Main Line Health (MLH) is a non-profit four hospital health system founded in 1985 serving Philadelphia and its suburbs. It has a staff of over 10,000 employees and over 2,000 physicians, and has received national awards for excellence.
MLH developed an initiative to improve medication administration and provide a safer environment for patients and staff. To accomplish this goal it implemented a device called “Smart Pumps” to ensure intravenous (IV) infusion flow rates and dosages are programmed within safe, acceptable ranges. Two challenges faced the success of this project: establishing one standardized set of infusion parameters and practices across the entire health system, and overcoming the resistance to change resulting from a recent project related to bar-coding devices that the nursing staff found cumbersome and chose not to utilize.
Greencastle planned and coordinated a system-level project through a collaborative effort that created consensus and buy-in across all units at each campus. They developed “project evangelists” among nurses who built enthusiasm for the safety tool, and worked with key physician groups to ensure use of the new technology. In addition, the Greencastle team created venues and a structure for senior leadership participation throughout the project while maintaining clear, frequent, multi-vehicle communications that engaged all stakeholders.
Greencastle also operated as the Implementation Coordinator – managing all the process improvements, organizational changes, and project work. The project team coordinated the activities of every area of the health system impacted by the initiative, including the device vendor. Greencastle established a project management office (PMO) to integrate work efforts, issues, and communications at the project and enterprise levels. The following were key tasks:
- Establishing accountability and ownership through project reporting and work team structures
- Adjusting processes to obtain the full safety and economic benefits of the technology
- Conducting “lessons learned” sessions after each roll-out, allowing for ongoing improvements
To deliver this project, Greencastle organized and actively managed workgroup deliverables to:
- Create a standardized drug library and configuration for use with the Smart Pump
- Identify, implement, and train staff on changes to the current policies, procedure and processes
- Develop the quality improvement processes to collect, analyze and report pump usage data
- Establish IS interfaces, wireless network and infrastructure
- Swap out of all infusion, syringe, PAC pump devices and IV poles at each hospital and transition to new disposables and sets for maximum compatibility with the new pumps
- Develop a module management process to ensure the availability of clean pumps, minimize the need for rentals, and reduce the possibility of infection.
The result of Greencastle’s partnership with MLH is that the project became the hospital system’s new standard for implementation of clinical technologies. It eliminated $343,000 in pump rental costs through an effective module management process and created an estimated $5,110,000 annual savings. In addition, a 90% usage rate of the Smart Pump technology was reached. MLH also achieved “Go Live” in all units, at each campus, on time, without patient care degradation, and usage data was available within two weeks after the first hospital began increased use of the device. Prior to “Go Live”, nearly 90% of staff were trained and all IV infusion practices were improved.