Reducing Patient Wait Times Through Connexall Portering Software

1. Reducing Patient Wait Times Through ConnexallPortering Software • Improving The Human Experience Through Technology

2. Trillium Health Partners Footprint: An Opportunity Picture • Click to edit text • Second level • Third level • Fourth level • Fifth level Click to ad to text

3. Various Portering Models • Centralized Portering – Could increase flexibility and utilization of porters • Decentralized Portering – Unit specific or area specific • Hybrid Model – Unit specific and centralized

4. Our Journey – Phase 1

5. Background and History: Prior to this project, there were separate paging and portering processes utilized by departments to request patient transportation by Trillium porters. Each Area operated independently of the other, functioning in a “silo” manner.THC porters respond to approximately 16,000 tasks per month The Diagnostic Imaging Department had dedicated portering resources. Various different methods of directing work to the porters were used, with very few calls to the central 2700 number. It was a manual, paper-based process. There were a high percentage of patients who were “not ready”. The Emergency Department (ED)relied upon an overhead paging system to call for transport assistance. This was very noisy and disruptive to patients and staff, and could be unreliable if portering staff were out of the department on another call. In addition, there was no way to track response times or acknowledgement of a request. The “Float Pool”for portering has always been dispatched through the Customer Support Centre (2700). The customer would call and request patient transport, and the Customer Service Representative (CSR) would dispatch calls via a page to the most appropriate resource through a service desk tool.

6. Interdisciplinary Team Members • Elena Pacheco • Director, Corporate Services • Michael Brunner • Manager, Corporate Services, Customer Support, Transportation, Linen • Sandy Balappa • Team Leader, Corporate Services • Mike Lindsay • Director, Diagnostic Imaging • Merideth Van Oene • Manager, Infrastructure Services • Clifford Docanto • Quality Analyst, Corporate Services • Sean Cassidy • Quality Analyst, Corporate Services

7. Porter Value Stream MapProcess Defects and Improvement Summary

8. Time/Motion Study results:Average Porter Calls by Hour ED

9. Call Location Breakdown Main Float Porter Pool Data for the start and end location of the task Showed a need to relocate Porters to Main Floor % of Calls starting from: Ground = 25.3% Main = 44.2% 2nd = 21.4% Other = 9.1% % of Calls ending at: Ground = 5.8% Main = 41.3% 2nd = 35.9% Other = 17.0%

10. Data for the start and end location of the task Call Location Breakdown Main Float Porter Pool Changes Implemented Showed a need to relocate Porters to Main Floor % of Calls starting from: Ground = 25.3% Main = 44.2% 2nd = 21.4% Other = 9.1% % of Calls ending at: Ground = 5.8% Main = 41.3% 2nd = 35.9% Other = 17.0%

11. Our Journey – Phase 2

12. Aim • Improve patient safety and quality care through reducing transportation wait times • Develop and implement an organization-wide quality process improvement and redesign for timely delivery of services to our Patients • Build on existing technology and apply lean methodology to new process

13. Project Measures/Indicators • Process Indicators • Porter response time from time request made to time request completed. • Before project initiated, no request detail reporting system was in place to measure response time, productivity or performance • Outcome Indicators • Routine Process Audits • Statistical analysis and transparency in posting stats in public space on Quality Board • Balancing Measures • Health Workplace Survey Results • Routine huddles with Portering Staff • Anecdotal feedback from Patients • Audits • Corporate Services active participation in daily Bed Meetings

14. Exchange of info 2700 CSR make Decision Dispatch to Porter Go & complete request Previous Model • Requests PUSHED to Portering • Time added due to not knowing where the Porter is located in the hospital

15. Connexall Model • Requests PULLED by Portering – No intermediary Call Centre • Value added as Porters can respond to calls geographically • which reduces wait times! CSR’s and Nurses are now in • DIRECT contact with Portering!

16. Changes Implemented • 2009 - Developed partnership with GlobeStar Systems, maker Connexallsoftware platform. • Process Mapping in ED, DI and trial commencement, training of Call Centre Staff • Cisco phone training with Portering Staff • Extensive training sessions with UCA’s and Nursing Staff • “Go Live” Organization Wide in August • 2010 - Hospital Wide Standardization • Establishment of benchmarks and performance monitoring • Process transparency through posting of Portering statistics in public space on Corporate Service’s Quality Board

19. Charts and Tables

20. Charts and Tables

21. Connexall Screen

22. Connexall Screen

23. Phone Technology

24. Engagement of Clinical/Organization • VERY IMPORTANT!!!!! • Everybody will be on board if the service is improving • Co-lead should include a clinical representative • Process mapping to understand current state • Ensure training champions are available around the clock

25. Engagement of Clinical/Organization • Train the trainer approach • THP focused first on unit clerks who then trained nursing • KEEP IT SIMPLE

26. Outcomes • Health Workplace Survey Results (Portering) • 10% improvement in satisfaction with workload. • 5% improvement in satisfaction with materials (wheelchairs, stretchers) needed to do the job. • “Pull” System • Allows Porters to respond to requests by geography reducing steps needed to arrive and reduce wait times • Customer Support Can Better Meet Your Needs • Over 2000 calls diverted per day from Customer Support • Turnaround Time Improvement • Less than 5 minute response time to ALL request types with a 13 minute total turnaround! • Customers Are Thrilled! • During Accreditation, Patients spoke of the high level of service and personable quality of care they received from Portering. This was even mentioned at the report out! • Accountability Increased • CSR’s and Clinical Staff can now track the status of their requests in real time. • Routine audits and stat tracking helps identify areas of high performance and opportunities for improvement!

27. Outcomes

28. Outcomes

29. Sustainability Plan and Next Steps • Sustaining Improvements • - Routine auditing of process, rapid response to any issues identified and transparency of our stats. • Monitoring our Measures • Corporate Services Quality Analysts run monthly reports to monitor response and turnaround times. • By listening to our Customers! • Team Leaders attend the daily Bed Meeting to help identify and address any issues that arise. • Huddles • Communication is the key to sustaining any process improvement and by listening to Staff and raising awareness of our commitment to our Customers and Patients we can ensure the momentum and change will be long term.

30. Sustainability Plan and Next Steps Sustainability

31. Sustainability

32. Lessons Learned • Staff respond well when they have control over their workload • Technology, when used right, can improve the human experience. • The Quality of Patient Care has improved with no needless wait • Communication and monitoring of performance is critical for any process improvement. • There is no cookie cutter approach and tweaks along the way – Don’t give up – do what works for your facility

33. Thank you