The same providers tend to see patients in both

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outpatient departments. The same providers tend to see patients in both inpatient and outpatient departments to allow for continuity of care and consistent coverage. Project Selection The team initially applied for participation in the second wave of Lean projects (August 2009) and submitted their charter for review. The project was not accepted at that time, but the team revised and resubmitted it for wave three, and it was accepted for a February 2010 start date. One interviewee, a manager in the department, believed that the aims of the charter as originally submitted were too broad, and that the narrower scope in the revised charter submitted for the wave three application process made it a more feasible project. All interviewees from this team agreed that the project goal was to improve patient experience and quality of care by creating better continuity between the cardiology inpatient and outpatient departments. Project Staffing As with all projects at Grand, the project leadership included the clinical department chair as the physician champion, the department operations administrator as administrative champion, a coach from the S&P Department, and a team lead (Exhibit 3.16). The team lead for this project was an advanced registered nurse practitioner (ARNP) because they are responsible for the bulk of the patient care in the inpatient setting. This specific ARNP was selected because she had the most experience working in both the inpatient and outpatient departments. In addition, team members included five nurses from the cardiovascular lab, clinical services, and hospital services; a scheduler; a physical therapist; and a representative from the medical education department. Other staff, such as the surgery scheduler and residents, were brought in on an ad-hoc basis to provide input. Exhibit 3.16. Project Team Composition Cardiology Follow-up Appointment Scheduling The team included 12 staff : Physician champion: clinical department chair Administrative champion: operations administrator for the cardiology department Coach: systems and procedures staff member Team lead: Advanced registered nurse practitioner (ARNP) Team members: five nurses representing the cardiovascular lab, clinical services, and hospital services; a physical therapist, a scheduler, and a representative from the medical education department
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119 Planning and Implementation In advance of the training, the project team collected baseline data on the accuracy of the followup appointments, defined as getting an appointment with the right provider within the right timeframe, meaning within 1-2 days of request. The baseline rate for an accurate followup appointment was 41 percent at the start of the project in January 2010, and the initial objective defined by the Lean project team was to increase it to 80 percent by the end of June 2010.
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