Mapping Barriers
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 respiratory 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?”
"Can I ask you a few questions if you have a moment?"
“Do you know when a better time is for them?”
Key stakeholders on the floors
(Who are) RT, Nursing, Physicians/Hospitalist
An HCP says that Aerogen is only for patients on vents. How do you respond?
“Are you aware of our handheld device, Aerogen Ultra, for your spontaneously breathing patients?”
You don't know which floor to go to
Ask your POC: what floors have the highest concentration of respiratory patients outside ICU, Step-down and ED?
RT says they're respiratory patients are spread throughout the floors, like the Med-surg and Cardiac floors. You know the floor, now what can you ask to learn about the patient mix?
"What type of patients are on those floors?"
and/or
“What % of patients on those floors are receiving breathing treatments?”
You engage a group of nurses, but they are unsure about key quality metrics- ask this question
“Is there a nurse manager on this floor you could direct me to?”
The 2 goals of mapping the floors
(What is) Start the process of going to the floors and understanding the opportunity outside the ED and ICU
An HCP says: RT and nursing deliver the treatments on the floors, so we use what is there- jet nebulizers. How do you respond?
“What is the reason Aerogen Ultra isn't accessible 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?"
The hospital does not have a dedicated unit for respiratory, but they do have step-down unit with a lot of respiratory patients on vents. How do you respond?
"Outside of step-down unit, where do you have the highest concentration of respiratory patients on the floors?"
When meeting with a nurse manager, you ask this question to uncover if they have a problem
“What are some of the key quality metrics you are focused on?”
What makes HF 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 being done on the floors, leverage this to go to the floors
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 says they do all the breathing treatments on the Med-surg floor. What are your next steps to get the full picture?
Go to Med-surg unit, ask nursing: What is your process for delivering breathing treatments to the respiratory patients on this floor?
You encounter a nurse on the floor. What's a good opening question to start a mapping conversation?
"When a patient needs a breathing treatment on this floor, what's that process like?"
When discussing metrics, if LOS or throughput is not mentioned as a key metric, you can ask this question to guide the conversation
“I am hearing from a lot of my hospitals that improving LOS is big focus. Is LOS or throughput also a bottleneck for you?”
3 key mapping questions to ask HCP
Any of these 3:
An HCP says that the data about Aerogen is only relevant to the ED. How do you respond?
“It is the same device proven to save 37-minutes in the ED where boarding is a huge issue- could you see this improving your throughput on the floors as well?”