Implementing a Virtual Quality Nursing Team to Mitigate Patient Risk Patient Safety Awareness Week 2020
The development of a Virtual Nursing (RN) program to support
Kaiser Permanente (KP) patients in Northern California (NCAL)
began in 2014 with the implementation of eHospital, a virtual
surveillance model, featuring real time monitoring and
identification of care delivery gaps. This began the Virtual
Quality Nursing Team that has subsequently grown in support of
other virtual programs aimed at improving safety. In 2016,
Advance Alert Monitor (AAM) was implemented in partnership with
the KP NCAL Division of Research (DOR). Utilizing a predictive
analytic model allows for surveillance of patients at risk. This
predictive model proactively identifies adult ward and
transitional care patients with considerable risk of mortality or
up-transfer to the Intensive Care Unit (ICU), it is used to
coordinate early rescue. AAM uses multiple factors, including
chemistry, hematologic, respiratory values and vital signs, to
predict early detection of impending deterioration for inpatient
adults. This tool gives clinicians a 12-hour lead time. Along
with early rescue it enhances patient safety, quality, and
experience outcomes with timely involvement of supportive care
services, including social work and palliative care consults.
Thoughtful conversations earlier in patient’s disease trajectory
and admission can promote understanding of one’s illness and
clarify their care directive.
Describe Kaiser Permanente Northern California’s hospital
early warning system score: Advance Alert Monitor
Describe implementation strategy for AAM in NCAL KP
Describe impact of implementing Advance Alert Monitor in NCAL
KP hospitals on patient outcomes
Laure Lisk RN MSN CPHRM, CPHQ
Executive Director Health Plan Quality and Regulatory
Northern California, Kaiser Permanente
Laure joined the Northern California Region in January of
2017. She is currently the Executive Director Health Plan
Quality and Regulatory. She has been with Kaiser Permanente
since 2007. Previously, Laure was the Senior Director of
the Quality, Risk and Patient Safety for the Colorado Region and
has worked extensively in the areas of Quality, Risk and Safety.
Laure worked in the inpatient arena in risk management and
patient safety prior to joining Kaiser Permanente. Laure’s
clinical areas of expertise include Neonatal Intensive Care, OB,
GYN, Labor and Delivery and Pediatrics.
Laure earned her undergraduate and graduate degrees in Nursing
from the University of Colorado Health Sciences Center in Denver.
Laure is recognized as a Certified Professional in Healthcare
Risk Management and a Certified Professional in Healthcare
Quality. Laure has a passion for providing care to children
in under-served countries.
Elizabeth Scruth RN PhD MPH CCNS CCRN FCCM FCNS CPHQ
Regional Director of Clinical Quality Programs and Data
Northern California, Kaiser Permanente
Lizzie is an accomplished scholar and nurse from Australia
where she started her nursing career before progressing into
Intensive Care nursing both in Australia and the US where she has
spent most of her career.
Lizzie holds a BSN, MN and MPH from Edith Cowan University of
Western Australia and a PhD from Australian Catholic University.
Lizzie obtained a post masters in Critical Care/Cardiovascular
Nursing from UCSF and has been certified as a Critical Care
Clinical Nurse Specialist since 2006. Lizzie also holds
certification as a CCRN and is currently the chair elect for the
Certification Board of the American Association of Critical Care
Lizzie is an active contributor nationally as an author and
representing clinical expertise on national and international
professional practice groups. She served as the chair of the ICU
Design Award Committee for the Society of Critical Care Medicine
Society and now serves on the Tele ICU Committee for the society.
Additionally, she was coauthor of the Patient and Family Centered
Care in Neonatal, Pediatric and Adult Intensive Care Units
guideline released in 2017 by SCCM. Lizzie is recognized for her
40 plus publications, numerous presentations both nationally and
internationally and is an Editor of the Australian Critical Care
Journal, section editor of the CNS Journal and one of the nurses
on the editorial board for the Critical Care Medicine Journal.
Lizzie was recognized by SCCM in 2014 being inducted as a Fellow
into the College of Critical Care Medicine and also by the
National Association of Clinical Nurse Specialists as a Fellow.
Continuing Education Credit
One complimentary CE unit will be provided to dues-paying member
hospitals of the Hospital Quality Institute, CHPSO Patient Safety
Organization, the California Hospital Association or the regional
hospital associations in CA.
HQI is an approved continuing education (CE) provider by the
California Board of Registered Nursing and will provide CHPSO
members an opportunity to earn CEs. Provider Number CEP16793
for 1.0 contact hour.
HQI does not currently offer ACPE approved Pharmacy CE, but
the State of California will accept CE from courses which have
been approved for continuing education by the Medical Board of
California, the California Board of Podiatric Medicine, the
California Board of Registered Nursing or the Dental Board of
California towards their California continuing education
requirement (Section 1732.2(b) of the California Code of
Regulations). Pharmacists need to keep track of CE from these
sources on their own as they are not submitted to NAPB.