Sunday, Sep 26 - Expo Hall Opening
Sunday, Sep 26 - Job Fair
Monday,
Sep 27 - AWHONN's Block Party
Tuesday, September 28, 2010
: 2:00 PM
Title: Just in Time: Improving Scheduled Cesarean Start Times
Venetian
Audio File
Discipline: Professional Issues (PI), Childbearing (CB)
Learning Objectives:
Submission Description:- Describe process mapping as a tool to identify barriers to efficient patient-centered care.
- Suggest solutions to improve the timeliness of scheduled procedures.
- List benefits of working within an interdisciplinary team.
Just in Time: Improving Scheduled Cesarean Start Times
Delivery of efficient, quality patient care has been the ultimate goal of healthcare professionals for quite some time. If care delivery is not at a level that meets or exceeds expectations, patients and care providers are frustrated. Instead of considering failed processes, stakeholders tend to blame each other for deficiencies. Research shows that forums such as interdisciplinary committees may allow physicians and nurses to learn more about each other’s workflow processes and perspectives, which provides a solid foundation on which to base change (Migueles & Brustowicz, 1997). If processes improve by collaboration among involved parties, outcomes may also be improved in a manner that could not be achieved by nurses or physicians working alone.
In 2008, obstetrical team members at Johnson City Medical Center observed that significant delays in cesarean section start-times were an issue that needed to be addressed. Working within our perinatal interdisciplinary committee, we began to reform the way we presented care to our clients who required scheduled cesarean sections. Beginning with process mapping, barriers to on-time start of scheduled cesarean sections were identified. Data was gathered by observation and interviewing of crucial stakeholders and numerous barriers were uncovered. The overall process as it currently existed, and the identified barriers were then presented to the committee, whose members began to deliberate possible solutions. Tools were created to assist nurses and physicians to insure all pre operative information was obtained prior to the patient’s scheduled operative date. Processes were changed to encourage patients to complete necessary pre operative forms, have pre-operative lab work, and complete pre-operative education in advance, promoting a more relaxed environment for the patient on the day of the scheduled birth. Anesthesia and obstetric care providers changed practice patterns to attend unit huddles in order to increase communication. All providers agreed to present to the OB unit at least thirty minutes prior to the expected procedure start-time.
As a result of our process improvements, scheduled cesarean birth start-times have improved by as much as 40%. By improving the consistency of scheduled cesarean start times, we have enhanced the experience for all stakeholders. An increased understanding was noted between nursing and physicians regarding each others’ perceived barriers, opening lines of communication for future issues. Obstetricians, anesthesia personnel, and nursing team members are satisfied with improved patient flow. Our patients have expressed increased satisfaction due to decreased wait times. This successful process change, facilitated by our perinatal interdisciplinary team, has strengthened our resolve to consistently strive for high quality, cost effective patient care.
Due to the complexity of patient needs, healthcare providers everywhere are being forced to develop their capacity to think together to develop collaborative thought and coordinated action (Grange, 2007).This presentation will show how process mapping, incorporated by a collaborative team, can illustrate stakeholder interests and is a tool that can be adapted by any focus group.
Delivery of efficient, quality patient care has been the ultimate goal of healthcare professionals for quite some time. If care delivery is not at a level that meets or exceeds expectations, patients and care providers are frustrated. Instead of considering failed processes, stakeholders tend to blame each other for deficiencies. Research shows that forums such as interdisciplinary committees may allow physicians and nurses to learn more about each other’s workflow processes and perspectives, which provides a solid foundation on which to base change (Migueles & Brustowicz, 1997). If processes improve by collaboration among involved parties, outcomes may also be improved in a manner that could not be achieved by nurses or physicians working alone.
In 2008, obstetrical team members at Johnson City Medical Center observed that significant delays in cesarean section start-times were an issue that needed to be addressed. Working within our perinatal interdisciplinary committee, we began to reform the way we presented care to our clients who required scheduled cesarean sections. Beginning with process mapping, barriers to on-time start of scheduled cesarean sections were identified. Data was gathered by observation and interviewing of crucial stakeholders and numerous barriers were uncovered. The overall process as it currently existed, and the identified barriers were then presented to the committee, whose members began to deliberate possible solutions. Tools were created to assist nurses and physicians to insure all pre operative information was obtained prior to the patient’s scheduled operative date. Processes were changed to encourage patients to complete necessary pre operative forms, have pre-operative lab work, and complete pre-operative education in advance, promoting a more relaxed environment for the patient on the day of the scheduled birth. Anesthesia and obstetric care providers changed practice patterns to attend unit huddles in order to increase communication. All providers agreed to present to the OB unit at least thirty minutes prior to the expected procedure start-time.
As a result of our process improvements, scheduled cesarean birth start-times have improved by as much as 40%. By improving the consistency of scheduled cesarean start times, we have enhanced the experience for all stakeholders. An increased understanding was noted between nursing and physicians regarding each others’ perceived barriers, opening lines of communication for future issues. Obstetricians, anesthesia personnel, and nursing team members are satisfied with improved patient flow. Our patients have expressed increased satisfaction due to decreased wait times. This successful process change, facilitated by our perinatal interdisciplinary team, has strengthened our resolve to consistently strive for high quality, cost effective patient care.
Due to the complexity of patient needs, healthcare providers everywhere are being forced to develop their capacity to think together to develop collaborative thought and coordinated action (Grange, 2007).This presentation will show how process mapping, incorporated by a collaborative team, can illustrate stakeholder interests and is a tool that can be adapted by any focus group.
