These days it seems every organization is being told to work smarter, due to unprecedented pressures in funding, staffing and supply costs. No place can this be seen more clearly than in the hospital setting. With all the changes in the American health care system, every hospital is struggling to maximize the use of whatever it has, be it equipment, staffing, or patient rooms.
In the May 2017 issue of ISE Magazine, Patrice Batamack, PhD and Christine A.N. Ndjee, MD discuss an effort by a Los Angeles academic acute care medical center to improve bed turnaround time in its 32-bed Intensive Care Unit (ICU), to better meet patient needs and control costs.
The hospital noticed that bottlenecks occurred when staff discharged or transitioned patients to lower acuity units. Leaders assembled a team to evaluate the situation using Six Sigma methodology.
The team focused on both the voice of the customer, i.e. patients desiring less wait time between transfers into and out of the ICU, and the voice of the business, i.e. the hospital, needing a faster turnover rate for these rooms.
The team went through the DMAIIC process (define, measure, analyze, improve, implement, control). Instead of jumping to the conclusion that the hospital needed more ICU rooms, the team collected data about the cause of delays surrounding the turnover of these rooms, such as cleaning and preparing the room for the next patient.
The cleaning process was owned by the Environmental Services Department. The team established turnover rates for these rooms. After collecting data for 6 months, they discovered that the process was out of statistical control. The main causes for the delays centered on the availability of managers; their trust in the hospital information system; the availability of the nursing floor staff; their ability to use the hospital info system consistently; availability of supplies; and staffing levels.
The team recommended several improvements, not the least of which was to promote and reinforce better teamwork, emphasizing collaboration, cooperation and staff flexibility.
The team developed a detailed implementation plan and a Visual Basic tool to monitor the process. By decreasing the median cleaning turnaround time from 67 minutes to 60 minutes, the project team anticipated an annual savings of at least $24,000 in the ICU alone!
Too often a problem such as this is addressed by trying to increase staffing, and/or facilities. Six Sigma tools helped this team use data to identify the root causes of delays, make informed decisions and implement solutions. This team proved that by improving the cleaning process, they could achieve better ICU room utilization, meeting the needs of both the customer (patients) and the business (hospital administration). Kudos to the team on a job well done!
How are you helping your employees to work smarter by reducing the amount of time they spend on non-productive activities and correcting errors? If your business processes need a “check-up,” please email me at michael@leadingchangeforgood.com! I’d love to help you get back to a healthy, productive workplace.
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