4:15-5:15 pm
Room: 225 AB North
This is part of an HQ Talks session, which includes two presentations during the hour.

Clinical Care Redesign: Development of a Clinical Milestone Pathway
Presenters: Kendra Folh, MSN RNC-OB CPHQ, and Patricia Heale, DNP RNC-OB EFM-C

This session is intended to discuss the planning, development, and implementation of the Clinical Milestone Pathway. The obstetric length of stay was 4.6 days from admission to discharge, significantly above the average for similar academic institutions. Also, there had been several instances of missed care with no pathway to follow. After attending this session, the participants will understand the importance of utilizing front-end staff in the development, planning, and implementation of a quality initiative while also seeing how the Clinical Milestone Pathway improves care and the discharge process. The Six Sigma DMAIC model was used to study, plan, develop, implement, and sustain this quality initiative. This initiative is important to healthcare quality as it has decreased the missed care events to zero and the length of stay decreased from 4.6 days to 2.6 days and saved $1.6 million throughout the system.

Learning Objectives:

  • Identify steps in development of a Clinical Milestone Pathway for discharge
  • Apply Six Sigma DMAIC concepts to the discharge process
  • Understand the importance of utilizing front-end staff in a quality initiative

NAHQ NEXT Speaker Kendra Folh
Kendra Folh
is the Senior Project Manager for the pediatric and obstetric service line for the Memorial Hermann health system. She is the lead of clinical redesign and transformation where she utilizes Six Sigma methodologies and comparative analytics to drive change. She is a member of multiple national collaboratives and serves as faculty for the Texas AIM Collaborative to reduce maternal mortality and morbidity.



For the last 30 years Patricia Heale has worked in Women's Health Care as a staff nurse, charge nurse and Clinical Nurse Specialist (CNS). As a CNS for the last 18 years, she has practiced in the three spheres of CNS practice: patient, nurse/nursing practice, and organization/system. To affect these spheres the CNS operates in four realms clinical practice, education, consult and research. In clinical practice, Heale has been seen as the clinical expert in perinatal nursing and offered educational opportunities for nursing staff throughout her career. As a consultant, she has participated in the planning of a $550 million Women's Center including a four-bed Obstetric Intensive Care Unit. Her research interests include second stage of labor and decreasing the incidence of primary cesarean sections through nursing measures. She is responsible for all Quality Assessment Performance Improvement (QAPI) initiatives in Women's Services and leads the weekly QAPI Meeting.

Audience Level: Core/Early
Topic: Performance & Process Improvement
Date: September 16