Often times, I hear hospitals, coordinators, and providers say that one of their main goals is to improve treatment times for X condition, or Y service line. My next questions are almost always about their current processes. It never fails that during this conversation, we discover numerous “barriers” or “hurdles” the teams have when it comes to optimizing their processes.
But perhaps the most threatening barrier is when teams don't — or won't — take the time to dig into the current processes they have in place, and to ask WHY those processes are the way they are. If you are willing to do that exercise, you'll quickly uncover things that could be optimized, but haven't for no other reason than "Because that's how we've always done it."
Over the years, I've noticed patterns among some of the most common hurdles and process inefficiencies. If you're ready to optimize your processes for better patient care, ask yourself and your team the following questions, and take time to reflect upon the answers you gave and to seek areas where your only reason is "Because that's how we've always done it." Then ask, "Is that STILL how we should be doing it?"
- Does EMS activate or alert the hospital from the field? Why or Why not?
- What is the significance to your team of the EMS alert?
- Is your relationship with EMS one of mutual respect (is there reciprocated trust and understanding?) What about education on true vs. false activations?
- Do you or can you pre-register patients prior to arrival to the ED? If not, why?
- Once the patients hit the ED, do they move to an ER bed immediately, or do they stay on an EMS stretcher and go straight to CT, for example?
- Where do you rack up the most time delays in your current process?
- If you're unsure, have you thought of capturing times to see where the bulk of your time is spent? How might you do so?
- Is it a lack of resources that causes delays? Or is it a lack of communication and/or broken communication systems that add up on the stopwatch timer?
- If your location is a spoke facility with limited services, what is your process for Door-in to Door-out? Is that process streamlined or convoluted?
- Once the patient gets definitive care, do you have a QA/QI process for improvement? Are all lines of communication in a closed loop fashion? How do your teams know what they did right or could improve on?
My hope is to shed some light on questions that reveal process inefficiencies, which have significant impacts on our patients, communities, clinicians, and caregivers. I’ll be going into detail on some common answers to these questions in part 2.
In the meantime, please reach out if our team of experienced clinicians can help you talk through any of the above questions. It’s About People.