Ideas that Work: Quality Improvement

Here's a fun and effective way to make sure your facility's written policies are followed. First, create a series of cards that each contain a policy your staff needs to know, and the steps required to comply with the directive. The cards should be double-sided, with identical steps printed under a green header on one side and a red header on the other. Next, create a display board in a centralized location with clear slots — according to the days of the week over a series of four or five weeks — in which the cards can be placed.

Set aside about 10 cards that contain the policies you'd like to monitor — hand hygiene and endoscope cleaning, for example. You can exchange policy cards as needed to ensure you're constantly monitoring practices that need extra attention. Pull a card out of the stack each day and observe your staff in action to make sure they comply with the card's policy. If staff are in full compliance, slide the card into the daily slot on the board with the green side facing out. If staff are not in compliance, display it with the red side facing out. Once a day, meet with your team in front of the board to discuss successes (green cards) and areas of needed improvement (red cards). Keep the conversations positive and constructive. The give-and-take should be used as opportunities for staff to share their ideas for improving practices, not as punitive reminders of what they're doing poorly.

Picking cards from a stack randomizes policy observations, preventing you from covering the same ground multiple times or simply running through a series check boxes during rote monitoring. The process also keeps staff accountable on a daily basis and lets you identify issues that need to be addressed immediately instead of waiting for monthly performance reports before acting.

Tami Geske, RN, BSN
Rogue Regional Medical Center
Medford, Ore.
[email protected]