Insiders’ Insights

Finding ways to improve clinical workflow is an ongoing challenge for hospitals. But the days of spending 30 minutes to find a lab result or track down a physician to clarify a medication order may soon be over. By investing in information technology and restructuring clinical staff, hospitals can get to patients more quickly, improve lab turnaround times and shorten the admission process—all while increasing caregiver and patient satisfaction.

Jack Weiner
President and CEO
St. Joseph Mercy Oakland
Pontiac, Mich.

We recently reinvented our emergency center by investing in information technology and process improvements, shaving precious minutes off of our wait time to see a physician. For example, we incorporated electronic medical record and physician order entry systems to track patients and identify potential bottlenecks. We also went to a team nursing model. This cuts down on the time it takes for each patient to get attention. In addition, we cut out triage. We bring a physician, nurse and paramedic together in the same room to evaluate a patient’s status instead of collecting the same information several times. Faster doesn’t have to mean better in healthcare, but in the emergency room, it can mean life or death.

Lynn Watson, MBA, B.S.N.
Manager, Case Management
The Washington Hospital
Washington, Pa.

We implemented the admission nurse process to improve patient flow by decreasing the repetition of information and creating a mechanism to store health history. Admission nurses are positioned in the busiest patient entry points of the hospital: the emergency department and presurgical unit. They obtain detailed information regarding the patient’s history, medication, functional abilities and presenting physical assessment. Clinical information is stored in an electronic medical record that enables the nurse to quickly confirm and update past medical history. The process gives patients undivided attention, allows staff nurses to focus on the implementation of orders and decreases the lengthy admission process.

Chris Laird
Associate Administrator
St. Joseph’s Hospital
St. Paul, Minn.

We’ve taken lean flow concepts to heart in the lab, surgery and emergency departments. The results? Down time, wait time and costs have been reduced while quality outcomes, patient satisfaction and revenues have risen. Lab turnaround times improved by 34 percent once staff started sending patient samples as soon as they were collected instead of batching them, and after the hematology and chemistry areas were redesigned to process tests individually instead of in batches. Computerized tracking systems in surgery admitting, waiting and recovery areas show exactly where an individual is in the surgical experience. It also reduces the number of overhead pages for surgeons and anesthesiologists.

Kenneth D. Graham
President and CEO
Overlake Hospital
Medical Center
Bellevue, Wash.

We have initiated a pilot medication identification program using a barcoding system to verify that the right drugs are being given to the right patients at the bedside. In addition to increasing patient safety, the goal is to decrease documentation time for nurses. Barcodes are placed on all medications and then electronically verified at the bedside by the nurses scanning the patients’ wristbands. PDAs, wireless laptops or computers on wheels will be installed for the pilot. The system will identify medications that are due for administration to patients—a point where more than 38 percent of all medication errors in hospitals occur. The system helps streamline the work flow for nurses by organizing the medications that are due to a patient.

—Carrie Vaughan