As an organization designated as a Best Practice Spotlight Organization (BPSO), Mackenzie Health has leveraged the opportunity to create deep sustainable change to support the development of a Healthy Work Environment through Patient Care Redesign. The elements of the transformational change in practice build upon the foundational work established as a LEAN organization, and the work environment redesign to enable the interprofessional team to function to their full scope of practice in the most efficient, safe and patient-family centred care. Strategies to support implementation include monthly reporting and visual management tools,
implementing LEAN methodology and strategies to the change process, scheduling, examination of staffing models, interprofessional huddles, manager rounding, discharge checklists and post discharge phone calls and a dedicated project manager. Essential to the process and success is the engagement from front line staff to executives from defining current state to the design, operationalization and refinement of the model.
Over the last two months, approximately 100 interprofessional team members, Managers, Directors and facilitators’ participated in Patient Care Redesign (PCR) events. In May, there was the first ever Kaizen event that saw 4 teams working together in the Berwick. The teams were: D4, C4, Paediatrics and the Continuing Care Program. The teams developed or revised their vision for their units, standard work for each team member, POD designs, Communication board designs, guest orientation book content, 4P rounding scripts, new assignment sheets and patient “delighters”.
In a separate event in June, D3 and CCU completed their first 4-day Kaizen event. They developed visions and attributes and patient “Delighters” that set the frame work for the design of their new units. They mapped out their current state, developed 22 different potential POD designs, wastes and opportunities, role redesign, 4P rounding scripts and assignment sheets. Their second Kaizen event is scheduled for early July.
The Emergency Department (ED) participated in a facilitated Role Redesign event that included physicians, nurses, unit secretaries, professional practice, geriatric emergency management (GEM) nurse, manager and director, Medical Director of ED, Chief of ED, and EVP & COO. The event was 4 days in length and the group mapped out the path of the ambulatory vs the non-ambulatory patient, redesigned the ED space to maximize flexibility to better meet patients’ needs and increase flow and explored redesigned roles to match the redesigned space. There are 2 more events to complete the work.
Upcoming PCR Events
June 17 – 20, 2013
July 8 – 11, 2013
- D3 and CCU
Congratulations C3N & 5E on a successful launch of their new Model of Care
C3N and 5E spent March 18th worked within their teams to launch their new model of care. Each unit reorganized their practice environment to align with the principles of PCR: aligning the right people/skills in the right jobs; address gaps in direct care; reduce duplication and cost; increase efficiency/patient flow; and increase staff/patient/physician satisfaction. Teams created new pod designs to support the model and spent time connecting with patients and families about the changes occurring. On March 19th, both units went live with PCR coaches at the point of care to assist staff with the transition.
Over the next two weeks, there will be a total of 15 coaches on the 2 units to help with the improvements to patient care. As the teams evolve the model, metrics including patient satisfaction, and clinical indicators such as falls, pressure ulcers, patient education, medication errors and UTIs, to name a few, will be monitored pre and post implementation. Results and continued progress will be shared in upcoming Practice Reports.
Mental Health Team
The Mental Health program participated in a PCR Refresh Day on March 22, 2013. The interprofessional team used the opportunity to regroup, examine successes to date and opportunities for enhancement to continue progress in PCR implementation.