Clinical Caregivers

K-cards Challenge -

What are they and why and how does Intermountain use them? 

The K-card system is a visual management tool that exposes non-conformance to established standards and drastically reduces variation in why, when, and how the work gets done.
Nurse at desk

Why a k-card system at Intermountain?


The kamishibai or K-Card system at Intermountain Healthcare helps ensure best-known standards have been established for critical processes and those standards are being followed. Much more than a simple checklist of processes and procedural “to-dos,” the K-Card system fosters learning, development, and coaching at all levels of the organization; and facilitates a consistent, high-value experience for all Intermountain patients, members, and caregivers. A properly deployed and managed K-Card system is foundational to reducing variation and improving patient and caregiver experience.

Primary steps for using and maintaining a k-card system:  

The primary steps for using and maintaining a K-Card system include:

  1. Best-known methods and practices that align with Intermountain policies and procedures have been uploaded into an electronic K-Card format for the following never events: Medication Administration, Specimen Labeling and Patient Identification.  A section where more specific details about the how and the why is included for training and review purposes.
  2. Print and post your K-Cards in a location near the process for easy access and reference. This will facilitate the use of the K-Card for training of new caregivers and for reinforcing proper steps in a process. A QR code has been added for quick and easy electronic scan and observation.
  3. Under the direction of the market leadership, caregivers complete a minimum of one (1) K-Card observation a week. You might consider quietly observing fellow caregivers in their everyday work. This will reduce anxiety and give you a more accurate idea of how caregivers actually complete a task. Keep in mind the observation should be done in real-time, while the caregiver is completing the tasks.
  4. Scan the QR code provided on the K-Card, or access the link on the MG clinical resources page. Observe the process as it is being performed; indicate on the survey tool which tasks were completed according to standard and which were not. Results will be tallied electronically. Keep in mind, finding opportunities for improvement is a GOOD thing and allows us to improve processes through education. Be sure to record on the K-Card form any issues found during the observation. Medical Group K-Cards (on
  5. Market nursing leadership will email the QR K-card completions report to clinic leaders at the 1st week of each month. Managers will post observation results on the team’s huddle or performance board. Review the results with the team.  Discuss and implement opportunities for improvement.

Challenge: Are the K-Cards printed and posted for all to access? Are you all aware of the QR code that's available and allows you to complete the observation on your phone or computer? Can each caregiver complete 1/week and learn with your team how to improve process. Ask any nursing leader for help—they are happy to assist.