Though the alliance may not be obvious, hospital leaders can turn to their facilities directors and engineers for advice on how to identify inefficiencies. That was the prime lesson attendees heard during a keynote last week at the American Society for Healthcare Engineering's (ASHE) annual conference in Anaheim, CA.
In some aspects, hospitals could learn from the operations of McDonald's Corporation, said Stephen Mayfield, DHA, MBA, MBB, senior vice president for quality and performance improvement for the American Hospital Association (AHA) and director of the AHA's Quality Center.
A consumer can go to any McDonald's across the country and know what to expect. However, hospitals don't use that business model, which leads to confusion for patients, Mayfield said.
"If we don't do anything about this … patients will eventually abandon hospitals [except in dire circumstances]," he said.
An example that he showed to ASHE attendees was a modern-looking, flat pill bottle, which because of its shape is easier to read a label from than more traditional circular pill bottles. The newer bottles also have color coding to indicate which medications a person should take on a particular day or at a certain time. Such simple changes can improve patient safety, Mayfield said.
Hospital engineers are familiar with this type of streamlining, he added. In the early 2000s, hospital facilities representatives worked with the Food and Drug Administration and medical gas vendors to review safety pin systems and labeling for medical gas line hook-ups, such that a nitrous oxide supply could not be inserted mistakenly into an oxygen connection. The changes occurred after at least 22 patients received the wrong medical gas and were injured or died.
Hospital facilities directors also understand the importance of the following tactics used to pinpoint deficiencies or areas of improvement:
- Walking around the units to identify concerns (e.g., noticing a door that doesn't latch properly to a maternity unit)
- Observing staff member behaviors and developing enhancements as necessary (e.g., monitoring worker actions during a fire drill)
- Taking pictures to document conditions (e.g., photographing egress doors mistakenly marked as "no exit" and sending them to department managers)
Surgical recovery rooms are a prime area to look for excess efforts. Mayfield showed a quick video clip from a hospital that put all necessary supplies for patient care in the recovery room. Environmental services workers keep the supplies stocked so that nurses don't have to constantly leave the recovery room to get something.
"Whatever's outside that door—let's bring it in the room," Mayfield said. Rather than give individual nurses their own computer-on-wheels to track down at the start of each shift, the hospital parks a laptop permanently by each patient bed and lets nurses log onto whatever computer they need. Near the computers are lists of frequently called phone numbers, another convenient item to have close to bedside rather than out at the nurses' station.
"These are very simple tools that we can bring [to nurses]," Mayfield said.