1. WP Detox Admission Lean
May 2017

2. The Issue 35% Value Added Arrival to admit complete= 4hrs 11 minutes
Entry to Unit
Admission Complete
175 minutes
76 minutes
35% Value Added
Arrival to admit complete= 4hrs 11 minutes

3. Intake Forms and Paperwork
34 pieces of paper given to patient
19 forms require patient signature

4. History and Physical Information
ART Evaluation
Nurse Practitioner
Paper Intake Form
Nurse
The same information is asked of the patient 6 times, with very little of the info flowing to the next person.
Nurse assessment completely obsolete, so RNs not thoroughly filling out their documentation
ART Intake Call
Psychiatrist

5. 95% Let’s design for the Designing for the 95%
Process was designed to prevent inappropriate admissions.
Patients that belong in ED
Patients that cannot get insurance verification
What does the data say?
5% are transferred to ED*
0% are turned away for financial reasons
Let’s design for the
95%
*From March 1- May 11, five patients were transferred to ED. 96 total were admitted to Detox

6. AIM
Looks like: Emptier lobby, no patients sleeping in the lobby, cleaner, team looks professional and cohesive
Feels: Personal touch, less chaos, more private, less like an assembly line. Welcoming from the 1st call. Our “chaos” is not visible to patients and families.
Sounds: Quiet voices, people explaining to patient what is happening in the process, consistent messaging from all staff, personal patient info kept more private.
Arrival to Patient on the Unit < 45 minutes with assessment complete

7. Tools and Decision Making
Process Maps
Affinity diagrams
Simple schedule modeling
A Sticking point
Who Brings down the labs to the hospital?
Batching versus 1 piece flow?
What time should admits start?
Morning Admit Model
Patient
Arrival Time
Lab draw time
Bring to Assessment Room
First Meds given
Onto the Unit
Lab pick-up time
Lab delivery time
Lab result time 1
8:00
8:15
8:30
9:00
10:30
10:45
11:30 2
9:15
9:30
10:00 3
10:15
11:00 4
11:15
12:00
13:30
13:45
14:30 5
13:00
13:15
14:00

8. What changes are we making?
Better Flow of information between team members
More info collected in initial screening calls
Nursing documentation flows to subsequent assessments/evaluations
Reduced paperwork
Creating intake/assessment room on the unit
Freed up Assessment and Referral Team to take on new initiatives
Teams working to the top of their license. Intake performed by someone they will see throughout their stay. Eliminated one handoff

9. Lessons Learned & Next Steps
Let the team know the team being freed up will be used for new initiatives.
Begin change management even earlier. How is the project being presented to participants and other staff?

10. Next Steps Engage the team using POPin Training
Refurbishing of clinical evaluation room on the unit

11. Comments from the Leaders

12. Questions?