By involving all areas of the health system and encouraging improvement at all levels, we have touched on a wide range of processes, from those as simple as reordering supplies to those as complex as a door-to-discharge examination of patient throughput in our emergency department. By involving frontline staff in cross-functional teams, we have been able to improve multiple aspects of shared workflows. In all of these projects, IT support has been essential.
In the example of our deep dive into the emergency department throughput, the Lean teams sought to both reduce patient walkouts and increase collections of co-payments. Once the improvement teams were formed, the teams mapped out the current state of our patient flow, identifying and eliminating those points in the process which did not add value to the patients or caregivers. Envisioning an ideal state and creating a roadmap to achieve it, the teams developed standard work to reduce variation and opportunities for errors. In conjunction with IT, they also identified key points where the judicious application of information technology could save time or add flexibility to work flows.
Our IT group bought a small number of laptops and mounted them on repurposed mobile carts we had in storage. This allowed our registration clerks to leave their stationary desks and meet patients at the bedside, rather than requiring that they spend additional time in the waiting room. We provided headset radios and pocket phones to the now mobile staff. Rich Fanelli, our Director of Patient Services, cites the use of this equipment and the ease of constant communication as critical to the success of the ED throughput project.