Healthcare Crisis From The Front Lines
Introduction 1 in 100 20% to 50% admitted will die from a medical mistake diagnostic procedures are unnecessary 6 in 100 5% to 10% will be permanently disabled acquire a nosocomial infection 1 in 2 3 in 100 (50%) will suffer some preventable harm have incorrect ID band All of these mistakes are 15 of 100 preventable! diagnoses are incorrect Lean Six Sigma for Hospitals - Jay Arthur
2012 Performance 134 MINS 88 MINS ED request to occupy EVS total turn time >4 HOURS 63 MINS ED hold times request to assign for bed 4.25% 9.25 HOURS Left Without Treatment (LWOT) discharge window 34 MINS $4M~/YR internal transport pending to in progress dead bed time All numbers in average
What Are The Priorities?
Process Steps Set expectations and Conduct value Streamline responsibilities by stream analysis documentation Identify and eliminate waste service provider
Drive To Excellence The EMR doesn’t have a robust Our Electronic Medical Record (EMR) doesn’t have capability to provide report writing application to push required throughput metrics out metrics to the care team
Operational Platform TeleTracking allowed true data analysis We built over 200 reports in Customized Reporting Solutions (CRS) Driving daily accountability Real time notification to best practice metrics upon non-performance
Care Traffic Control Registration Direct Admissions Case Management Transfer/Access Center Bed Placement Helicopter Dispatch Electronic ICU (EICU)
Real-Time Dashboards
Emergency Department Outcomes Request to assign time 12% increase Reduction in ED wait reduction of 81% in ED visits times >70% (33K hours) (57 mins to 10 mins) Hospital acquired Reduction in Left conditions reduced by Without Treatment 15% without rebound (LWOT) to less than .25%
Hold Time In Dollars In The Emergency Dept $180,000 $3.8M/YR $160,000 $140,000 UCL $121,281 $120,000 $100,000 Dollars $1.3M/YR $80,000 CL $61,867 $60,000 $40,000 $20,000 LCL $2,452 $0 1 5 9 13 17 21 25 29 33 37 41 45 49 53 57 61 65 69 73 77 81 85 89 93 97 101 105 109 113 117 121 125 129 133 137 141 145 149 153 157 161 165 169 173 177 181 Week
Discharge Kaizen 11.11 10.11 9.11 DC 8.11 Kaizen 7.11 Hours 6.11 5.11 4.11 IMPROVEMENT PROCESS DEFINE 3.11 MEASURE ANALYZE IMPROVE CONTROL 2.11 1.11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 Month
Questions & Answers
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