Patient Transport One Hospital s Approach To Improve Both Services and Productivity. Jesse Moncrief Cengiz Tanverdi

Transcription

1 Patient Transport One Hospital s Approach To Improve Both Services and Productivity Jesse Moncrief Cengiz Tanverdi

2 OUTLINE BACKGROUND GOALS APPROACH ANALYSIS CHANGES IMPLEMENTATION PATH FORWARD

3 CHRISTIANA HOSPITAL LEVEL 1 TRAUMA CENTER OVER 40,000 ANNUAL ADMISSIONS AVERAGE DAILY CENSUS OVER 600

4 PATIENT ESCORT CENTRALIZED DIPATCHED & DEDICATED AREAS RESPONSIBLE FOR PATIENT TRANSFERS DISCHARGES OXYGEN ERRANDS

5 PATIENT ESCORT STAFF (FTE) MANAGER SUPERVISORS - 3 DISPATCHERS - 9 ESCORT STAFF - 75 TRIP VOLUME ANNUAL - 404,000 WEEKLY - 7,800 WEEKDAY 1,300

6 PATIENT ESCORT REQUESTS FOR MORE DEDICATED STAFF AFFECTS PERFORMANCE OF OTHER DEPARTMENTS RESPONSE TIME COMPLAINTS PRODUCTIVITY PERCEIVED AS LOW

7 PROJECT GOALS ESTABLISH PATIENT ESCORT OPERATIONS THAT EFFICIENTLY RESPOND TO VARYING CHANGES IN WORKLOAD VOLUME ADJUST STAFFING LEVELS TO IMPROVE PRODUCTIVITY AND REDUCE DEPARTMENT OPERATING EXPENSES

8 APPROACH SUPPORT FROM ALL DEPARTMENTS IDENTIFY DEMAND PATTERNS IDENTIFY OBTACLES REVIEW DISPATCH PRACTICES DEVELOP NEW STAFFING ASSIGNMENTS AND DISPATCHING PRACTICES

9 DEPARTMENTS INVOLVED PATIENT ESCORT MANAGEMENT SYSTEMS RADIOLOGY REHAB SERVICES HEART CENTER EMERGENCY DEPARTMENT CATH LAB NUCLEAR MEDICINE

10 DATA COLLECTION TWO WEEK COLLECTION PERIOD DISPATCH SOFTWARE DOWNLOAD MANUAL LOGS FOR DEDICATED AREAS SHADOWING ESCORT STAFF

11 DATA ANALYSIS CHALLENGES VOLUME MANUAL LOGS DATA DOWNLOAD MERGING MANUAL AND AUTOMATED DATA VIRTUAL WEEK CREATION GROUPING TRIPS CREATING VISUAL PICTURE OF WORKLOAD DEMANDS

12 CHRISTIANA TRIP/STAFFING DISTRIBUTION ( MONDAY - FRIDAY ) 60% 50% 40% PERCENTAGE 30% 20% 10% 0% STAFFING TRIPS DEDICATED DISPATCH

13 CHRISTIANA PATIENT ESCORT WEEKDAY TRIPS NUMBER OF TRIPS MON TUE WED THU FRI HOUR OF DAY

14 CHRISTIANA PATIENT ESCORT WEEKDAY TRIPS 6% 5% PERCENT OF TRIPS 4% 3% 2% DEDICATED DISPATCHED 1% 0% HOUR OF DAY

15 CHRISTIANA PATIENT ESCORT DISPATCHED TRIPS MON HOUR OF DAY FRI THU WED TUE

16 CHRISTIANA PATIENT ESCORT DEDICATED TRIPS MON HOUR OF DAY FRI THU WED TUE

17 CHRISTIANA DISPATCH STAFFING VERSUS TRIPS AVERAGE HOURLY TRIPS HOUR OF DAY TRIPS STAFF NUMBER OF STAFF

18 CHRISTIANA DEDICATED STAFFING VERSUS TRIPS AVERAGE HOURLY TRIPS NUMBER OF STAFF HOUR OF DAY TRIPS STAFF 0

19 OT HER 5T H FL W OM ENS BLDG SUPPORT LL SUPPORT 1ST FL OTHER LL OTHER 1ST FL NURSING UNIT OP LOBBY WHS EM ER DEPT CLINICAL 4TH FL C L INIC A L 1ST FL SUPPORT LL S U PPO 2ND SUPPORT 1S T F PHARMA CY O TH E R LL OTHER 1ST F NURSING UNIT OTH E R NURSING UNIT LOB BY WHS LOBBY CH E M ER DEPT CLIN IC AL LL CLIN IC AL 4TH F C L IN IC A L 2 N D F CLINICAL 1ST F 20% 18% 16% 14% 12% 10% 8% 6% 4% 2% WOMENS BLD OTHER 2ND F S URG, MAP, M AP 0% CHRISTIANA PATIENT ESCORT TO/FROM TRIP DISTRIBUTION FROM TO

20 TRIPS TO/FROM CHRISTIANA NURSING UNITS (M ONDAY-FRIDAY) NUMBER OF TRIP TO IP NU FROM IP NU FROM IP NU TO IP NU HOUR OF DAY

21 CHRISTIANA TRIPS FROM IP NURSING UNITS TO CLINICAL 1ST FLOOR MONDAY-FRIDAY 16% 14% 12% 10% 8% 6% 4% 6TH FL C-D(CH) 6TH FL A-B(CH) 5TH FL C-D(CH) 5TH FL A-B(CH) 4TH FL C-D(CH) 4TH FL A-B (CH) 3RD FL C-D(CH) 2ND FL C-D(CH) 2ND FL A-B(CH) 2% 0% HOUR OF DAY

22 CHRISTIANA PATIENT ESCORT TRIPS FROM IP NURSING UNIT TO CLINICAL 1ST FLOOR MONDAY-FRIDAY 6TH FL A-B(CH) 15% 6TH FL C-D(CH) 10% 2ND FL A-B(CH) 6% 2ND FL C-D(CH) 9% 3RD A-B(CH) 0% 3RD FL C-D(CH) 6% 4TH FL A-B (CH) 6% 5TH FL C-D(CH) 15% 4TH FL C-D(CH) 12% 5TH FL A-B(CH) 21%

23 CHRISTIANA TRANSPORTER TRIPS PER HOUR ( Excludes ED Xray and Radiation Oncology ) 30% PERCENTAGE OF OCCURANCE IN G 25% 20% 15% 10% 5% DEDICATED DISPATCHED 0% TRIPS PER HOUR

24 DISTRIBUTION OF CHRISTIANA TRANSPORTER TRIPS PER HOUR 5 4 NUMBER OF HOURLY TRIPS TH PERCENTILE 75TH PERCENTILE AVERAGE HOUR OF DAY

25 REHAB SERVICES

26 CHRISTIANA REHAB TRIPS BY HOUR OF DAY MONDAY - FRIDAY TOTAL DISPATCHED DEDICATED

27 CHRISTIANA REHAB TRIPS BY HOUR OF DAY NUMBER OF TRI MON TUE WED THU FRI

28 CHRISTIANA REHAB TRIPS BY HOUR OF DAY FRI THU WED TUE MON

29 HOURLY TRIPS TO AND FROM CHRISTIANA REHAB 14% 12% 10% PERCENT 8% 6% TO IP N U FR OM IP N U 4% 2% 0% HOUR OF DAY

30 CHRISTIANA DEDICATED REHAB TRIPS BY HOUR OF DAY FRI THU WED TUE MON

31 DEDICATED REHAB TRANSPORTER TRIPS PER HOUR 25% 20% PERCENT OF OCCURAN 15% 10% 5% 0% TRIPS PER HOUR

32 DEDICATED REHAB ESCORT STAFFING AND TRIP PATTERNS AVERAGE HOURLY TRIPS BY DEDICATED NUMBER OF DEDICATED ST DEDICATED TRIPS STAFF

33 INITIAL OBSERVATIONS # TRIPS INCONSISTENT BETWEEN STAFF # TRIPS OVERALL LOWER THAN EXPECTED DEDICATED STAFF NOT AS BUSY ASSIGNMENT OF DEDICATED STAFF DOES NOT ELIMINATE DELAYS DEDICATED STAFF SLOTS ALWAYS FILLED

34 INITIAL OBSERVATIONS STAFF FINDING REASONS TO EXTEND CALLS STAFF FINDING WAYS TO DISAPPEAR DELAYS TO FIND EQUIPMENT INFREQUENT ACTUAL TRANSPORT TIME FROM 3-5 MINUTES

35 INITIAL OBSERVATIONS DISPATCHERS NOT ABLE TO WATCH BIG PICTURE SIGNIFICANT VARIATION IN DEMAND BY HOUR OF DAY AND DAY OF WEEK

36 CHANGES NEEDED INCENTIVE TO TAKE CALLS SUPERVISION IN DEDICATED AREAS FLEX DEDICATED STAFF ADDITIONAL SUPERVISION TO MONITOR BIG PICTURE

37 IMPLEMENTATION INDIVIDUAL PERFORMANCE GOALS JOINT SUPERVISION FOR DEDICATED STAFF DISPATCHING DEDICATED STAFF DISPATCHERS ASSIGNED AREAS RENOVATION OF DISPATCHER WORK AREA ADDED 1 DISPATCHER

38 IMPLEMENTATION NEW DISPATCH CONTROL DESK RECOGNITION

39 PATIENT ESCORT PRODUCTIVITY TRIPS/HOUR 07/12/ /09/ /06/ /04/ /01/ /29/ /27/ /24/ /21/ /20/ /17/ /15/ /12/ /10/2004

40 CHRISTIANA PATIENT ESCORT ON TIME PERFORMANCE PERCENT ON TIME Jul-03 Aug-03 Sep-03 Oct-03 Nov-03 Dec-03 Jan-04 Feb-04 Mar-04 Apr-04 May-04 Jun-04

41 TURNING POINTS DEPARTMENTS USING DEDICATED STAFF SEEING ACTUAL WORKLOAD SETTING # OF TRIPS PER SHIFT INCORPORATING GOAL IN PERFORMANCE STANDARDS

42 PATH FORWARD ESTABLISH APPROPRIATE STAFFING LEVELS FOR STAFF IN DEDICATED AREAS DISPATCH ALL STAFF BY RADIO