Healthcare performance improvement in the ED

Improving the patient experience and patient throughput in the Lakeland Regional Medical Centre A&E

 

Despite investing in healthcare performance improvements such as mobile Ultrasound (US) units with wireless capabilities, Lakeland was still experiencing challenges with delivering services for the A&E within the target timeframe.

 

Several issues were identified as possible causes of delay.

 

Philips was asked to provide external validation of the identified issues and to make recommendations for additional improvements in ultrasound exam efficiency in the A&E.

 

Our project recommendations focused on mitigating delays while improving patient throughput and the overall patient experience. The subsequent improvements resulted in Lakeland winning EmCare’s 2014 Genesis Cup Award for A&E Innovations*.

Lakeland Regional Medical Center

Where: Lakeland Regional Medical Centre, Lakeland, FL.

 

What: Improve examination turnaround time for diagnostic ultrasound services

 

How: Conducted data analysis, staff interviews, and onsite observations, followed by root cause analysis and prioritised change recommendations.

 

Results: Average two hours length of stay reduction, ~ 80% of patients are treated and discharged or admitted to an inpatient bed in fewer than three hours.*

The Philips team provided a thorough analysis and astute performance recommendations. As a result, we made several changes that helped us to significantly improve our workflow and our patient care experiences.”

Maureen Leckie, RN, MSN, Associate Vice President of Clinical Operations

Lakeland Regional Medical Centre

Our approach

 

Following a project and scope review, our consulting team recommended a short-term performance improvement engagement to provide a rapid assessment.

 

A collaborative Philips-Lakeland project team including clinical staff and members of management agreed to the key project goals:

 

  • Measure current performance
  • Assess and identify operational inefficiencies
  • Recommend change initiatives/programmes to increase performance
  • Prioritise the recommendations and present to management

Key recommendations

 

Bases on Philips analysis the following recommendations were made:

 

• Improve alignment between triage and ultrasound to reduce non-value travel time and improve resource utilisation

• Relocate and reconfigure the technologist workstation to allow two techs to utilise the space at once

Modify the existing ultrasound room, bathroom, and probe

cleaning area to streamline patient care

• Improve the ultrasound area assets to reduce rework

Divert patients to the most appropriate care level to

streamline workflow

Results

 

Lakeland implemented many of the Philips recommendations including:

 

  • Use of single patient rooms to leverage portable devices and shorten exam times.
  • Modified A&E Ultrasound Rooms to add a dedicated restroom to reduce delays and improve patient satisfaction.
  • Moved the technologist workstation to allow two techs to simultaneously use the space.
  • Use of ‘sleep mode’ on the Philips EPIQ systems, allowing movement between rooms without the delay of shut-down and restart.

These changes have resulted in immediate improvements* including:

 

  • Decreased exam times
  • Increased patient throughput
  • Improved workflow efficiency
  • Enhanced error-500