Dissemination a management engineer and two frontline

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Dissemination. A management engineer and two frontline staff attended and gave a presentation on the Bed Flow Value Stream at the Institute for Healthcare Improvement (IHI) and the GetWellNetwork Users Conference. Department-Specific Projects In addition to the two cross-cutting projects, we also studied an outpatient clinic project. Outpatient Medical Records and Patient Flow The outpatient medical records and patient flow project took place at an outpatient medical facility where providers see 80 to 100 patients each day. The practice directly employs three doctors and two nurse practitioners. The goal of this project was to create a new process for medical records flow to ensure that (1) patient charts could be easily located before a patient visit and promptly filed after the visit, (2) lab results would be inserted into the charts in advance of patient visits, and (3) the space in a small medical records room would be used more efficiently. A nurse at the clinic nominated this project for consideration based on her assessment of inefficiency in the record- keeping system. After a physician saw a patient, the patient’s record would be placed in a pile that was not organized, resulting in a backlog of over 1,000 unfiled records. Further, files were not signed in or out, so no one knew where a file was or who had last taken it out. Over time, it became ever more challenging to find files. The project was staffed by members of the clinic staff as shown in Exhibit 1.13. The process owner was the nurse who recommended the project, and an individual from the Management Engineering Department was the Lean leader. Additional clinic staff including the physician leader were also on the project. Other physicians were not formal members of the team but were kept up to date, and they were asked for their input on the process. The management engineer began gathering initial data as part of project planning and preparation in December 2007. The 3.5-day Kaizen event was held in February 2008 and began with training on Lean tools and concepts. The steps or activities implemented by the project team and the Lean tools used are described in Exhibit 1.14. m Press Ganey Associates, Inc., South Bend, IN (http://www.pressganey.com). Exhibit 1.13. Project Team Composition Clinic Flow Project Total of eight staff: Executive sponsor: COO of Hospital 4 and the Outpatient Medical Facility Management engineer/Lean leader Process owner: nurse Physician Nurse practitioner (one) Medical records staff (one) Nursing staff (one) LPN (one)
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40 As a result of the project, the team made several infrastructure changes to assure that medical records staff and frontline staff could better communicate and keep the files sorted properly. For example, front desk staff were responsible for pulling and/or requesting charts as patients arrived for their visits, but they were unable to find charts and keep the patient appointments running on time while managing their other duties, particularly responding to and triaging phone calls. to
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