There was a lot of celebrating on October 3, 2014 as seven Saskatoon Health Region teams reported the results of their week-long improvement events. The teams brought together patients, employees, and physicians focused on improving specific aspects of care and services. So far, the Region has hosted 101 of these events, and more are being held every month; all have resulted in achievements to celebrate.
“The work done this week has been fabulous,” said Candice Bryden of Saskatoon Health Region’s Kaizen Promotion Office. “And it’s so important. It’s making a huge contribution to helping us reach our strategic goals as a region, and is very important to our patients and families.”
The teams reporting out focused on different areas, from those directly patient- and client-related to those focused on support services, such as human resources and payroll.
The successes are as follows:
- A new process at Royal University Hospital (RUH) for receiving and processing MRI requisitions has reduced steps for MRI staff and has located radiologists right on the MRI unit. Changes were made to where and how patients in RUH 6300 are screened to be sure they can safely receive an MRI. Through reorganization of duties, setup time from receipt of the requisition to completion of all the necessary documentation has been reduced from 20 hours to 28 minutes. These changes mean that inpatient waits for appointments will be reduced. Outpatients now register directly with the Department of Medical Imaging and Nuclear Medicine, speeding up the process for them and avoiding repetitive questions. The new standard work processes will be trialed and eventually used throughout RUH.
- New tools have helped eliminate defects in information flow between Registered Nurses and the rest of the interdisciplinary care team on RUH 6200. Shifting to electronic organization of information reported when the care team rounds on all patients has saved more than an hour per day of the nurse coordinator’s time. A tool developed for shift handover ensures the right information is being communicated about each patient, and another tool helps patients know how their care is going and when they are likely to go home.
- Improving the flow of information between the maternity ward at RUH and the Healthy and Home program means that a nurse with the Healthy and Home program, which visits mothers and new babies after discharge, no longer needs to be on the Postpartum ward every morning collecting information on upcoming discharges. This is thanks in part to a nurse-to-nurse referral form created to ensure that information is passed from Labour and Delivery to Postpartum to the Healthy and Home program. This has increased capacity for the Healthy and Home program, as nurses with that program can devote time previously spent collecting information to caring for their clients.
- A focus on improving information for parents of children in the Neonatal Intensive Care Unit at RUH led to widespread changes in the unit. Teaching parents about caring for their baby at home now begins at admission. Parents are given a package of information that explains milestones their baby needs to reach and other necessities for discharge. Visual information about milestones, in the form of a colorful house, is presented as general information in each bay. Each baby has a tag that shows his or her goal for the day, and corrected gestational age. All this will mean parents will have a better understanding of how close their child is to discharge, and have adequate time to prepare to take their baby home.
- Changes in processing for health records have resulted in a 42% decrease in the time required to assemble patient charts after discharge. Elimination of defects in assembling the chart will ensure all the patient information needed for safe care will be in the chart. New standard work processes will soon be trialed throughout Saskatoon’s three hospitals.
- Changes to the time sheet entry process have cut down on cycle time by 95% and will eliminate defects and rework in the schedule-to-pay process. The new process is being tested in pilot areas and will eventually be used throughout the Region.
- A new e-communication board for those responsible for hiring resulted in a 77% reduction in time, as well as fewer errors and rework in processing new hires and staff transfers.
- Although great improvements were made by these teams, the work does not stop there. Units and departments will continue to further implement and refine the new processes, train staff, and assess whether the improved results are sustained.
“We’ve heard a lot about teamwork, about the right person doing the job,” said Maura Davies, president and CEO of Saskatoon Health Region and a participant in one of the week-long improvement events, after the report-out concluded. “We are working to get today’s work done today and eliminating defects. It really is all about the patient. There’s been a lot of criticism about Lean, but it works.”
Davies also presented outgoing Kaizen Promotion Office director Candice Bryden with flowers in honour of her retirement, saying, “We owe so much to you.”