Lean events are about quality, safety improvements

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The Prince Albert Parkland Health Region continues efforts to improve quality and safety for patients, and find efficiencies using Lean methodology.

More than 70 managers, physicians and staff members are at various stages of Lean Leadership training.

Several improvement events have been held in the past several months, including activities at the Victoria Hospital for both the emergency department and surgical care, and for long-term care and primary health-care. Highlights from some of those events include the following Rapid Process Improvement Workshops and Mistake Proofing Projects.

Rapid Process Improvement Workshop #13: Decrease lead time from when long-term care room is available until resident is ready for occupancy

Key accomplishments:

  • Reduced nurse walking distance to access computer to 0 steps.
  • Reduced time from vacancy notice to resident chosen by 99 per cent, and from vacancy to home care notification by 98 per cent.
  • Reduced the number of defects in identifying vacancy process in facilities by 27 per cent.
  • Reduced time to select appropriate individuals for placement by 95 per cent.

Rapid Process Improvement Workshop #14: Reduce lead time for CTAS 3 patients from triage to seeing a physician in the Victoria Hospital Emergency Department

Key accomplishments:

  • Reduced lead time for assessment of CTAS 3 patients by 75 per cent.
  • Reduced space required for supplies in exam rooms by 20 per cent.
  • Reduced part traveled requirement for the glucometer by 88 per cent.
  • The RPIW team was impressed with how staff and physicians took ideas and ran with them.

Rapid Process Improvement Workshop #15: Reduce lead time for Victoria Hospital patients from holding area to starting on time with roll in to theatre with first Operating Rooms of the day.

Key accomplishments:

  • Reduced patient wait time from holding area to roll in by 20 per cent (no IV required) and 14.5 per cent (IV required).
  • Reduced the number of late starts due to missing staff by 69 per cent.
  • Reduced the number of late starts due to bed availability by 100 per cent.
  • Improved patient safety by reinforcing the surgical site infection protocols.

Mistake Proofing Project #6: Suicide Risk Assessment—Mental Health Inpatient Unit

  • Key accomplishments:
  • Percentage of patients who did not have suicide risk screening completed reduced from 24 per cent to 6 per cent.
  • Reduced the percentage of patients requiring a suicide risk assessment from 60 per cent to 6 per cent.
  • Visual controls to identify patients requiring assessment and patients at risk.

Mistake Proofing Project #7: Eliminating the defect of Long-term Care residents acquiring or progressing pressure ulcers (Herb Bassett Home).

Key accomplishments:

  • Eliminated the wound care cart and distance travelled to retrieve supplies.
  • Time between repositioning has been standardized.
  • Residents with a pressure ulcer reduced from 6 to zero.

Mistake Proofing Project #8: Reduce the incident of Post-Surgical Site Infection in all cesarean sections completed at the Victoria Hospital

Key accomplishments:

  • Increased the number of patients receiving antibiotics prior to cesarean section from 90 per cent to 93 per cent.
  • Increased the collection of accurate data from 46 per cent to 99 per cent.
  • Reduced the number of time people entered to OR during a procedure by 39 per cent.

Photo: Reporting results: Tannice Thompson, Nursing Unit Manager for Level 5 at the Victoria Hospital, was the Sub-team Lead for a Rapid Process Improvement Workshop that focused on reducing the lead time for CTAS 3 patients from triage to seeing a physician in the Victoria Hospital Emergency Department. The team’s Report Out was on January 31, 2014.

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