LAUSR

248 Background: In a high risk setting such as an oncology Intensive Care Unit (ICU), providing quality care and maintaining a culture of safety is vital to patient outcomes. Operational excellence built a foundational operating framework in the ICU, created process reliability and connected value streams through standardization, while increasing value to patients and employees. The purpose of this investigation was for the ICU and operational excellence teams to examine and eradicate defects. Five areas: Safety, Quality, Engagement, Innovation/Finance were determined to be most impactful and aligned with the unit’s key performance indicators. Metrics centered on patient safety and hospital-acquired complications (VTE, HAPU, VAE’s and CLABSI) became the focus of data collection and daily discussion. Methods: A multidisciplinary team designed and implemented a Lean Daily Management Board based on five predetermined metrics. The team met daily for a brief huddle to review a checklist confirming documentation adherence, patient outcomes, productivity, and employee engagement. Fallouts are addressed using a problem solving tool, displayed for awareness and corrective measures. Results: Initial data collected starting in January 2014, noted medication scan rate of 75%, fall rates at 1.32/1000 patient days, VTE 77%, HAPU 1/1000 patient days, VAE’s 1/1000 patient days, and CLABSI 0.3/1000 patient days. Continuing education and certifications among nurses were not defined at baseline. After implementation of the Lean Daily Management Board, 2015 data revealed an increase in medication scanning to 98.9% and 99.05% in 2017. Fall rates remain consistent at 1/1000 patient days and VTE prophylaxis climbed to 100% in 2015 and through 2017. HAPU’s decreased to 0.6/1000 patient days, and VAE’s were reduced to 1 in 2015, 0 in 2016 and 2017. CLABSI rates decreased to 0. Nursing certifications rose from 28% to 62% in 2017. Conclusions: Lean daily management empowered the staff to drive quality and safety in the ICU. Deficiencies fostered accountability and implementation of evidence-based patient care practices. Process improvement, positive patient outcomes, and increasing nurse engagement were achieved utilizing operational excellence.