The poster described the first phase of the project which involved teamwork training and coaching with the pediatric cardiac OR team. The study concluded that teamwork training in an operative department can be done without interrupting workflow and can provide the correct environment for implementation of standardized guidelines and protocols.
Themes expressed at the conference coincide with the aim of Project TICKER, to create a patient- and family-centered safe practice infrastructure. Maureen Bisognano, President and CEO of the Institute for Healthcare Improvement, spoke about the patient perspective, "We need to change from 'What is the matter?' to 'What matters to you?'".
Silo’s in medicine must be replaced with seamless systems that have the patient and family at the heart of the design including partnerships with payors, the community, and the outpatient care setting. Clinical pathways need to be used that are evidence-based and include what matters to the patient and family. Finally, Donald Berwick, Former Administrator of Centers for Medicare and Medicaid Services and Former President and founder of IHI, expressed that we have an ethical obligation to pursue all of the IOM aims including one that we have not done well with in healthcare – that is efficient care. We must eliminate waste in our healthcare system.
TICKER includes many of the aspects that are at the forefront of transformation in health care. We have implemented a system to break down inpatient silo’s of care, we have included family advisors and are making an effort to ask “what matters to you” instead of designing systems without them. We must continue to create and follow evidence-based clinical pathways with the best practice care included that decreases unnecessary variations in care leading to waste all while improving the other IOM aims (see below).
- Safe — Avoid injuries to patients from the care that is intended to help them. Safety must be at the forefront of patient care.
- Effective — Match care to science; avoid overuse of ineffective care and underuse of effective care.
- Patient-Centered — Honor the individual and respect choice. Each patient’s culture, social context and specific needs deserve respect, and the patient should play an active role in making decisions about her own care.
- Timely — Reduce waiting for both patients and those who give care. Prompt attention benefits both the patient and the caregiver.
- Efficient — Reduce waste. The health care system should constantly seek to reduce the waste and the cost of supplies, equipment, space, capital, ideas, time and opportunities.
- Equitable — Close racial and ethnic gaps in health status. Race, ethnicity, gender and income should not prevent anyone from receiving high-quality care.