In 2014, Chatham-Kent Health Alliance (CKHA) implemented a patient flow dashboard tool to improve patient outcomes and increase organizational efficiency. The tool, developed by Oculys Health Informatics, quickly helped the organization have a real-time visual picture of the needs of patients in the Emergency Department (ED) waiting to be admitted while also providing an indication of bed capacity at a glance.
With the needs of patients visible across the organization, the staff responded – and with impressive results. “Before, there was a push to hurry and get people out of the Emerge, but now, we can pull them up to us,” explained Marguerite Miller, unit clinical aide at CKHA.
Visibility combined with accountability started to shift the culture and in less than six months, CKHA’s performance accelerated. As one of Ontario’s 74 Pay for Performance hospitals, CKHA moved from 17th for total length of stay for admitted patients and 14th for time to inpatient bed respectively up to 6th place for both.
More impressive is that the organization reduced its total number of beds in operation from 265 to 216 within the same timeframe, allowing it to solidify its financial position, improve length of stay and reduce unnecessary wait times for patients.
While the results were both impressive and rewarding, there was something else happening. Interestingly, the organization noted that performance started to plateau at about the six month mark.
In a constrained environment, hospitals cannot afford to let performance idle. It’s well documented that the longer a patient waits in an ED stretcher to be admitted, the faster they deteriorate. This lapse in time has a negative impact on the patient’s outcome and the productivity of the ED and receiving inpatient units.
So, what else could be done to ensure effective patient flow continues across departments? What other barriers to receiving appropriate and timely care exist?
“We knew that one of our process improvement opportunities was to improve the communication, notification and efficiency through which housekeeping could prioritize and organize the bed cleaning requirements on any given day,” said Sarah Padfield, chief operating officer at CKHA.
In almost every hospital today, beds are at a premium – bed capacity at CKHA averages 92 percent. With the prevalence of infectious diseases, there is also the need to understand the patient environment and be vigilant in appropriate and effective cleaning practices within the hospital.
The balance between turning beds over quickly and doing it properly is something the organization holds in high regard.
In fact, CKHA’s ability to go outbreak-free in 2014 is largely attributed to housekeeping’s role as part of the care team. While it’s understood that housekeeping is a key to the equation; their work is not well documented and they did not have effective tools to communicate and allocate resources to best support emerging needs across the organization.
And then a light went on. If Oculys delivers real-time visibility of admission needs and bed capacity, could it be expanded to make the role of housekeeping visible too?
“Because of our culture of innovation, success in working collaboratively with a technology partner and most importantly the leadership and willingness of our housekeeping team, we said why not put BlackBerry smartphones in the hands of housekeepers and let’s see what improvements we can make,” noted Padfield.
Adopting concepts used by hotels, Oculys, working in collaboration with CKHA staff, created a tool to automate workflow and track housekeeping tasks. This new solution, supported by the existing patient flow module, creates communication channels that reach across all disciplines and units. The real-time data and organizational view helps streamline decision-making and resources, which ultimately delivers consistent and timely responses by housekeeping staff throughout the hospital.
The process begins in the inpatient unit, when nursing staff identify a patient discharge through Oculys Performance. Then, a task is sent electronically for housekeeping staff to accept on their new BlackBerry Z30s (and because it’s integrated with the regular Oculys tool, isolation protocols are known prior to entering the room too.)
Once they do, the tool helps track how the room cleaning is progressing and upon task completion, the system immediately notifies admitting that the patient waiting for that bed can be transferred.
“The Oculys Performance solution with the new housekeeping component supports real-time efficiency. Our goal is to distill the complexity of the hospital into a simple solution that is easily adopted and implemented,” says Franck Hivert, Oculys Health Informatics president and CEO. “We worked closely with the CKHA team to solve a problem that would deliver measurable results and improve performance.”
The housekeeping solution can also be used to support ongoing patient care needs, such as assigning tasks to support spills or urgent requests across the facility. Over time, the Oculys solution should alleviate the ‘air traffic’ syndrome the management team faces in trying to manage multiple and competing priorities.
“This project has created a real sense of pride within our team because it showcases that we are a progressive group who can see the benefits that technology will bring to our work,” says Carrie Sophonow, housekeeping manager, CKHA. “Once fully implemented, we know we’ll see increased efficiencies and we expect, new opportunities for our team to make a positive impact for patients at CKHA.”
While CKHA is in the pilot phase of this new initiative, it is already providing promising opportunities to improve housekeeping processes, including reducing a lot of wasted time and energy in locating staff, duplicating communications and prioritizing and assigning tasks. By implementing this new Oculys solution and deploying it on BlackBerry smartphones, CKHA aims to further improve patient care while also reaffirming the role of housekeeping as a critical part of the care team within the hospital.