Capital Health Medical Outpatient Unit April 12th 2007 Final Presentation Kyle Brown Hillary Higgins Justin Lang

Outline 1.Overview MOU The Problem 2.Methodology 3.Analysis and Application Academic Research Survey Results Simulation Design Layout 4.ST Recommendations Implementations 5.LT Recommendations Implementations 6.Implementation Steps

Overview Overview Methodology Analysis and Application Short-Term Long-Term Steps PROBLEM:  Increased demand  Poor facility  Inadequate layout design  Nature of treatments procedures  Scheduling “The MOU needs a more effective layout, and better utilization of resources”

Overview Overview Methodology Analysis and Application Short-Term Long-Term Steps

Methodology Overview Methodology Analysis and Application Short-Term Long-Term Steps From Understanding to Insight  Extensive time in the MOU  Surveys  Academic research  Layout measurements (AutoCAD)  Hospital investigation  Staff presentation & feedback

Analysis and Application Overview Methodology Analysis and Application Short-Term Long-Term Steps ACADEMIC RESEARCH  Focus on patient experience  Reducing perceived procedure times - Low cost, high benefit solutions  Layout Design - Focus on decreasing clutter and improving work-flow

Analysis and Application Overview Methodology Analysis and Application Short-Term Long-Term Steps ACADEMIC RESEARCH  Specific Techniques -Told wait times, procedure/treatment durations -Distractions: posters, TV’s, soft music, portable DVD’s, library collection

Analysis and Application Overview Methodology Analysis and Application Short-Term Long-Term Steps SURVEY RESULTS (Staff)  Increased safety for staff and patients -Reduce clutter -Better organization  Improve the working environment -Need more suitable area for charting and medication mixing -Need increased privacy for patients

Analysis and Application Overview Methodology Analysis and Application Short-Term Long-Term Steps SURVEY RESULTS (Patients)  Need better scheduling system for advance booking and appointment changes  Need better privacy  Need more information on wait time and duration of appointment  Would like more entertainment while waiting

Analysis and Application Overview Methodology Analysis and Application Short-Term Long-Term Steps SURVEY RESULTS (Doctors)  Long wait time to get patients in for treatment (1 month) - Checking Out-patients in as In-patients  Desire a private medical assessment area

Analysis and Application Overview Methodology Analysis and Application Short-Term Long-Term Steps SURVEY RESULTS (Overall)  Top Priorities -Improve safety in the MOU -Improve organization of the layout and organization of work space -Need more capacity for procedures -More space allocated to the MOU -Enhanced privacy for assessments and for procedures

Analysis and Application Overview Methodology Analysis and Application Short-Term Long-Term Steps DESIGN LAYOUT  Measured entire MOU - As well as surrounding units - Also measured all furniture and equipment  AutoCAD Model - To scale replica of the MOU - Permits experimentation with various layouts and designs

Analysis and Application Overview Methodology Analysis and Application Short-Term Long-Term Steps CAPACITY  Issues -Wide range on procedure times -No recorded patient out-times -Daily procedure hours difficult to calculate -Undocumented patients  Electronic Scheduling System - Would resolve many of these problems

Analysis and Application Overview Methodology Analysis and Application Short-Term Long-Term Steps CAPACITY  Utilization Rates - Minimum utilization rate: 26% Minimum daily procedure hours 16 hours of unrestricted capacity - Maximum utilization rate: 74% Maximum daily procedure hours 10 hours of unrestricted capacity Additional 30 hours of daily procedures (To account for undocumented patients)

Analysis and Application Overview Methodology Analysis and Application Short-Term Long-Term Steps CAPACITY  Daily procedures - Average week day procedures: 58 - Minimum week day procedures: 41 - Maximum week day procedures: 76 - Does not account for undocumented visits

Analysis and Application Overview Methodology Analysis and Application Short-Term Long-Term Steps CAPACITY  Seasonality - Typical procedure hours on Monday: Typical procedure hours on Wednesday: 150  Main have implications toward more efficient scheduling - Both staff and patients

Analysis and Application Overview Methodology Analysis and Application Short-Term Long-Term Steps CAPACITY  Seasonality  Electronic Scheduling System - Would resolve many of these problems

Short Term Overview Methodology Analysis and Application Short-Term Long-Term Steps RECOMMENDATIONS  Assuming current facility layout…  Short term: -Safety -Clutter & Reorganization -Patient Wait Time -Patient Privacy

Short Term Overview Methodology Analysis and Application Short-Term Long-Term Steps IMPLEMENTATION  Safety - Centralized utility outlets - Hillrom - Stools - Hand Sanitizers  Reorganization - Chemical mixing station -Exchange large desks for shelves and charting tables

Short Term Overview Methodology Analysis and Application Short-Term Long-Term Steps IMPLEMENTATION  Reduce Perceived Wait - Patient told wait and appointment duration - Wall posters - DVD personal players and library - Book library -TV suspensions -Soft music and personal lighting  Patient Privacy -Isolation room for assessments

RECOMMENDATIONS  Layout Design - 2 possibilities  Scheduling -Increase capacity -Better patient care (pre MOU) -Increased morale Long Term Overview Methodology Analysis and Application Short-Term Long-Term Steps

Long Term Overview Methodology Analysis and Application Short-Term Long-Term Steps ROOM NEGOTIATION: X-Ray RoomETU Room Additional Capacity- 3 Chairs- 4 Chairs - 2 Beds Confidentiality- Private assessment room - No Bed/Chair segregation - Bed/Chair segregation - No private assessment room Waiting Area- Designated waiting area Office Space- Designated office space Patient/Staff Storage- Locker space Safety- Improved staff flow and proper storage of supplies

Long Term VARiS Overview Methodology Analysis and Application Short-Term Long-Term Steps

Implementation Steps Overview Methodology Analysis and Application Short-Term Long-Term Steps STEP:ISTEP:IISTEP:IIISTEP:VSTEP:IV Regulations Room Negotiations Inquiries Short Term Layout Short Term Distractions Long Term Layout Long Term Scheduling

Implementation Steps STEP ONE:  Regulations - budgetary approval - work orders - hospital order catalogue  Room Negotiations (Benefit of chairs & beds) - X-ray Room (3 chairs) - ETU Room (4 chairs, 2 beds) Overview Methodology Analysis and Application Short-Term Long-Term Steps

Implementation Steps STEP ONE: (continued)  Inquiries - ‘Artists on the Ward’ - Safety disposal - Sanitization stations - VARiS software (focus long term) Overview Methodology Analysis and Application Short-Term Long-Term Steps

Implementation Steps STEP TWO:  Short Term (layout) - Chair movement - Remove old equipment (Desks) - Purchase shelving & install - Install new mixing station - Purchase new stools - Reorganize supplies Overview Methodology Analysis and Application Short-Term Long-Term Steps

Implementation Steps STEP THREE:  Short Term (distractions) - Nurse assignments Posters Book/magazine library Personal DVD players DVD library - Overhead music (no vocals) - TV installation Overview Methodology Analysis and Application Short-Term Long-Term Steps

Implementation Steps STEP FOUR:  Long Term (layout) - New room assigned to MOU - Create weekend plan to change layout - Renovations to waiting/office space - Installation of lockers - Other... (depends on room) Overview Methodology Analysis and Application Short-Term Long-Term Steps

Implementation Steps STEP FIVE:  Long Term (scheduling) - Obtain funding - Obtain software - Schedule training Out of house In house - Run software with paper scheduling concurrently Overview Methodology Analysis and Application Short-Term Long-Term Steps

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