Newark Beth Israel Medical Center
Challenge
Newark Beth Israel Medical Center is a 673-bed inner-city hospital. The Emergency Department (ED) was designed to handle 45,000 patient visits a year but it typically handles 90,000. Approximately 54,000 of these patients are admitted. When a patient is admitted and transferred between departments there is a risk of losing critical patient information, creating unnecessary costs and producing potentially life-threatening events. Accelerating the design and implementation of a safer, more satisfying and clinically more effective patient-transfer process was a big challenge especially in an environment of skepticism and with minimal resource availability.
Solution
Using a customized version of its high-engagement, strength-focused process of inquiry and innovation, IPI worked with the Medical Center through a series of steps that included interviewing, opportunity mapping, goal-setting, self-organizing implementation activities and evaluation.
Result
A variety of organizational, work relationship and technical innovations were developed and implemented including a map that serves as an overall guide to the “Ultimate Patient Handoff Process,” a low-risk cardiac transport protocol, a safety-assessment process, a standardized transfer report and a patient-welcome script. To ensure buy-in, a “build on it” communications strategy was developed to engage stakeholders affected by the changes.
Medication administration record compliance jumped 82 percent, skin assessment completion by 70 percent, nurse satisfaction jumped 9.3 percent and patient satisfaction was up more than 10 percent—all indicators of success. On top of that, there was a 60 percent increase in the number of patients transported without a cardiac monitor, resulting in a savings of 67.5 nursing hours per month as a result of this one transfer process alone.
As word of the success spread, other units throughout the hospital adopted these improvements and the Medical Center asked IPI to support a much larger, more comprehensive redesign within the hospital.
Rutland Regional Medical Center (RRMC)
Challenge
RRMC needed to design, develop and deliver a whole-system Performance Improvement (PI) initiative that would allow RRMC to re-engineer its core business processes, design a Leadership Effectiveness Program and improve the satisfaction levels of various stakeholder groups including physicians, staff and patients. It would also enable the organization to realize related initiatives that were key to achieving its vision of being the best hospital in New England.
Solution
Over two years, 15 project teams—supported by senior leadership—interviewed stakeholders, gathered and analyzed data and created innovations that had a significant impact on the operations of the hospital. IPI consultants used a Plan, Do, Check, Act methodology as the foundation, incorporating traditional quality tools as well as Appreciative Inquiry, change-management and Project-management tools. Topics included transition management, stakeholder engagement, data gathering and analysis, project management, team development and facilitation skills. This enabled teams and management to make sound decisions regarding whether, or how, to implement system-wide improvements.
Results
There was an 83 percent reduction in paper waste by going to paperless billing, patient satisfaction in the psychiatric ward was raised dramatically (Press Ganey results showed that RRMC jumped from the 30th to the 90th percentile), the level of accuracy in care increased by 16 percent to 92 percent and patients admitted through the Emergency Department were admitted to beds 70 percent faster. The results also supported the opening of additional beds.
Kemptville District Hospital
Challenge
To improve patient care, obtain accreditation by the Canadian Council on Health Services Accreditation and integrate quality into everyday operations, Kemptville District Hospital reorganized into Quality Teams that were responsible for operations and continuous improvement. The CEO team required a methodology and standard approach to provide the quality teams with the skills and tools to make the necessary changes.
Solution
Our consulting team designed and lead an organization transformation initiative for the hospital. Coaching was provided to the CEO team on whole-system, stakeholder engagement and guidance. This project involved the training and coaching of teams on how to facilitate and lead teams through a change process/methodology, identify metrics/indicators of success, solicit multi-stakeholder input, benchmark, gather data and analyze and identify areas for innovation and improvement as they relate to the strategic plan. We provided assistance with an evaluation process, as well.
This innovative program combined the best practices of traditional quality improvement tools, change and transition management, project management and processes within the principles of positive change philosophy.
Results
Project teams have created improvements large and small that have had an impact on patient safety and satisfaction. Healthy-workplace initiatives have revamped the cafeteria of the hospital such that more healthy food options and less trans fats are available while other initiatives have led to the loss of over 200 pounds for hospital staff (in total). As well, a system was put in place to record and reward inspired improvements such that it is enabling their accreditation process.
Rutland Community Care Network (RCCN)
Challenge
The Network had embarked on a Journey of Excellence and our role was to improve quality and client service while assisting in merging several programs.
Solution
Working with the Leadership Team of Rutland Community Care Network, we designed and delivered training, facilitative consulting and coaching services to the leadership team who were each leading specific innovation areas as identified by their organizational self-assessment. We provided numerous quality tools and facilitation techniques that proved extremely useful in organizing their ideas, focusing their work and creating a productive team environment.
Results
Our consulting team was instrumental in helping the client meet their project milestones and a successful result. Results of the first phase were so positive that RCCN renewed the contract for the next phase of knowledge transfer/internal capacity building. As well, RCCN received accreditation from the Commission of Accreditation of Rehabilitation Facilities for a period of three years for 22 of its programs.