Three foundational and two design Rapid Process Improvement Workshops (RPIWs) reported out in the last session of 2014, held December 5.

The three foundational RPIWs, the first held in three different areas, show that small changes can make a big difference for staff and for our clients and patients, stated Jackie Mann, Interim President and CEO of Saskatoon Health Region at the report-out.

The design workshops, she added, involved teams very experienced with the process jumping into the future to see what things will look like in the new maternal and children’s hospital, what processes can change today, and what needs to be done before that hospital opens so everything is in place when it does.

Highlights of the report-out include:

  • Labour assessment at Royal University Hospital and the future maternal and children’s hospital was the focus of a design RPIW. The team, which looked at standardizing the patient flow process from the time a patient walks onto the maternal floor to the completion of their assessment, created new, very clear signs that direct expectant parents to maternal registration. The signs have already gone up in the current ward at Royal University Hospital. Most importantly, to improve patient safety, the team redesigned the process so that patients meet a triage nurse and are assessed using a process similar to that used in emergency rooms to determine the acuity of care needed. The team also presented the idea of implementing a pre-registration process to shorten the time between arrival and assessment. In the new hospital, the team suggested a proposed family area be used as an early labour lounge: a place patients can use while in pre-labour, before they are admitted. This would be especially useful, they felt, for those patients coming in from out of town. The team also suggested certain rooms be used for the triaged patients in the new facility, with their level of assessment determining their proximity to an RN.

    A sign depicting a pregnant woman with an arrow that reads "Maternal Registration"

    This new poster was designed to provide a clear indication to expectant parents as to where to go to register when their baby is about to arrive.

  •  A design RPIW for the Pediatric Outpatients Department at Royal University Hospital – and for the future Children’s Hospital of Saskatchewan – focused on improving the scheduling process to distribute visits more evenly throughout days and weeks. To do this, the team recommended developing a waterfall schedule, which would have patients arrive every few minutes instead of in batches at certain points in the day. This would allow physicians to see more patients every day, and eliminate wait times. More touchpoints with patients – sending confirmation letters for appointments, and email or text message appointment reminders – was recommended to eliminate no-shows, and an improved process to fill short-term cancellations was developed. The team also recommended physicians and learners review patients within the patient room to save time and improve the patient and family experience by encouraging “nothing about me without me” discussions. The team also began testing a production board, which will show the daily flow of the clinic and placement of patients for providers. The new process has had promising results in the first week of testing, and an implementation plan for these improvements has been put in place.
  •  A team focusing on reducing waits for audiology clients attending the unit at Royal University Hospital not only created standard work on reduced waits but developed a visual system to indicate which rooms were empty and which had patients, eliminated walking distances completely for the registration clerk, and improved signage to help clients reach the unit without having to ask for directions along the way. Installing 17 hand sanitizers and developing standard work around clinical room cleanliness has improved patient and staff safety, as well. This all resulted in decreased wait times for patients, and improvements in the look of the area by removing clutter and making it more welcoming.
  • Payroll developed new forms and processes to eliminate time corrections from the emergency department staff at Royal University Hospital. The new forms are located in a more secure area at the hospital, are easier for staff to use, contain information staff want to know, and are approved daily. Implementing a recommended electronic submission process will further eliminate errors from illegible faxed documents, the team reported.  A visual time management tool was also developed for the payroll department. The improvements noted in this workshop will soon be spread across the Region, to further eliminate time corrections, save time for payroll clerks, and keep staff happier, which will result in better patient care.
  •  New shortcuts and a new electronic system for the purchasing department has resulted in a much shorter lead time (a 90 per cent reduction) from the creation of a purchase order to its completion, and an 86 per cent reduction in errors, thanks to improved forms, education for end users, and a new understanding about the capacity of clerks in the department. This RPIW also laid the groundwork for a scanned barcode system for the purchasing department.