Rebecca Burns, inpatient director, completes the admission assessment flow sheet in the convenience of a patient’s room.
Quality is a vital characteristic that Horn Memorial Hospital (HMH), located in Ida Gove, strives to achieve when caring for patients and within all departments of the hospital. HMH staff regularly evaluates ways to improve quality and most recently implemented the “Lean” process to help eliminate waste in the organization.
Heather Gann, the hospital’s quality services director, and Kristin Dixon, quality specialist, each attended Lean training in Des Moines through the Iowa Healthcare Collaborative. The training taught them how to implement the Lean philosophy, which emphasizes evaluating processes and instituting change in order to make the process more efficient.
“After seeing the impressive outcomes that other organizations have been able to obtain, I was excited to bring this knowledge back to our staff,” said Gann. “We have had great buy-in and look forward to using these tools to effect change in various areas of the hospital.”
When implementing the hospital’s first Lean project, it was decided to focus on a patient-related process, which led to the development of Horn’s first “Lean Team” made up of nursing staff. Collectively, team members identified the admission process as an area they believed could be improved. The team chose to evaluate this process because frontline staff felt it took a large amount of their time each day and patients were also dissatisfied with how long it took.
With the help of the frontline staff, team members observed the process and broke it down into individual steps. The phase in the process that was identified as having the greatest need for improvement was the “admission assessment flow sheet”. More specifically, the team identified duplicate charting based on information that was located elsewhere in the electronic medical record.
Once these duplications were recognized, the flow sheet was reformatted, leading to a dramatic conclusion. Staff slimmed down the time it took to complete the flow sheet from 45 to 10 minutes. This adds up to a staggering 4,560 minutes or 76 hours of nursing time over a six-month period!
Not only is this outcome a time-saver, but it’s also a patient-satisfier.
“We have received comments through our surveys indicating that our patients have also noticed the difference,” Dixon said. “When initiating our Lean project, we knew staff would see a difference, but it’s even more effective when our patients can see the difference! Our plan is to incorporate this process into every department of the hospital. We are working to give staff the tools they need to utilize this process in all aspects of their work.”
