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CS429
Take Apart and Make New So as to Help Others: Improving Patient flow from the ED to the MICU using a Kaizen model
By: Mary Lu Daly; Rochester General Hospital; NY
For further information, please contact: marylu.daly@viahealth.org
Purpose: Patient flow from the ED to the MICU was identified as an issue. The MICU charge nurse was faced with a new challenge – collaborating with the ED charge nurse to improve patient flow. The purpose was to facilitate decision-making by improved communication between the two departments.
Description: : Kaizen, a quality improvement process, was undertaken to assess existing patient flow. A Kaizen event is used to “make a leap” when the other processes & tools have hit an obstacle. With this philosophy in mind, our hospital undertook the challenge of promptly getting patients seen in the ED to the proper level of care – in this case the MICU. Usual practice was examined with multidisciplinary stakeholders involved. Discussion centered on individual perceptions of current practice problems and opportunities for improvement. A key component to the planning process involved resolving interdepartmental conflicts with active listening and mutual respect. Our solution was an innovative approach involving an autonomous collaborative effort between nurses in both departments. The outcome was to give the authority of the patient flow process to the ED and MICU charge nurses. The two charge nurses were optimally qualified to decide which patients should be transferred first when multiple admissions were in the ‘queue.’ No longer were there delays in transfer due house staff procrastination. To facilitate the process, the charge nurses communicate via cell phone. Weekly Kaizen rounds occur to monitor the process.
Evaluation and Outcomes: Cooperation between departments has led to increased respect, collaboration, and better patient flow. The MICU staff is now challenged with beyond capacity census requiring the boarding of patients in our other ICUs. The MICU charge nurse has taken on increased responsibility with positive results. Increased collegiality and respect between departments, more efficient patient flow, and less ED overcrowding are all benefits of this program.
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