Leadership Lean QI Powerpoint
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Transcript of Leadership Lean QI Powerpoint
ED DISPOSITION TIMEat St. Vincent Williamsport Hospital
Kiera BonebrakeTeam Leader
Abby BullerdickUser RepresentativeRachel Noyes
Administrator
Sara SimsUser RepresentativeLeah SteeleDesignerLindsey WaltzImplementer
LEAN Project• St. Vincent Williamsport Hospital• Critical Access Hospital• Problem with disposition times from Emergency
Department (ED) to In Patient unit (IP)• Disposition time: a measurement of the time when the
physician admits the patient from the ED until the patient is taken to IP unit
• Involves both the ED and IP, however our group’s focus is on the ED aspect
• Main Stakeholders: Patients, Trina Marlatt (CNO), Physicians, RNs, housekeeping, technicians, secretaries, and all other St. Vincent Williamsport Hospital employees
DefineProblem statement:
• The average time at St. Vincent Williamsport Hospital for emergency department (ED) disposition to inpatient admission is 94 minutes.
Background: • Prolonged disposition times and ED crowding compromises care quality, increases costs, and compromises community
trust. Furthermore, ED crowding will be measured by Centers for Medicare & Medicaid Services (CMS) under the Hospital Inpatient Quality Reporting Program initiative. By improving patient flow hospital-wide, this problem can be improved (McHugh, Van Dyke, McClelland, & Moss, 2011).
• The desired level of performance is 60 minutes or less. • Due to the prolonged disposition wait time, the following have occurred:
• Intergroup hostility between units has increased• A delay in patient care has developed• HCAHPS scores have decreased
• Current score of 54.8%• Target score of ≥70%
• There has been a projected loss in revenue to the ED.• According to Pines, Batt, Hilton, and Terwiesch, “A 1-hour reduction in ED boarding time
would result in $9,693 to $13,298 of additional daily revenue from capturing left without being seen and diverted ambulance patients” (2010, p. 331).
Measure: Current State Map
Measure
Analyze
Analyze
Improve: Future State Map
ImproveDeliverables• SAINT Handoff Reporting Tool • Time Data Collection Tool• Bed Placement ChecklistRecommendations• Inpatient RN should always be the one to
transfer the patient from the ED• Inpatient RN ensures PRN orders are obtained
from ED physician during patient handoff in the ED
• Inpatient RN will pick up patient from ED within 30 minutes of bed assignment confirmation
• If inpatient RN does not get patient within 30 minutes then ED RN will transfer patient to inpatient unit
Improve
Control
Control
Management and Leadership Principles•Delegation•“Defined simply as getting work done through others or as directing the performance of one or more people to accomplish organizational goals” (Marquis and Huston, 2012).
•Collaboration•“All parties set aside their original goals and work together to establish a supraordinate or priority common goal” (Marquis and Huston, 2012).
Conclusion• Going forward
• Data collection• Discover more areas of waste
• Implement SAINT tool and bed placement checklist• Continued interdisciplinary communication• Reinforcement of the process by leadership• Scheduling meetings at each interval of process implementation
to evaluate current state and make further improvements• Encourage staff communication