UTILIZATION OF AN INTERPROFESSIONAL KAIZEN PROCESS TO IMPROVE LABOR INDUCTION SCHEDULING

Purpose:
Re-design the labor induction scheduling process to reduce delays in admission, and improve patient and provider satisfaction.

Significance:
Accurate and timely scheduling of patients for labor induction is required to ensure patient safety. Inaccurate prioritization or delays in scheduling may increase the risk for maternal and fetal complications. Frequent rescheduling leads to patient, family, provider and nurse dissatisfaction.

Strategy and Implementation:
In response to a concern about delays in admission for maternity patients scheduled for labor induction, nursing and medicine leadership at a Level I Perinatal Center performing over 700 labor inductions per year formed an interprofessional Kaizen team to evaluate and improve the process. Over a two-day period, team members utilized Kaizen methodology to formulate a concern and purpose; collect data; evaluate the physical and interpersonal area involved; assess for waste in the process; and develop solutions for implementation. Fifty-one areas of waste were identified. Solutions included: revision of the labor induction scheduling form, creation of a new scheduling process, and development of a patient education handout. Education was provided to all stakeholders prior to implementation. Team continues to meet monthly to review audit data and make adjustments to process in order to meet established targets.

Evaluation:
Comparative metrics prior to and 6 months after implementation: 1) Patients rescheduled- 37% to 22%; 2) Average hours from scheduled admission to actual admission- 34 to 17 hours; 3) Patients receiving patient education handout- 0% to 62%; 4) Scheduling forms complete- 44% to 83%.

Implications for Practice:
Patient safety and satisfaction have improved as a result of this interprofessional Kaizen process. Scheduling forms are fully complete more often, ensuring correct patient prioritization. Admission delays have decreased, and patients now verbalize a better understanding of the scheduling process.