HAP Achievement Awards Spotlight: Bryn Mawr Rehab Hospital
January 14, 2019
Bryn Mawr Rehab Hospital received HAP’s 2018 Optimal Operations Award for its 1 to 1 Supervision Reduction at an Acute Rehabilitation Hospital program. The program’s goal was to reduce by 40 percent the time spent by employees on 1:1 supervision, which is when a “sitter” stays with a patient to observe them due to safety or behavioral concerns. Due to 1:1 supervision time consistently being over budget, the team at Bryn Mawr Rehab Hospital set out to determine why and to create a more effective process that also would enhance patient satisfaction and ensure better patient flow.
After determining that the majority of 1:1 supervision was ordered on one particular unit, the project initially focused on that unit.
Through the collection and analysis of patient data, it was revealed that there was a large amount of variability in the process involved in requesting 1:1 supervision orders. Process mapping and cause and effect diagrams were used to determine the places in the process in which the major variations occurred. Once the variations and their causes were identified, two major interventions were introduced:
- Standardization of orders in the electronic medical record to reduce variability and increase staff’s ability to track the order
- Creation of a communication and documentation worksheet to standardize the reasons for 1:1 orders, record interventions used, and provide a step down path for patients
Following the introduction of the two major interventions, the team saw a “dramatic” reduction in full-time equivalent (FTE) hours spent on 1:1 supervision. The project goal was to reduce FTEs per 1,000 patient days by 40 percent; the project successfully reduced FTEs per 1,000 patient days by 78 percent.
After success in the initial unit, the interventions were implemented across the hospital with varying degrees of success. During full implementation, education about the process was key to ensuring success in units of the hospital that didn’t experience as much volume with 1:1 supervision.
The team noted that this program could be successfully replicated in other facilities that perform 1:1 supervision. Bryn Mawr Rehab Hospital’s successful award-winning program is available at HAP’s website, along with other Achievement Award winners for 2018.
Congratulations to Bryn Mawr Rehab Hospital’s for improving its 1:1 supervision program and for being awarded HAP’s 2018 Optimal Operations award.
Questions about the HAP Achievement Awards may be directed to HAP Member Services at (717) 561-5359.