August 6 and 7, 2019 — In order to meet with as many inpatient hematology/oncology team members as possible, I had the pleasure of visiting this team on two different dates. And this group really went big with the travel theme, even setting up their conference room like the inside of an airplane!
During both visits, I began by taking my seat in the first-class cabin. Before we took off, our friendly flight attendant (and clinical nurse) Emily Schnecker made sure to stamp my passport, and we were soon underway. Once airborne, we watched the “in-flight movie.” This was the video shown to every family at the start of their inpatient journey, in which Emily and clinical nurse Katherine Roque go over what families can expect during their stay. As Margaret Fitzgerald, manager of the Peckham Center for Cancer and Blood Disordersput it, “Every family is given the opportunity to have their questions answered, expectations set and receive the information they need at the start of their stay.” I learned that this is just one of the ways staff members strive to make families more comfortable during what is often a difficult and overwhelming time. For example, every family receives a New Diagnosis Information handbook when their child is admitted (I had one conveniently placed in my seatback pocket). The team successfully implemented a learning assessment tool for family caregivers. This ensures caregivers understand important topics based on the “teach-back” technique, in which caregivers are asked to repeat in their own words what they have learned.
This team is full of great ideas! Below are some of the other initiatives and practices I learned about during my visits:
- The BARF scale — just what it sounds like! This was developed for determining how nauseated a child is after receiving chemo. The child points to one of six faces that represent varying degrees of distress, kind of like the universal pain scale.
- A focus on infection prevention by thoroughly cleaning high-touch areas such as call lights, bed rails, monitors and computers.
- Implementation of the “bin project.” Parents are given two bins to store their personal items to reduce clutter. They are also given a 15-minute warning before housekeeping visits so they have time to remove items that might prevent thorough disinfecting.
- Safety huddles during every shift to address any concerns and share information.
- A safety and quality wall that lists how may days since the last CLABSI infection, mislabeled specimen and patient fall.
- “Good catch” recognition when a team member identifies and prevents a potential issue. The reward is a photo with the Good Catch Dog and a Frisbee!
- A team of safety coaches on staff (11 total) who are on the front lines of managing and reporting safety risks to our patients, families and co-workers.
- Guidelines for chemotherapy administration that ensure the right patient is getting the right dose of the right medicine at the right time.
- Development of the Bedtime Cart, which is stocked with hot tea, books, toys, lotions (I got my own sample!), toiletries, stuffed animals and other items that assist with a comfortable night’s sleep. Law enforcement volunteers operate the cart several nights per week and even get to read bedtime stories to the kids.
- A colorful beach-themed drawing that includes vital information for parents when they are preparing for their child to be discharged from the hospital. Parents follow the path on the drawing to make sure they are familiar with the five things they need to know and the five things they need to do before heading home.
- A hematology/oncology code of conduct
- A kudos board with notes from team members recognizing each other for their good work. The notes are read at staff meetings.
- The peer-nominated Starfish Award, which recognizes excellent staff.
- A “free take” program that allows nurses who are interested in becoming certified nurses to take the qualifying exam free of charge.
The outstanding care this team provides is evident in the multiple awards it has received from Professional Research Consultants: five-star excellence awards in 2017 and 2018 and the Excellence in Healthcare award in 2019 for overall quality of care. This year’s engagement scores also speak volumes: inpatient hematology/oncology is in the 96th percentile for engaged employees of all of the hospitals who have taken the engagement survey!
Of course, the ultimate measure of success is the care our kids receive, and this team has thought of everything necessary to go above and beyond. The passion they have for their roles is unmistakable. On behalf of our patients and Rady Children’s, a heartfelt thank you for all that you do. And thanks for the incredible jacket and the tasty food!