Latest Kaizen event aims to improve Diagnostic Imaging booking and registration
Look at those smiles! Great participation and enthusiasm during the latest Kaizen event!
It seems simple. Physician requests Diagnostic Imaging (DI) exam. DI exam is booked. Patient is notified. Exam happens. Ba da boom ba da bing. Done. But things were not this smooth – hence the need for a Kaizen event to improve the processes surrounding DI booking and registration. In total, 293 wastes were identified and 97 action items are being implemented to improve processes. “The process mapping was just awesome,” said Mark Coulter, Director of Diagnostic Imaging. “It was a wonderful, detailed view and opened our eyes to things that are happening in the department that we can start to fix right away. We had fantastic participation from all of the Kaizen participants. It was a very worthwhile week.” The team found a big waste that had a huge impact on work flow. “An unbelievable 49 per cent of DI requisitions were being rejected and sent back for not being completed correctly,” explained Lisa Camp, MRI Tech and Kaizen participant. “That’s a lot of rework. The physicians were frustrated and we were frustrated.” The requisitions for each modality (X-ray, MRI, CT etc.) were completely different. Each requisition had a different phone and fax number and there was no continuity. The team agreed on a new standard format for requisitions. The upper one-third of the form will be the same, regardless of modality, and the lower twothirds will be modality-specific. Previously, the requisitions were received any which way – fax, email, tube system, dropped off in an envelope, delivered by carrying pigeon… OK maybe not that one. Now, the team is asking that all requisitions be faxed. These changes will be communicated further in the coming weeks. Continued on Page 2
Continued from Page 1— Latest Kaizen aims to improve DI booking and registration
Another outcome of the Kaizen that will improve flow is relocating the DI Booking office next to the DI Registration area at BGH. The two offices were on different floors, in different wings, making work flow challenging and causing many extra steps for staff. Both offices are now collocated in the larger DI Department. With input and participation from many different areas (clerical staff, booking staff, registration staff, DI leadership, Information Systems, Communications, a patient advisor, and community partners), various perspectives were considered when determining action items that will have an impact. “As a community partner, it was inspiring to be a part of this process,” said Dawn Calnan-Kerr, Clinical Services Coordinator, Prince Edward Family Health Team. “In health care, we’re all striving to improve care for our patients. For me, it was exciting to see all the individual action items that are implemented to achieve a greater plan. Having the leadership engaged in culture change and all members of the team involved in the process is key.” “Bringing all of this expertise to the table and giving participants the freedom to make recommendations is what this is all about,” said Mary Clare Egberts, President and CEO, QHC. “We’re always striving to improve – always trying to make things better for us and our patients. The team did a fantastic job.”
Good things happening in TMH Emergency Department! The TMH Emergency Department now has two speciallydesigned treatment chairs for lower acuity patients who would be more comfortable sitting than lying down on a stretcher. One chair is in the green zone, the other is in the new medical directive area that the Emergency team has been working on setting up. The intention of the medical directive area is that nursing staff can expedite care to the patients, improving department flow and promoting patient satisfaction. Because the chairs fully recline, ECGs can be performed in the chairs – and with a second ECG machine coming to the department (courtesy of the TMH Foundation), ECGs will be completed much quicker! In terms of the safety of the treatment chairs, staff can pull out a step if shorter patients are having difficulty getting into the chair, the chairs also have brakes, and the vinyl material makes them easily washable between patients. On the topic of safety, an extra stretcher in the TMH Emergency Department is being equipped with pinel restraints. This stretcher will be kept in the department, easily accessible in the event that staff safety is at risk because of a violent patient. TMH Emergency staff practice least restraint, as per best practice, however if there is a safety issue and restraints are required, they will be equipped to handle the situation.
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Hip and knee replacement patients benefiting from “seamless” bundled care Care is now more seamless for patients undergoing hip or knee replacement surgery (arthroplasty) at Quinte Health Care! They now receive all of their care – assessment, surgery, inpatient rehabilitation and post-care outpatient rehabilitation – at QHC. Previously, QHC patients received post-op physiotherapy through Home and Community Care. This change is part of the Ministry of Health’s bundled care initiative. In a bundled care approach, a team of health care providers receives a single payment to cover all the care needs of an individual patient’s full spectrum of care for a specific health issue. That care team is responsible for providing or coordinating the patient’s care, from start to finish, resulting in seamless care and reduced rates of readmission to hospital. With this new model, patients meet with a physiotherapist as early as their pre-op assessment appointment to begin discussing rehabilitation goals. After their surgery, physiotherapy is a big focus – first as an inpatient, then as an outpatient in Belleville General Hospital’s fullyequipped outpatient rehabilitation gym on Sills 2. The outpatient physiotherapy program involves group classes run by a Most patients rehabilitating from hip or knee surgery now receive physiotherapist and an Occupational outpatient physiotherapy on-site in BGH’s fully-equipped rehabilitation Therapy Assistant/Physiotherapy Assistant, gym, rather than through Home and Community Care. as well as intensive one-on-one care for those who require extra attention. “The program is very patient focused,” said Kristina Cruess, Program Director, Surgery. “Patients often find the group sessions to be highly motivating and a positive experience.” Three weeks post-surgery, Katherine McCracken shared her thoughts: “You can get frustrated doing your exercises at home but then you come here and feel reassured by the physiotherapist that everything is going well. And it’s not just reassurance from the Physiotherapist, but the interaction with people going through the same thing. You can talk to each other about your progress. I think it’s a wonderful thing.” “By providing this care on site, we can better track patient progress, ensuring they are recovering well and thereby avoiding future readmissions,” said Kristina. The Ministry of Health now requires health care providers to report specific outcome and experience measures – something that wasn’t previously required for arthroplasty patients. Having a patient’s care bundled under one team, at one site, makes this reporting easier and more accurate. Home and Community Care services are still an option for patients meeting service criteria or those with complex service needs.
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The Hospital Experience – Two students from St. Paul Catholic High School have the opportunity to experience the inner workings of a hospital during their co‐op placemeent at Trenton Memorial Hospital. TMH Emergency Department Manager, Perry Simard, acts as facilitator, managing Sophie and Olivia’s daily schedule. The students spend much of their me in th he Emergency Department where they get water and/or blankets for pa ents, prepare saline bagss, take vitals, help pa ents get dressed/gowned, conduct pa ent surveys, and spend plenty of me observing the nurses and m physicians. Sophie and Olivia have also spent some me in Diagnos c Imaging and will spend some me in the surgical area in the New Year. At the end of each shi , Perrry spends me debriefing with the students to further their understanding and talk through anytthing the students may have found overwhelming. “I know I want to go into the medical field, so thee co‐op gives me the opportunity to be here in the hospital to see what it’s like,” said Olivia.. “It’s been a great experience.”
#TakeOwnership
#4MyT Team
#RespectEveryone
#ImagineItsYou Warm items for pa ents – Kudos to our Belleville General Hospital Emergency Department staff for se ng up a "dona on tree" within the department! “As we know, coming to the hospital isn't always a planned event, and pa ents aren't always able to bring or may not have, the appropriate a re for the weather,” explained Kathleen Kramer, RN and organizer of the dona on tree. “The dona on tree was created to provide warmer clothing op ons to our many pa ents throughout the cold winter season. Dona ons of mi ens, scarves, hats and socks have been brought in and hung on the tree by our staff and paramedics. These dona ons are available for the pa ents who are discharged from hospital and require warmers items upon leaving the ER.”
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#WeAllHelpProvideCare
Who inspires you? Anyone can share in celebra ng our teams – staff, pa ents, physicians and volunteers. Contact C Carly Baxter at ext. 2677, cbaxter@qhc.on.ca.
Time with the doc – “My son Spencer, who is in Grade 1, had a project to do for school. He was to interview a community helper and he had his li le heart set on mee ng an ‘appendix doctor.’ As I work in PACU, I reached out to one of our surgeons, who made him an appointment, met with him for about 15 minutes, answered all his ques ons, explained things in a manner that a six‐year‐old would understand and even gave him pictures of a real appendix. Spencer was so thrilled by mee ng and interviewing Dr.Francesco Barnabi for his project.” – Candace Black, RN
Fes val of Trees success! – The Prince Edward County Memorial Hospital Auxiliary’s 11th annual Fes val of Trees raised a record‐se ng $50,000 toward the purchase of a new pediatric/neonatal monitor for use at PECMH. The monitor cost $22,668 and will serve the needs of infants and young children that are brought into the Emergency Department for care. The remaining $27,332 will be directed toward the purchase of addi onal priority medical equipment. “The Auxiliary is indebted to many people, who have worked cheerfully and relessly to make the Fes val of Trees a very special event: our sponsors and donors, the Fes val Commi ee, our volunteers and friends who worked many hours, all those who baked and bought and preserved and purchased, the bou que and the many musicians who freely gave of their me and talent,” said Pat Evans, President of the PECMH Auxiliary. “Isaiah Tubbs Resort donated a beau ful space for our event, and their staff helped to create a warm Christmas atmosphere.”
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Gearing up for our May 2019 Accreditation
Welcome Anna-Marie!
In 2015, Quinte Health Care received exemplary standing from Accreditation Canada. Congratulations to those staff members who helped make that happen! For those who are new to Quinte Health Care or health care in general, you may be wondering what exactly is Accreditation? Health care accreditation gives us the opportunity to assess our organization against standards of excellence. The week of May 6-10, 2019, a team of peer-surveyors will come to our hospitals to evaluate our clinical and administrative processes. They will talk with and observe patients, families, staff and leadership.
Anna-Marie Sutherland is QHC’s new Director of Medicine, Critical Care and Rehabilitation. Anna-Marie came to us from Northumberland Hills Hospital where she was a The work of preparing for the on-site survey allows our teams to take a Program Director since 2013. She close look at how we function. This preparation and the feedback from has varied experience in medicine, surveyors, help us to understand how to make better use of our critical care, emergency services, resources, increase efficiency, enhance quality and safety, and reduce surgical services, ambulatory care, risk. maternal child, cancer care, nephrology and pharmacy. Anna-Marie is passionate about selfmanagement and chronic disease prevention. “We’re seeing more and more patients coming in with a number of different comorbidities,” said Anna-Marie. “It’s important that people be a part of their care.”
On December 18, Silvie Crawford, Executive Vice President & Chief Nursing Executive, Kingston Health Sciences Centre, came to the ICU to give us a better idea of what the surveyors will look for in May. She spent time talking to staff and pointing out areas of opportunity so we can be prepared for the real survey in May.
Having been at QHC for a little more than a month, Anna-Marie says everyone has been welcoming and supportive. “There’s lots of great work going on at QHC. I can sense the focus on patient and staff safety and people wanting to do the right thing. I look forward to working with everyone moving forward.”
QHC Vital Signs Newsletter, December 2018: Published by QHC Communications Department Editor: Carly Baxter (613) 969-7400 ext. 2677, cbaxter@qhc.on.ca.
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