Chairman's Award 2017-2018

June 27th, 2018

The Cheshire Medical Center Chairman’s Award recognizes the work of teams to continuously improve the quality of our health services.  This year’s nominees represented teams across a range of services and areas, from patient care on the Kingsbury Unit to Mohs procedures in dermatology, and from advanced breast care to substance misuse and -use disorder care coordination. 

All of the projects teams nominated recognized an opportunity and developed and implemented a strategy to receive outstanding results.  Below are details of the winning projects.

Clinical Informatics & Superusers Team

The successful conversion from multiple electronic health records (EHRs) to a shared single Epic platform took a great deal of planning, the right organizational structure to keep the flow of information moving, and a lot of highly motivated, well organized individuals with real-life knowledge of the work that takes place on the front lines of patient care.

For 18+ months, Clinical Informatics worked closely with colleagues from within Cheshire Medical Center and the Dartmouth-Hitchcock Health system to learn the Epic software, the new workflows, and to identify changes that would be necessary to meet the needs of our community medical center. 

In addition to the Clinical Informatics team, it was necessary to engage more people, the right people—  SuperUsers, staff who represented their department teams during the building and testing of the new EHR.  This group was instrumental in sharing what they learned with their colleagues.  When the new EHR went live, SuperUsers provided direct support for end users. They answered questions, helped end users navigate the system, reported issues to the project team to support prompt resolution, and supported staff morale.

They continue to provide feedback and suggestions to improve both the software and the workflows their departments use.

Neonatal Resuscitation Improvement Team

The first few moments of a newborn's life can be the most critical. If needed, effective emergency care during this transition can prevent harm. Neonatal Resuscitation is intervention after a baby is born to help it breathe and to help its heart beat.

Neonatal resuscitation isn’t a common occurrence at Cheshire Medical Center.  When it does occur it is an event of considerable magnitude.    

Staff reviews of updated American Academy of Pediatrics Neonatal Resuscitation Program (NRP) guidelines revealed opportunities to improve neonatal resuscitation processes. Women and Children’s Health Unit (WACHU) nursing staff, pediatricians, and Quality and Patient Safety team members collaborated to develop a neonatal resuscitation improvement plan. 

Actions included changes to the equipment and medications on the neonatal code cart and more realistic training with a new neonatal resuscitation mannequin.  Pediatricians participated in neonatal resuscitation skills trainings facilitated by a Dartmouth-Hitchcock Health system neonatologist, and WACHU nursing staff attended neonatal resuscitation skills trainings.  Both groups jointly participated in mock codes. 

This dedication and commitment by WACHU nursing staff and pediatricians has helped ensure that we provide the best possible care to babies born at Cheshire.  

Second Stage Situational Awareness Improvement Team

The second stage of labor is from full dilation until delivery.  During this time a nurse and midwife are usually in the room with the laboring mother, focusing solely on her.  This intense, sometimes lengthy focus can lead to tunnel vision and a loss of situational awareness.  The loss of situational awareness can affect the team member’s ability to fully comprehend all details of the current situation. 

Women and Children’s Health Unit (WACHU) nursing staff, OB/Gyn providers, and a member of the Quality and Patient Safety team proactively collaborated to develop a process for this stage of labor using a checklist created by Northern New England Perinatal Quality Improvement Network.

The process for completion of a Situational Awareness Second Stage checklist (SASS) was developed to be completed for patients in the second stage of labor.  The process includes completion of the SASS and a huddle between direct caregivers and a clinical staff member not actively involved with the patient, multiple times during the second stage of labor.  All WACHU nursing staff and OB/Gyn providers were educated on the form and process.    

The SASS process has helped to maintain situational awareness and provides an additional safety measure as we care for laboring mothers and their babies.