Clinical Partnership - Valley Children's Hospital & SVMC

Colleagues,

I received a letter a few weeks ago from Dr. Beverly Hayden-Pugh, Chief Nurse Executive & Jane H. Wilson, SVP and Chief Strategy Officer at Valley Children’s Medical Center. Both executives expressed their appreciation for our commitment to the Clinical Partnership that began December 18, 2014. From the beginning, SVMC has experienced a Clinical Partnership that has enhanced patient care outcomes, access to care, and educational opportunities.

The Clinical Partnership program brings our organizations together on enhancing neonatal and pediatric care, and keeping children closer to home for their healthcare. In addition, the collaboration helps prevent children from being transferred unnecessarily yet can assist in identifying earlier when a child does require a higher level of care. Together with improved communications, coordination of care, clinical tools and sharing of best practices, we increase the confidence of providers in caring for children and improve the healthcare experience for patients and their families.

The goals of our Clinical Partnership include:

• Enhanced, coordinated care
• Improved quality
• More care closer to home
• Increased patient/family satisfaction

Through collaboration, the Clinical Partnership process includes:

• Mutual identification of areas of focus
• Establishment of a steering committee and work groups based on the areas of focus
• Assessment, gap analysis and action planning related to standards of care, policies and scope of service
• Assessment, gap analysis and action planning related to clinical education
• Assessment of clinical quality measures, transfer data and development and monitoring of a quality dashboard

As we move towards the three year anniversary of our partnership, It is important to recognize the collective work and accomplishments of the partnership. I want to recognize that Valley Children’s has contributed over 430 hours to this Clinical Partnership in 2016.

Activities to date for these working groups were documented by Hayden-Pugh and Wilson:

• NICU
  • Reestablished work group leads, as well as routine meetings/conference calls to continue work
  • A gap analysis was done to identify opportunities related to policies, standards, pathways, education, etc.
  • Delivery Room Standardization course provided
    • 18+ RNs and Respiratory Care Practitioners (RCP)
  • STABLE (neonatal education program) education completed
    • 4 RNs completed at other organizations
    • 2 RNs on Oct 20, 2016 at Valley Children’s
    • 13 RNs on Oct 28, 2016 at SVMC
  • Shared new Neonatal Resuscitation Program (NRP) guidelines for current and new NRP instructors
  • Delivery Room Standardization (DRS) Course provided in October, 2016
  • Job Shadow for SVMC L&D nurse at Valley Children’s in the NICU, November 2016
  • Planning for 2017
    • Plan for SVMC to observe NRP course
    • Morbidity and Mortality (M&M) Presentations to be scheduled twice per year

• Pediatric Acute Care
  • Reestablished work group leads, as well as routine meetings/conference calls to continue the work
  • A gap analysis was done to identify opportunities related to policies, standards, pathways, education, etc.
  • Provided Fall Prevention policy
  • VCH provided National Institute of Health (NIH) Safe to Sleep brochures
  • VCH provided Asthma SBAR and Just-In-Time (JIT) training sheets
  • VCH provided PowerPoint presentation on asthma and bronchiolitis pathways
  • SVMC provided asthma education via PowerPoint and home materials to the team.
  • VCH provided code white assessment sheet for mock code evaluations
  • 2 RNs attended Acute Care Core on 4/25/2016
  • 1 RN came to VCH on 8/16/2016 to job shadow
  • Planning for additional SVMC staff to attend Acute Care Core educational program at VCH

• Emergency Department
  • Reestablished work group leads, as well as routine meetings/conference calls to continue work
  • A gap analysis was done to identify opportunities related to policies, standards, pathways, education, etc.
  • Shared Diabetic Ketoacidosis (DKA) Transfer Algorithm
  • Shared ED Delivery of Care Policy
  • Reviewed patients transferred from the Sierra View ED to Valley Children’s ED for:
    • Transfer diagnosis same as discharge diagnosis
    • Patient’s discharge from ED versus admitted to inpatient status
    • Patient’s admitted to PICU from ED
  • Powershare Imaging Program presented to participants with intent to bring their ED/Imaging departments on board
  • Planning for 2017
    • Bidirectional job shadowing
    • Review of all transfers to VCH that have discharged within 24-hours

• Telemedicine
  • Ensured ongoing availability of Valley Children’s neonatologists for telemedicine consults, as requested, to SVMC NICU physicians
  • Evaluated potential need for telemedicine in the ED and Acute Care settings
  • Continued weekly video conference meetings when Valley Children’s has SVMC-referred babies in the NICU
  • Discussed the update on PowerShare and how it relates to providing support for pediatric cardiology

• Respiratory
  • Reestablished work group leads, as well as routine meetings/conference calls to continue work
  • Continue to provide support to individual work groups as respiratory concerns are identified
  • Reviewed “just-in-time” teaching for the bronchiolitis and asthma protocols
  • Reviewed high flow nasal cannula (HFNC) policy

• Quality
  • Reestablished work group leads, as well as routine meetings/conference calls to continue work
  • VCH provided support to individual work groups to help identify and track quality metrics for objectives established
  • Developed a “scorecard” of quality/PI metrics based on objectives identified by the work groups, utilizing delivery room collaborative and California Perinatal Quality Care Collaborative

Thank you for all you do! Be good to yourself.

Dr. Jeffery Hudson, VP/Chief Nurse Executive