2.50
Hdl Handle:
http://hdl.handle.net/10755/182028
Category:
Abstract
Type:
Presentation
Title:
Applying Lean Initiatives to Inpatient Rounds to Improve Discharge Process
Author(s):
Sanchez-Rubiera, Nikole; Soto, M.; Cunill-DeSautu, B.; Mestre, M.; Rodriguez, A.
Author Details:
Nikole Sanchez-Rubiera, RN, MSN, MBA, Miami Children's Hospital, Miami, FL, email: Nikole.Sanchez@mch.com; M. Soto; B. Cunill-DeSautu; M. Mestre; A. Rodriguez
Abstract:
Purpose: Outcomes in an organization could have different implications to the patient and to the bottom line. The organization used LEAN methodologies to increase patient flow and improve patient satisfaction; the initiation of the process was established as discharge order time by physician to the time the room was ready for the next patient (admission). The multidisciplinary team included nursing, residents, physicians and environmental services. The pilot was initiated in one inpatient unit and was shared amongst all other inpatient units after successful implementation. Method: Lean concepts were utilized to evaluate the discharge process in the inpatient units. A value stream map was developed to measure the duration of the discharge process which initiated when the physician wrote the discharge order until when the room was ready for the next patient (admission). The nursing team's improvement intervention consisted of the 1) standardization of patient boards (magnets), 2) standardization of the charge nurse in inpatient rounds 3) standardization of medical team rounds (residents/physicians). A "try-storm" or pilot of the interventions was conducted in which it was noted that the discharge process could take up to 8 hours, due to different delays that occur throughout the process. Findings:
The discharge process from decision to discharge to admission of a new patient took up to 8 hours with variation amongst process steps. Discharge decision to time of discharge order written (a resident function) took up to 4 hours. 80% of discharge orders were processed after 1 pm. After the intervention implementation, the discharge process time decreased by 60% to 3.25 hours. Discharge decision to time of discharge order written decreased by 88% from 3 hours to 12 minutes. Discussion: Multidisciplinary participation in the LEAN Initiative for the discharge process yielded multiple benefits amongst several departments and improved communication. The intervention by the medical, nursing and environmental service team led to a significant reduction in discharge delays and improved patient flow. Additionally, multidisciplinary communication, care coordination, and patient satisfaction all indirectly benefited from the intervention. Efficiencies in rounding and the discharge process benefited the nursing team by involving them in the discharge process and assisting in the patient flow of the inpatient unit. The patient flow of the nursing unit enabled patients waiting in the emergency department or direct admission to be admitted sooner.
Repository Posting Date:
28-Oct-2011
Date of Publication:
28-Oct-2011
Conference Date:
2010
Conference Name:
7th Annual Florida Magnet Research Conference
Conference Host:
University of South Florida College of Nursing; Sigma Theta Tau International; Florida Organization of Nurse Executives
Conference Location:
Naples, Florida, USA
Description:
7th Annual Florida Magnet Research Conference - Theme: Research at the Point of Care. Held 11-13 February 2010 at the Naples Grande Beach Resort, Naples, Florida, USA.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleApplying Lean Initiatives to Inpatient Rounds to Improve Discharge Processen_GB
dc.contributor.authorSanchez-Rubiera, Nikoleen_US
dc.contributor.authorSoto, M.en_US
dc.contributor.authorCunill-DeSautu, B.en_US
dc.contributor.authorMestre, M.en_US
dc.contributor.authorRodriguez, A.en_US
dc.author.detailsNikole Sanchez-Rubiera, RN, MSN, MBA, Miami Children's Hospital, Miami, FL, email: Nikole.Sanchez@mch.com; M. Soto; B. Cunill-DeSautu; M. Mestre; A. Rodriguezen_US
dc.identifier.urihttp://hdl.handle.net/10755/182028-
dc.description.abstractPurpose: Outcomes in an organization could have different implications to the patient and to the bottom line. The organization used LEAN methodologies to increase patient flow and improve patient satisfaction; the initiation of the process was established as discharge order time by physician to the time the room was ready for the next patient (admission). The multidisciplinary team included nursing, residents, physicians and environmental services. The pilot was initiated in one inpatient unit and was shared amongst all other inpatient units after successful implementation. Method: Lean concepts were utilized to evaluate the discharge process in the inpatient units. A value stream map was developed to measure the duration of the discharge process which initiated when the physician wrote the discharge order until when the room was ready for the next patient (admission). The nursing team's improvement intervention consisted of the 1) standardization of patient boards (magnets), 2) standardization of the charge nurse in inpatient rounds 3) standardization of medical team rounds (residents/physicians). A &quot;try-storm&quot; or pilot of the interventions was conducted in which it was noted that the discharge process could take up to 8 hours, due to different delays that occur throughout the process. Findings:<br/>The discharge process from decision to discharge to admission of a new patient took up to 8 hours with variation amongst process steps. Discharge decision to time of discharge order written (a resident function) took up to 4 hours. 80% of discharge orders were processed after 1 pm. After the intervention implementation, the discharge process time decreased by 60% to 3.25 hours. Discharge decision to time of discharge order written decreased by 88% from 3 hours to 12 minutes. Discussion: Multidisciplinary participation in the LEAN Initiative for the discharge process yielded multiple benefits amongst several departments and improved communication. The intervention by the medical, nursing and environmental service team led to a significant reduction in discharge delays and improved patient flow. Additionally, multidisciplinary communication, care coordination, and patient satisfaction all indirectly benefited from the intervention. Efficiencies in rounding and the discharge process benefited the nursing team by involving them in the discharge process and assisting in the patient flow of the inpatient unit. The patient flow of the nursing unit enabled patients waiting in the emergency department or direct admission to be admitted sooner.en_GB
dc.date.available2011-10-28T16:11:28Z-
dc.date.issued2011-10-28en_GB
dc.date.accessioned2011-10-28T16:11:28Z-
dc.conference.date2010en_US
dc.conference.name7th Annual Florida Magnet Research Conferenceen_US
dc.conference.hostUniversity of South Florida College of Nursingen_US
dc.conference.hostSigma Theta Tau Internationalen_US
dc.conference.hostFlorida Organization of Nurse Executivesen_US
dc.conference.locationNaples, Florida, USAen_US
dc.description7th Annual Florida Magnet Research Conference - Theme: Research at the Point of Care. Held 11-13 February 2010 at the Naples Grande Beach Resort, Naples, Florida, USA.en_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.