The nurses’ station at Kaiser Permanente Woodland Hills Medical Center’s Telemetry/Observation unit could be a stage set for a science fiction film.

A busy staff bustles through the hallways checking pagers connected to the main telemetry system. Large computer screens flash and glow from a series of wireless receivers and transmitters that provide the staff with the heartbeat of each patient.

But behind the technology, the unit, known as 4-West, has found a more old-fashioned way to their patient’s hearts: customer service.

Changes adopted

The telemetry system monitors heart rhythms from transmitter packets worn either in a pocket or around the patient’s neck in a plastic holder. The data is sent back to receivers at the central monitoring station. But to help members on the busy 24-bed ward feel connected emotionally as well as electronically, the department’s unit-based team developed and adopted several changes:

• Staff members are assigned to do regular face-to-face check-ins.
• The administrator’s name and phone number are written on the bulletin board of each room.
• Each shift begins with an assessment of each patient in a “seamless handoff.”

“We are able to fine tune areas to help ourselves give better patient care,” said Laura Marcos, a UNAC/UHCP member, UBT co-lead and night charge nurse.

Their hard work has resulted in the UBT being among the first to be honored in a new program in the Southern California region that recognizes inpatient UBTs for highest or most-improved hospital rating scores. The first two teams to win were honored for their high ratings by Benjamin Chu, MD, the president of Southern California region, and Jeffrey Weisz, MD, the medical director of the Southern California Permanente Medical Group; both were in the 90th percentile nationwide. The telemetry team, in fact, scored in the top 2 percent.

The other winner this quarter was the West L.A. Labor & Delivery/Family Centered Care team. Next quarter, most improved winners will be selected in addition to high performers.

The environment of care will make a difference. That is part of how the patients get better.

Glenn D. Pascual, 4-West department administrator
and UBT co-lead

Minimizing anxiety

Glenn D. Pascual, 4-West department administrator and UBT co-lead, said that the team wanted to focus on the H-CAHPS Overall Rating of Hospital scores because telemetry patients need to feel they are in good hands. The unit has consistently scored above the 90th percentile, Pascual said.

“There is already a great deal of anxiety,” Pascual said, describing how telemetry is a safe, noninvasive way to monitor cardiac patients at risk of complications after surgeries and other treatments. “The environment of care will make a difference. That is part of how the patients get better.”

John Sundahl, a Kaiser Permanente member recently getting ready to be released from the unit, recalled how he felt ignored in other medical facilities.

“I’d push the button and no one would come,” he said. “The only thing I could do is disconnect the machine so they would think I was having a heart attack.”

Sundahl, a 40-year-old pilot, continued, “Being at Kaiser makes being sick a lot easier. You feel safe here.”

Cooperation is “liberating”

While the unit’s key purpose is to make sure patients are stable, Pascual said, members must also be satisfied with their care. The 4-West UBT reviewed the ratings for key areas of improvement. Meeting regularly, the team, which includes staff from different shifts, could compare notes on what keeps members pleased with their care. One important finding was that members like ready access to medical staff. In other words, they do not want to be ignored.

Marcos, a veteran nurse, called the team’s cooperation liberating.

“It has freed my ability to give good care and do the right thing,” she said. “We’re not antagonistic. Management and labor are together.

“I invite people to come and take a look at what we are doing. We’re busy, but we’re smiling.”