Following are a few highlights from the many innovative efforts initiated by Unit Councils throughout Crozer-Keystone hospitals in FY 2008.

Click on the links below for additional information on specific Crozer-Keystone hospitals.

Crozer-Chester Medical Center

Delaware County Memorial Hospital

Springfield Hospital

Taylor Hospital

Crozer-Chester Medical Center

1 West Medication Room Improves Patient Safety and Privacy

1 West nurses pose in the new medication room.

In the past, nurses on the 1 West medical/surgical unit dispensed medications from four carts kept in the unit hallway that were vulnerable to public access. In addition to compromising patient safety and privacy, this practice created hallway clutter that was not conducive to best patient care. The 1 West Unit Council determined that the best solution was to add a second dedicated medication room. The challenge was finding a place for it on this busy 39-bed unit where every bit of space was in use. 

In a two-month multidisciplinary effort that involved Facilities, Pharmacy, the storeroom area and Environmental Services as well as the nursing staff, 1 West moved a mountain of supplies and equipment and adopted new working habits to create another medication room. Conveniently located near the nurses’ station, the new room is secured with badge locks and features ergonomically friendly medication countertops supplied by Facilities as well as a medication refrigerator provided by Pharmacy.

 “Our council appreciated the interdepartmental support and the patience of all staff including the physicians who were inconvenienced during the project. The results were certainly worth it,” stated Nancy Mekenney, RN, unit council chair.

Completed in 2007, the medication room has helped the unit achieve its goals of ensuring patient safety and privacy, providing a quiet environment for nurses to safely prepare medications for administration, and reducing hallway clutter.

1 West Unit Council
Melissa Macelroy, RN
Lynette Maraldo, RN
Christine Massa, RN
Nancy Mekenney, RN
Melissa Mullen, RN, BSN

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Delaware County Memorial Hospital

Preprinted Kardexes Improve Efficiency, Patient Safety on 5 East

From left to right: Loretta Harper, RN, Joanne Bailey, HUC, and Tina Dickinson, RN.

DCMH’s 5 East Unit cares for most of the hospital’s post-operative orthopedic patients. For knee and hip replacement patients, this involves handwriting a full page of orders on kardexes for each patient, a very time-consuming process. Last year, the 5 East Unit Council developed preprinted medication and treatment kardexes, eliminating the need to handwrite orders each time. This has dramatically improved operational efficiency as well as patient safety.

“What used to take about half an hour per patient now takes about five minutes,” says Susan Foster, RN, BSN, MHA, NE-BC, 5 East nurse manager. “Instead of writing every medication and every care order, now the nurses only have to write the date it was ordered on the kardex and initial it next to the preprinted order. This frees them to spend more time caring for patients instead of doing paperwork. In addition to saving time, the preprinted kardexes also enhance patient safety by reducing the chance of errors due to illegible handwriting or misinterpreted abbreviations.”

Foster credits Tina Dickinson, RN, 5 East Unit Council chair with organizing the effort. “While the whole Unit Council contributed, the three members who actually developed the new kardexes are Loretta Harper, RN, BSN, Susan Simpson, RN, and Joanne Johnson, HUC, our health unit coordinator,” says Foster. Bailey also suggested that the preprinted kardex practice be expanded to include kyphoplasty, an idea that was also implemented.

5 East Unit Council

Joanne Bailey, HUC

Mary Anne Christ, LPN

Tina Dickinson, RN 

Susan Foster, RN, BSN, MHA, CNA-BC

Helene Halligan, RN, BSN

Becky Harrington, RN, BSN

Loretta Harper, RN, BSN

Bea Olinger, RN

Susan Simpson, RN

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Springfield Hospital

ED Unit Council Plans Logistics for New Emergency Department

Springfield Emergency Department staff members celebrate the opening of the new unit.

When Springfield’s Emergency Department Unit Council was established last year, one of its first orders of business was planning logistics for the newly constructed Emergency Department. Council members determined assignments for inventory, stocking and maintenance of the department and made recommendations for the best patient flow. They also volunteered to be part of the task force established to plan the physical logistics, volunteering their time after shifts and on weekends to plan the move to the new facility, which was completed in two phases ending in October 2008. Currently, the unit council, led by Kelly D’Ambrosio, RN, is working on recommendations for a new communications system for the ED.

“We put the decision making into the hands of our unit council and they really took ownership, creating a working environment that they felt would be most efficient,” says Amy Meehan, RN, ED nurse manager. “They continue to own the process and make improvements as we adjust to our new facilities. The nurses’ participation has heightened morale and led to very positive outcomes.”

Emergency Department Unit Council

Carol Beneke, RN

Barbara Clendening, RN, CEN

Kelly D’Ambrosio, RN

Steve Edwards

Diane Neary, RN, BSN, CEN

Gwynn Sinkinsonn, RN, BSN, NP, CEN

Mary Pat Towne, RN, BSN, MSN, CEN

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Taylor Hospital

Redesigning ED Arrival Process and Patient Flow

During the past year, Taylor’s Emergency Department Unit Council redesigned the ED arrival process, patient flow, and patient identification process/ID banding practice based on patient feedback and best practices. Following are innovative practices that have been proposed and researched, and are being implemented by the unit council:

• 100 percent bedside registration.
• Quick triage, including mini-registration.
• The five-level triage system endorsed by the Emergency Nurses Association and the American College of Emergency Physicians has been implemented as a best practice.
• TEC (fast track area) has been expanded to seven days a week.
• Patient Access uses flexed hours to ensure that a representative is always available to cover TEC (fast track area).
• Paramedics support the ER care team as nurse extenders with tasks that are part of their scope of practice. The paramedics function within their scope of practice and maintain a steady presence in the ER waiting area, using the ED playroom area to assist with patient flow. 
• The virtual treatment room concept is now used to start patient work ups from the waiting area when no treatment rooms are available. Rounding is done in the waiting area to update patients.

The Emergency Department’s unit council is spearheaded by Nicki Alesi with the support of their nurse manager, Pat Eckenrode, RN.

Emergency Department Unit Council

Nicki Alesi, RN

Patricia Eckenrode, RN

Jenn Hart, RN

Lisa King, RN

Annette Turnbull, RN, CCRN

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