There were many firsts and a last as five teams reported the results of their week-long improvement events, or Rapid Process Improvement Workshops (RPIW) on October 31.

Among the firsts were two reports from the first design and “superflow” improvement workshops ever done by Saskatoon Health Region.  These workshops differ from others in that they are about reviewing a process or a department that is not yet in existence. The real work on these RPIWs actually begins after the fact, as they set the stage for changes to be made in the future. This requires a degree of creativity for the event team, and makes the process more intense.

The two design workshops were not only a first for the Region but also for Saskatchewan.

“It’s my honour to be here and see the buzz in the room,” stated Saskatoon Health Region president and CEO, Maura Davies.

Though each team focused on very different areas – medical imaging, pediatrics, wound care, and patient flow – there were commonalities.

“There were some common themes of the right person doing the right work at the right place. We’re increasingly hearing about the importance of matching resources and demands, about having the tools and the training to do the work, including having the right technology to help that. We heard about the importance of teamwork,” said Davies.

Most of the teams also spoke about increasing productivity of staff.

“This is not about asking people to work harder or work faster, but enabling them to do the work they need to do by eliminating the waste,” Davies clarified.

Maura Davies and her flowers.

Saskatoon Health Region outgoing president and CEO Maura Davies was presented with flowers at her last RPIW report event on October 31.

The results reported were as follows:

  •  One team focused on designing a Medical Imaging (MI) Registered Nurse (RN) model of care, meant to ensure appropriate care for medical imaging patients. The team recommended that a former filing room in medical imaging be repurposed to house the new unit, which would integrate RNs into the medical imaging team, and provide them with a central location.  While improving quality of care for clients of MI, this model would also decrease reliance on other units. This RPIW team also repurposed two holding bays, one of which will be used as a family area. This model of care will require additional resources, and an implementation plan is being developed, with tentative project timelines anticipated in December 2014.
  •  Creating a process to make patient information available at a glance to families and caregivers on acute care pediatrics at RUH is meant to improve communication and patient safety. The team of this design event recommended the installation of an electronic at-a-glance board for patient information for health care providers. This board would be updated by nursing staff, physicians and other care providers so that all are aware of what is happening with a particular patient. It was also recommended that whiteboards in patient rooms be redesigned as an information exchange point between families and caregivers. Also as a result of this RPIW, a storage room was cleaned up, and inappropriate items removed, and the breast pumping room was improved with the addition of a new leather chair for moms, and better organization around the chair.
  •  To eliminate scheduling defects for West Winds Wound Care clinic, the workshop team trained the receptionist to use their scheduling software to full potential, and created standards for timelines for certain kinds of wound care appointments so timing is right for each one. They also eliminated the printing of schedules offsite, so each client is presented with up-to-date information. Changes in stocking procedures for the care rooms and better scheduled appointments have resulted in increased capacity for the two RNs at the clinic. They can now see 20 clients per day – an increase of five people. This work will help the Region set up an ambulatory wound care clinic at SCH in the future.
  •  Two “Super Flow” RPIWs – called that due to the size of the undertaking – in adult inpatient units at Royal University Hospital  challenged teams to redesign what were called bed rounds to improve the flow of patients requiring inpatient care, and keep the care team focused on the patient’s needs.  The teams focused on ensuring each patient had a plan either for bed placement or for discharge at these rounds every day. The event teams recommended who should be involved in the rounds (renamed Patient Flow Huddles), that the focus of discussion be on planning instead of exchanging information, and that the huddles be held in a centralized area twice per day instead of only in the morning. The use of an electronic patient flow information system was suggested, as was the use of electronic tablets, in order to ensure the information being discussed is current. Changes suggested by these teams are to be implemented in the next few weeks.

At the close of the reports, a special presentation was made to Davies by Petrina McGrath, vice president of People, Practice and Quality for Saskatoon Health Region.

“I just wanted to say thank you, on behalf of everybody here, for your leadership, for putting patients and families first, always, for your leadership in getting on the (wards) and getting your hands dirty, and leading with vulnerability…. Just thank you for always being there,” McGrath said as she presented Davies with flowers.

“I’m going to be watching you,” Davies told the assembled staff after accepting the flowers. “I don’t know where I’m going to be, but I’m going to be watching you. And I will be watching you with pride and gratitude.”