Page 22 - The Rounds Vol1

Lenox Hill Hospital
The E.A.R.L.Y.
bird provides
the best care.
By Ashley Dorfman, RN, BSN
Assistant Nurse Manager
Facilitating the Collaborative Care Council (CCC)
is one of the most rewarding things that I do
in my role as an Assistant Nurse Manger in the
Cardiothoracic ICU and step-down unit. Our unit’s
Collaborative Care Council is evidence of what can
be accomplished when unit leadership and frontline
staff are engaged and empowered in unit decision
making. We come together to evaluate and identify
opportunities for improvement by reviewing our
HCAHPs scores, quality data, employee satisfaction,
operational efficiency, and patient out-comes
monthly. What are we working on?
Our biggest initiative is the E.A.R.L.Y. project. Due
to a 20% increase in volume, we implemented the
E.A.R.L.Y. Project in April of 2016 in order to improve
unit operational and business efficiency. We began
by initiating Early Extubation, Early Ambulation,
Rapid de-lining (prioritizing line removal to facilitate
transfers out from ICU), “Lets Communicate and
Educate” (improving communication, formulating
monthly staff education topics), and “You’re Ready
for Discharge” (preparing and facilitating efficient
and safe patient discharges).
22 Northwell Health
How have the results been?
• We improved the patient transfer from ICU to
step down unit, decreasing the average
ICU LOS from 8.9 days in 2015 to 6.61 days
in 2016.
• We achieved significant decrease of total
mean ventilation hours of patients in the
ICU from 14 hours in 2014 down to 8.7 hours
• The reintubation rate also went down from
in 2016.
2.5% in 2014 to 1.2% in 2016.
• Since patients were extubated early, ventilator
associated events (VAEs) also decreased from
5 VAEs in 2015 down to 2 VAEs in 2016.
• Through the early ambulation component of
the project, we had a significant reduction in
hospital acquired pressure ulcers (HAPU),
from 8 in 2015 down to 3 in 2016.
• In addition, we noted improved patient
experience scores with an increase in the
annual likelihood to recommend from
the 75th percentile rank in 2015, to the
89th percentile rank in 2016.
Our Collaborative Care Council embodies the mission
and vision of Lenox Hill Hospital and Northwell
Health by constantly pushing the envelope to
achieve excellence through their initiatives.
In collaboration with the New Visions
Program, Northern Westchester Hospital
(NWH) provides education opportunities to
high school students from the surrounding
communities who are interested in a nursing
career through a structured educational
program. One such graduate of this program
is Laura Spallina, MS, FNP-BC, RNC-OB,
C-EFM. After graduating from the New
Visions Program, Laura began her career
as a Labor and Delivery Nurse at NWH in
June 2010. In just two short years, Laura
was promoted to Patient Care Manager of
Employee Recognition
Laura Spallina, MS,
FNP-BC, RNC-OB, C-EFM
Northern Westchester Hospital
Labor and Delivery while actively pursuing
an advanced degree as a Nurse Practitioner.
In April 2013, Laura attained that degree
from Pace University, and in July 2015,
assumed a role as a Nurse Practitioner on
our Surgical Unit. She currently cares for
patients post-operatively through discharge.
Laura is always grateful for the advancement
opportunities that NWH has given her and
feels fortunate to work in a place that fosters
and promotes her love for professional
growth and development.
Emergency Nurses
Put your skills to the test.
Are you Made for this?
Become part of it all
The Rounds • Volume 1, 2017 23