GI Suite Changes Effectively Improves Quality of Patient Care and Staff Satisfaction

Purpose:
A multi-pronged effort by the York Hospital GI Lab nursing staff working in conjunction with medical personnel and IT department brought about changes in work load and case scheduling which served to improve Patient and RN satisfaction in several key component areas, using a Lean 6 Sigma approach.

Significance:
Process improvements and significant staff involvement in redesigning of workspace, staffing and patient flow were the major factors contributing to gains in RN satisfaction, and patient satisfaction as related to time available for patient care, documentation and lifting/moving patients.

Strategy and Implementation:
Serveral innovations were implemented as a result using the Lean 6 Sigma methodology to address patient flow in the GI Lab. A new computerized case scheduling system Surginet© was installed, when data from the system provided clear evidence of physician block time exceeding expectations. Using the Surginet© results the procedural case length times were adjusted to fit the actual physician history. By recognizing the limits of block time, the case loads could be adjusted to better reflect performance and decrease staff workload previously experienced. To address unit efficiency and patient throughput, a new staging system was created – with flags for Pre-procedure Readiness, Physician (GI & Anesthesia) Reviews; Recovery; Post-procedure Physician reviews, and Discharge; and, unit layout redesign for improved flow and provider operations. The RN Staff were also involved in reviews of supply concerns and scheduling of patients to acheieve greater patient satisfaction.

Evaluation:
The success of the innovation was measured by RN Satisfaction Survey results from NDNQI which depicted increasing trends in several major catagories: task, decision makingm automomy, professional development and RN-MD interfaces. Also, quarterly patient satisfaction results from F&M college.

Implications for Practice:
The new “footprint” for the Lab following the full implementation of the Lean 6-Sigma recommendations for redesign - with an increase in workscope, and patient throughput resulted in staff satisfaction in the moderate to high ranges, and patient satisfaction scores improved.