IntroductionAccording to a recent survey (August 2010) performed by HealthLeaders Media Intelligence Unit of more than 200,000 healthcare executives 93% of the healthcare leaders say patient experience is among their top priorities". Baptist St Anthony Health System (BSA) is a health system which considers patient satisfaction to be a critical measure of their success.
It so happens that a key area identified via the patient feedback was related to wait times. Bottom Line – long wait time equates to decreased patient satisfaction. With the implementation of Unibased ForSite2020 Surgery Management System BSA considered this an opportunity for them to understand the impact the scheduling system could have on patient satisfaction.
BSA took this goal to heart, and began designing a better patient experience around it, from the time the Patient entered the workflow, through to the completion of care.
Overview of what took place
Scheduling
Through the usage of block tracking in the ForSite2020 Surgery Management system, BSA gained previously unrealized visibility to utilization and helped streamline block assignments. As a result the staff was able to target under utilized areas for reassignment. In addition, BSA was able to identify areas of need which included the best times for assigning blocks based on specific surgeon and service procedure volume. Although BSA has not yet been able to quantify the increase in surgeon satisfaction the general belief is that it has increased.
Pre-Admission Testing
BSA began scheduling their patient activity within the ForSite2020 Enterprise Scheduling system, and as a result they experienced a significant reduction in the use of manual logs and schedules. In addition, the BSA staff was able to better manage patient evaluations workload. This improvement in operational efficiency contributed to the reduction in the patient time spent in the Pre-Admission Testing area by approximately 50%. Based on the BSA premise that longer wait times equates to decreased patient satisfaction, the positive patient experience of a 50% reduction in length of stay has increased the patient satisfaction level.
Pre-Operative Area / Post Operative Stage 2
These two departments are physically the same and share a common staff. Coordination and efficient utilization of resources is critical. It is common that patients return post-operatively to the same room that they were in pre-operatively. Through the combination of automated documentation and the more predictable availability of Pre-Admission Testing information, the overall process in these areas has been streamlined.
The departmental manager was able to rearrange staff schedules based on blocks and scheduling automation. The improvements in these departments contributed an increase in staff satisfaction and a decrease in overtime expenditures.
Intra-Operative Area
BSA determined an on-time start for the first case of the day was critical as it would impact the remainder of the day. BSA also acknowledged a decreased delay in first case starts leads to decreased overtime and that subsequent case throughput was enhanced throughout the day.
BSA initially focused on surgeon arrival times in the hospital. For example, with cases scheduled to start at 0800, the surgeon was expected to arrive by 0730. The surgeon notifies the front desk of his/her arrival and this is marked on the white board and tracked in a spreadsheet for reporting purposes.
The ForSite2020 Surgery Management system, in conjunction with the manual surgeon tracking mechanism, alleviated the need to be reactive to anecdotal information. Use of the system enables the focus to shift from time consuming direct observation and concerning hearsay to more pertinent workflow activities.
First case start times have progressively decreased in average delay time by as much as 18 minutes. In correlation to the Advisory Board’s estimation on delay times, this improvement represents as much as $1,800 of previously unrealized revenue per on-time first case start. In addition successful first case starts contributes positively to consecutive case throughput during the remainder of the day. Although the value of increased throughput has not yet been fully quantified it is deduced the impact is significant and positive.
Final Thoughts
The O.R. Educator had 3 months set aside for completing the training on ForSite2020 prior to go live with Intra-Operative documentation. It actually only took approximately 3 weeks; less than 1/3 the time originally allocated. “It was amazing”.
BSA has improved the communications between employees and employee morale, which BSA believes to have positively impacted care delivery and the overall patient experience. One example was the simple change in a question from “Why isn’t your patient in the room yet?” to “How can I help you get your patient to the room?”
Decreasing overtime expenditures has been a long standing goal of BSA. Since implementing ForSite2020, BSA has been able to decrease overtime expenditures by approximately 2% and expect that improvement to continue. This reduction contributes to increased cost savings, staff satisfaction and an improved patient experience.
About Baptist St. Anthony's Health System:
Baptist St. Anthony’s Health System (BSA) is an extensive hospital system providing clinical excellence to the Texas Panhandle and the tri-state area. BSA is acclaimed for its superior quality and Star Customer Service - compassionate care delivered by a diverse team of skilled professionals and is the fourth largest employer in Amarillo, with a medical staff of more than 450 physicians and 2,700 employees. For more information about Baptist St. Anthony's Health System, visit: http://www.bsahs.org/
