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Six Hospitals address regional ED congestion & improve patient flow through inpatient psychiatric units
BCPSQC, Vancouver: February 28, 2013
Sumeet Kumar, BEng, MBA, LSS Black Belt, PMPLean Transformation Services, Vancouver Coastal Health
• The Problem
• Our approach
• Results & Sustainability Process
• Summary and Lessons learnt
• Q&A
2
Presentation Outline
4Source: Toyota Kata by Mike Rother
Step 4:Set the Target
Condition/ Future State
Step 2: Understa
nd the Current
State
Step 3: Identify the Ideal
State
Step 1:Set the Vision
Ideal State is a value add
process from the customer’s
perspective
Our Approach
• 100% utilization of inpatient beds in psychiatry at each of the 6 hospitals
– Establish a system to track bed inventory regionally
– Establish a regional standard operating process for inter-hospital transfers
5
The Goal Set the Vision
Current State Process Map
Step that directly involves patient
Step taken by Transport Coordinator at transferring hospital
Step taken by member of a team atTransferring hospital
Step taken by outside stakeholder
Understand the
Current State
Patient arrives in ED and is admitted to
psychiatry but there are no
inpatient bed available
Patient is transferred to
another hospital which
has a bed available and
is handed over to the care
team at that hospital
8
• Australia
• New Zealand
• Netherland
• UK
Literature Review & Best Practices around Inter-Hospital Transfers
Identify the Ideal
State
The Regional Issues Resolution group continue to meet on a 6 monthly basis to address issues, that may arise
Regional SOPStandard Transfer & Repatriation Forms and Transfer Checklist.A system to share their bed inventory levels twice daily across sitesMaintain accuracy of bed inventory
Jan 2011
Mar to May 2011
Jun to Oct 2011
Jun 2011
Feb2011
Jan 2011
Standard Operating Procedure createdNew Forms created for the Inter-hospital TransfersPilot for 12 weeks (Mar 1st to May 31st, 2011)Project rolled-out regionally on June 1, 2011
Establish a Standard Regional System for Inter-hospital Transfers of Mental Health & Addiction Acute patients (across 6 different hospitals namely VGH, UBC, RGH, LGH, SPH & MSJ)
Different process at each hospitalsDifferent terminologiesNo roles & responsibilityDifferent FormsPerson dependent ProcessNot all hospitals participated in Triage callInformation of Bed Inventory not known at each hospital during the day
ProjectDefinition
CurrentState
FutureState
Implementation
Audit/Refine
Sustain
Results: Six Hospitals Combat Regional ED Congestion
94% regional bed utilization
Regional bed inventory updated 87% of time
100% accuracy of bed inventory update
• 30-60-90 days metric tracking by LEAN facilitator and Operations team
• 6 monthly reviews by Operations team
• Issues Resolution Group
15
Regional Sustainability Process
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