Eliminate repetition. That’s what a team dedicated to designing a blueprint for admission used as their priority during their Rapid Process Improvement Workshop (RPIW) in March.

On average, there are 34 admissions at Royal University Hospital in Saskatoon every day, and eight of those to the Clinical Teaching Unit (CTU). However, many of the forms used to admit a patient ask for the same information over and over again, which can make it a  long and tedious process.

The team working on Design RPIW No. 126, which used the CTU to design the new admissions blueprint, counted 53 pages of admitting documents. Within those pages, 79 topics were covered, the team noted, but there were also 126 duplications of information.

The repetition not only makes for more paper than necessary, of the 19 patients surveyed by the team, almost all agreed it can be exhausting to “tell your story” multiple times.  While patients understand that some repeated questions are necessary for their care, if information is already gathered or questions need to be asked multiple times, the key is in the messaging.  Confirmation of details rather than asking repeated questions would improve the patient experience.

The team redesigned the admission forms to eliminate 20 pages and 86 instances of repetition. The new form, called an Integrated Assessment and Order document is a new blueprint for the admission process.  It RR-2015-04-RPIW-admissions-pre-pages

Documents on a wall

Admission documentation was cut down by 20 pages as repetition was removed from the process.

also acts as a single source of truth for caregivers, and decreases both the number of questions asked of the patient as well as documentations for the caregiver.

The team also looked at improvements to eliminate the time Pharmacists spent walking from patient care areas in emergency back to their office to print patient forms.  By using tablets, online forms and obtaining access to emergency room printers, it will save a Pharmacist 30 minutes per day – enough to complete one additional patient assessment.   The pharmacy staff also updated their standard work to reflect a clear process for communication and handovers between the Pharmacist and the Medication Reconciliation Pharmacy Technician.

Over the next 90 days, the blueprint will be reviewed, modified and trials conducted. The RPIW team will be consulting with other stakeholders, then testing it in the CTU. Following that trial, it may be tested in other units as well.