Improving Patient Transit at Auckland City Hospital Presenter: Tim Winstone

1. Improving Patient Transit at Auckland City HospitalPresenter: Tim Winstone Innovation Poster Session HRT1215 – Innovation Awards Sydney 11th and 12th Oct 2012 Health Service: Auckland District Health Board 2-2b_HRT1215-Session_WINSTONE_ADHB_NZ The Health Roundtable

2. This problem had existed for a significant amount of time and it involved many areas of the hospital. It was decided that a traditional project approach to solving it would not yield the desired results quickly. It was decided to run a Rapid Improvement Event over a week to solve this problem. A Rapid Improvement Event is a concept that was pioneered by Toyota to resolve a problem by dedicating three to five days to identify and implement a solution. It usually takes about four weeks of advance planning to understand the objective and identify the key people who need to be involved in the event. The team involved in the Rapid Improvement Event included representation from Radiology (MRTs and nurses), Ward Nursing, Transit Nursing and Orderlies who supported by a multi-disciplinary advisory group. The event was facilitated by improvement specialists with senior management sponsorship. The process was reviewed in detail and opportunities for improvement were identified and prioritised. Based on these priorities, a new process was defined and piloted during the event. Based on the pilot, additional process improvements were made. Member of teams across the organisation were communicated with throughout the event to obtain feedback and increase acceptance of change. Tim Winstone, Auckland District Health Board (twinstone@adhb.co.nz) • Solutions • Results • More than 80% of all patients are now arriving within 15 minutes of their appointment time. This has greatly improved the operations of all parties involved: Patient Transit (Orderlies and Transit Nurses), Radiology (and other in-house services) and the Wards. • More importantly, patient experience has been significantly improved! • Improvements have not ended and the goal is to exceed 95%! • Lessons learnt • A Rapid Improvement Event is a very effective way of creating a step change across a process involving many disciplines in a short timeframe. • Engaging and communicating with staff during the event was key to the success and reduced resistance to change. • Momentum is sustained through ongoing visibility and audits of performance post the event. Improving Patient Transit at Auckland City Hospital Definition A Rapid Improvement Event was held in September 2011 to increase the number of inpatients reaching their destinations (eg. Radiology) within Auckland City hospital on time. Our objectives Increase patient adherence to appointment time to 95% 'on time'. Create a cross-disciplinary view of how we move patients with clear roles and responsibilities Improve patient safety by ensuring the right patient is being taken for the right procedure at the right time Improve patient experience by reducing the time they spend outside of their ward environment Increase the throughput of operations (e.g. Radiology) Reduce the overloading of orderlies and transit nurses Reduce delays in the patient transit process. Problem definition and baseline Only 50% of patients were arriving at their desired location (e.g. Radiology) within 15 minutes of their appointment time. This significantly affected the ability to schedule and run operations to plan. The delays impact the number of patients able to be seen and increase waiting time for patients. Methodology and approach Our key result areas: patient safety better quality care improved health status economic sustainability engaged workforce