questions
- Access to an electronic nursing referral form on all computers
- Fixes for issues such as missing keys on keyboards and an area of the floor where chair wheels were getting caught
Sandra E. Anderson, Nursing Vascular/General Surgery, is a nurse manager and member of the TEM committee. “These were barriers to timely patient care. Now, we are not getting as bogged down in little hassles, so we can all be more available to care for patients and more receptive to meeting patient needs.
“It’s more than just clearing up little concerns; these are barriers to getting work done, and we’re taking them seriously. If, at the end of the day, we have each other’s backs, we are successful as a team,” says Anderson.
Photo: Left to right are Jen McGuire, Katie Fencl, Tammy Loehrer, Rachel Gagliasso, Sandi Anderson, Alex Bandy, Mark Fleming, Carly Chiodo, Tina Wangen, Hannah West and Hussam Jenad.