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Dome - Hundreds of employees, hundreds of processes

January 2012

Hundreds of employees, hundreds of processes

Date: January 10, 2012


Hope Gainey
All Children’s frontline staff, like nurse Hope Gainey, came together in “workout” groups to find ways to improve patient care.

A year ago, hundreds of All Children’s employees started working out—not at the gym, but as interdisciplinary team members taking part in a series of 100-Day Workouts dedicated to improving several dimensions of quality care.

Frontline staff, department directors, physicians and support staff worked collaboratively to target everyday processes, such as getting the right patient to the right bed quickly, that could be improved. They used rapid-cycle testing to determine the success of each approach and to make further changes as needed.

Each workout completed to date had a distinct focus. The first looked at reducing waste caused by redundancy, delay or other types of waste targeted by the process-improvement tool, Lean Six Sigma. A parallel track focused specifically on increasing patient throughput by reducing delays and changing flow patterns in surgery/perioperative services.

Overall, more than 500 projects were initiated in the first 100 days, leading to approximately $1.5 million in savings. The second workout focused on staffing, with more than 400 improvement plans created either to better match shift hours to demand or to shape demand to better match hours.

For the third workout, the team included nearly 450 frontline staff and 90 physicians, all studying patient flow to help All Children’s meet an overall quality goal to increase the percentage of patients getting to “the right bed” within one hour. Thanks to their efforts, this overall benchmark went from 35 percent at the start of the workout to 62 percent at its conclusion. The All Children’s Emergency Center made noteworthy progress in getting patients who need to be admitted transferred to an inpatient bed within one hour: a jump from 16 percent before the start of the workout to nearly 60 percent in October. Emergency Center Director Susan Byrd credits her team’s focused efforts, collaboration between physicians and other staff, and hospital-wide support for this success.

The celebration marking the end of the patient flow workout doubled as the launch of another 100 days dedicated to this focus. “We have seen phenomenal results and our teams are excited about continuing to look at more ways to improve patient flow,” says Hella Ewing, All Children’s Hospital vice president and chief nursing officer. Some of the metrics for these ongoing efforts include transfer time from PACU or PICU to the appropriate bed, discharge before 2 p.m. and discharge within two hours of a discharge order. All of these can help All Children’s reach an 80 percent benchmark for getting the right patient to the right bed within an hour.

To build on these successes, staffers from across the hospital are taking part in “green belt” Lean Six Sigma training. The first group of 15 trainees includes frontline staff from the Emergency Center, the Heart Center, Respiratory Care, Case Management and other areas.

—Ellen Arky

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