Pediatric continuity of care after the projects 90

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Pediatric continuity of care: After the project’s 90 -Day Report, 100 percent of patients, excluding walk-ins, were seen by their primary care provider. There was a reduction in missed appointments and a decrease in payment denials by an estimated 70 percent as the result of: 1) calling pediatric patients in advance to verify appointments and coverage; 2) recertification of Medicaid patients with expired coverage prior to the visit; and 3) verification that physicians were on the insurer’s primary care panel. Residents’ schedules were obtained 6– 8 months in advance, further allowing patients to get an appointment with the same physician. Space was made for last-minute appointments with the patient’s primary care provider. Thus, the need to staff a separate doctor just to see walk-ins was eliminated. Staff absenteeism rates were lowered and timeliness improved. Changes to the patient workflow and scheduling helped ensure that the pediatric clinics started and ended on time.
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197 Two managers in Pediatrics noted that there may be a limit to the amount of efficiency the RIE brings to workflow because the RIE also leads to redesign of processes that increase work (e.g. checkpoints, increased documentation). Other Lean projects: A project in the Oncology Department reduced wait times for patients and increased the volume of patients being seen. In a perioperative surgery value stream project, a daily meeting, or huddle, was called to improve communication and planning for operating room cases and to incorporated staff from Central Supply into the meeting. Ultimately, this created a central cell for all staff to communicate daily about what went well the previous day and what could be improved, especially with regard to availability of specialty surgical instruments. The BDO reported that, following implementation of the daily operating room huddle with Central Supply, immediate-use steam sterilization in the main operating suite at Heights Hospital decreased from a rate of between 5 8 percent of cases to a rate of 1 percent or fewer of cases. The Advance Deployment Office encourages project teams that can reduce full-time staff by using process improvements to shift those staff to a value-added activity. However, a hiring freeze at the hospital makes this shift difficult for some, even though it can benefit departments in need. Managers fear that shifting full-time staff to another department will make their own departments short staffed if any of their staff were to leave their department or become unavailable during the hiring freeze. Patient Experiences Minimal data on patient experience and satisfaction were obtained as part of Lean projects. Information on patient experience data comes from CAHPS ® measures used in the inpatient, outpatient, and ED settings. For the Pediatric Continuity of Care project, an executive stated that the project improved patient experience because the department assured patients that they would
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