In 2012, University of New Mexico Hospital (UNMH) decided to use LEAN, a formal method of evaluating systems and processes to ensure efficiency and value. UNMH has since seen reduced wait times, more efficiency, less unnecessary paperwork and decreased delays in delivering care.
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In 2011, to improve safety in the operating room, UNMH started a surgical safety program called LoboWings. This uses the crew resource management program, similar to that used by airline pilots. All surgical staff were trained in effective communication strategies.
Staff use tools throughout the surgical process, from before a patient’s operation through recovery. The tools are verbal checklists, which each team (nurse, surgeon, anesthesiologist, and technician) review verbally in a “time-out” session. This ensures that all team members can stop a procedure at any time if they see a safety issue.
The goal of this training was to ensure that mistakes are caught early and communicated effectively in the operating room. Since starting LoboWings, communication among providers in the operating room has significantly improved.
Antibiotic Stewardship Program
The Antimicrobial Stewardship Team (AST) at UNMH was established in November 2010 and consists of a physician and pharmacist trained in infectious disease care. Their mission is to better use antimicrobial agents to improve patient outcomes, reverse or delay antimicrobial resistance, and economically benefit the hospital.
Each day, the AST checks the appropriateness and duration of treatment for all adult patients who are on targeted antimicrobial agents. Although costs are important to any health care institution, the focus of antimicrobial stewardship is the patient and public health.
Sepsis, commonly known as blood poisoning, is caused by bacterial or fungal infections that can begin anywhere in the body, enter the bloodstream, rapidly infect the entire body and even cause death. Early identification and treatment improve outcomes.
UNMH joined forces with care teams from emergency medicine and internal medicine to identify and review all cases of severe sepsis. We gave case-by-case feedback to providers, improved system processes and identified ways to improve care. Through these efforts, we reduced deaths linked to severe sepsis by more than 10 percent.UNM Sandoval Regional Medical Center providers also have taken steps to quickly identify and treat sepsis, resulting in a 50 percent improvement.