1. Improving Healthcare Through Better Customer Service
Ani Bodoutchian MD, MBA, FAAFP and Samar Raza MD
Ryan Cowan, Industrial Engineer/ 6 Sigma Black Belt
Southside Hospital Administration; Nancy Riebling, AVP Improvement Sciences
Departments of Case Management, Social Worker and Rehabilitation
Southside Hospital, BayShore NY
Opportunities to Improve Suboptimal Exit Strategy
Results/Conclusions
Ramp 1 PDSA
Identified the need for physician compliance in documenting discharge plan at the time of admission of the patient.
Compliance led to a more prompt social worker, case management and physical therapy evaluation.
Ramp 2 PDSA
Initial turnaround time of 3-5 days for social worker, case manager or physical therapist to see/evaluate the patient.
Current patient evaluation turnaround time is <24 hours, from initial request to initial consult.
Ramp 3
There was no change in the physician decision to discharge (no change in Length Of Stay).
The variable factors were family and social issues as well as family and patient resistance that were hindering the discharge process.
Another issues brought to light – insurance authorizations, denials and non hospital influences that were hindering expedient discharge.
Physician informing the family and/or the patient of their impending discharge within hours was variable among physicians; however there was no change in the length of stay whether family and/or patient were notified
Maximizing our hospital operational efficiencies using the PDSA process has introduced change and improved understanding in the influences in patient flow. We stand committed to our patients/their families as well as our staff in moving forward with our next process in implementing change and thus creating value.
Introduction
When we think of improving healthcare, we immediately think of cutting edge innovations and technology at a low cost. Customer service sets the foundation of patient’s component of any health system’s success.
When hospital team-members create a culture of excellent customer service, patients have a level of comfort, confidence, trust, and satisfaction with their care. This in turn, may result in patients telling others about the outstanding care they received , thereby creating value.
We set out to improve our hospital discharge process via a PDSA model of improvement with a multi-disciplinary team based approach and the results revealed the outcome is multifactorial from poor ancillary staff timing of services to non hospital related issues.
Objectives
Find the gap in the “process” of discharge and to improve the quality in inpatient service and improve patient flow.
Patient and family awareness of impending discharge reducing wait time for discharge.
Multi-disciplinary team-based approach impacted a more efficient hospital discharge which leads to greater customer satisfaction.
Increase physician and staff satisfaction and potentially increase marketability.
Methods
Team approach with the involvement of Social Worker, Case Manager, Administration, Residents and Hospitalist as well as 6 sigma team leader/advisor.
We set out several PDSA cycles (Plan, Do, Study, Act) whereby we have attempted to refine the discharge process to decrease the length of stay and added to customer (patient) satisfaction and making more beds available. The diagnosis’s we followed where:
Pneumonia
Febrile illness
COPD
Cellulitis
Pancreatitis
UTI