Take aggressive approach to eliminating waste
Take aggressive approach to eliminating waste
23 ideas for quick quality lifts in your hospitals
By Duke Rohe, FHIMSS,
Management Consultant
Holland & Davis
Houston
Every hospital needs to be continually knocking out every ounce of waste in their delivery systems. It’s with this type of aggressiveness that change will become second nature. These are some CQI "quick hits" that worked well at St. Luke’s Episcopal Hospital in Houston.
• Phones in hallways save 130 hours per floor a year.
• Ice machines accessible to patients save 105 hours a year.
• On-unit pharmacists reduce cycle time from 85 to 25 minutes.
• Automated drug distribution system reduces cycle time for as needed doses from 25 to three minutes.
• On-unit menus are ready for use daily.
• Microwave meals for late-unit arrivals save 15 minutes per tray and hunger pangs.
• Humor library was set up to entertain patients; channel on TV does the same.
• Beepers used instead of overhead paging, coded for room and for type of call.
• Staggering admits between nurses and allowing the floor to designate where and when to place patients smooths the workload.
• Keypads used on supply closets reduces "borrowing."
• Telephone cords were lengthened for new mothers so they could feed their babies and answer the phone at the same time.
• A single day was selected for council meetings, making them easier for staff to remember.
• Admission package supplies were reduced in number of items to reflect shorter stays.
• Arrows on an ambiguous sign sent guests in the right direction, saved 27 hours a year.
• Labor and delivery flow sheet set up for documentation by exception saved 40 minutes per nurse or 7,300 hours a year.
• Using clear sports cups instead of Styrofoam cups eliminate spills and allow staff to see if refills are needed.
• Narcotic lock box houses the narcotic key, and all licensed staff have key to box; no waiting saved a surgery floor 120 hours a year.
• Morning review of IV bags and their remaining volume keeps them continually flowing.
• Consulting physician sticker with name and phone number of front of chart provides quick reference.
• Walk-a-mile posts encourage ambulation progress. Every 25 feet of hallway is marked with a mile marker sign for beginning ambulators.
• Combination walker/seat allows patients to rest during ambulation trips, encouraging them to go farther.
• Operating instructions for daybed laminated onto the frame saves time for staff, gives more control to patients and family members.
• Reduce inventory of narcotic or crash cart supplies by placing a breakable seal over the opening of the item; if the seal is not broken, it doesn’t need to be counted.
[Editor’s note: Duke Rohe is now a management consultant at Holland & Davis in Houston. He can be contacted at (713) 877-8130.]
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