Barriers to Mapping
HCP doesn’t have time to talk. How do you respond?
"When is the best time to come back?"
A question you ask when you want to learn where the patients are outside the ICU & ED
"Where is your highest concentration of nebulized patients on the floors?"
If the nurses tell you the nurse manager is unavailable, ask this question to CONTINUE the conversation.
“Is there a charge nurse I could speak to instead?”
Or
"Can I ask you a few questions if you have time?"
Key stakeholders on the floors
(Who are) RT, Nursing, Physicians/Hospitalists
An HCP says that Aerogen is only for patients on vents. How do you respond?
“Are you aware of Aerogen Ultra, our handheld device for your spontaneously breathing patients?”
You don't know which floor to go to
(What is) ask your POC: "What floors have the highest concentration of nebulized patients?"
RT says respiratory patients are spread throughout the floors, specifically 5E and 6W. What can you ask to find out the AMOUNT of nebulized patients on those floors?
“What % of patients on those floors are receiving breathing treatments?”
or
"How many of those beds are receiving breathing treatments?"
You engage a group of nurses, but they are unsure about quality improvement metrics- ask this follow-up question
"Is there someone on this floor you could direct me to?"
“Is there a nurse manager you could direct me to?”
What are the 2 goals of mapping the floors.
(What is)
1. Start the process of going to the floors
2. Learn about the patients outside the ED and ICU
An HCP says: We use Aerogen in the ICU and ED, but BAN on the floors. How do you respond?
“What is the reason you are doing something different on the floors?”
RT/ nursing doesn’t know the answers to the mapping questions
"Is there someone else you could connect me with so I can better understand the workflow on the floors?"
RT says they do not have a dedicated respiratory unit, but have a step-down unit with a lot of respiratory patients. How do you follow-up?
“Outside of step-down unit, where do you have the highest concentration of nebulized patients on the general acute care floors?”
When meeting with a nurse manager, you ask this question to uncover a problem they are trying to solve.
“What are some of the quality improvement metrics you are focused on?”
What makes High-Flow part of the floors strategy?
(What is) HF is everywhere including the floors
or
(What is) HF is being done on the floors therefore Aerogen is, leverage this to go to the floors
A nurse asks why Aerogen Ultra is different from the jet nebulizer they are currently using. How do you respond?
(What is) vibrating mesh technology is at the heart of the Aerogen Ultra and is proven to deliver ~6x more medication to the lungs than traditional JNs, improving patient outcomes and throughput.
RT says they do ALL the breathing treatments on the Med-surg floor. What are your next steps to get the full picture?
(What is) go to Med-surg floor and talk to nursing to verify
You encounter a nurse on the floor. What's a good question to ask initiate a mapping conversation?
"Can you tell me a little about your unit?"
"Can you tell me how many beds are on this floor?"
"How is census?"
"What types of patients do you treat on this floor?"
You are speaking with a Nurse Manager and they did NOT mentioned LOS/throughput as a focus, ask this powerful question to guide the conversation there.
“I am hearing from a lot of my hospitals that improving LOS and patient throughput is big focus. How are you managing LOS and throughput on this floor?"
What are 3 mapping questions to ask HCP
- Where is your highest concentration of nebulized patients on the floors?
- What type of patients are on this floor?
- What are the # of beds on this floor?
- What is the avg # of breathing treatments?
- How are you currently delivering breathing treatments?
- What respiratory modalities do you use on this floor?
- What devices do you use to deliver breathing tx?
- Who prescribes and who delivers?
An HCP says that the jet nebulizers they are using work fine, even though they mentioned an increase in LOS. What's a good powerful question to ask?
“How could reducing LOS per nebulized patient impact your floor?"