Identify Tools for Developing a Plan to Reduce ED Wait Times
This paper is being submitted on January 20, 2019 to LaTarsha Turner’s Advanced Quailty Management in Healthcare HI370/ HIM3710
The amount of time that a patient waits to be seen upon walking in the emergency room is important to the patient’s health outcome. A four hour wait time in the ED department can get frustrating and discouraging to a patient in a critical or chronic state of illness. According to many statistics, patients who are seen quickly have better health outcome than those who have long wait times. Critical conditions, such as heart attacks and strokes make every second count and are critical to a patient’s survival rate and recovery time.
According to the IOM (Institute of Medicine) several factors can play a critical role in the delays in a healthcare setting. Some of the following are major causes of delays:
The IOM suggests applying Six Sigma to the healthcare setting. The concept behind the implementation is to increase efficiency without sacrificing quality of care. Six Sigma is a five-step methodology (Measure, Analyze, Improve, Control) which is used to improve an existing process in a healthcare organization.
- Mismatched supply and demand, which can be anywhere from staff shortage to the availability of room.
- A focused approach to scheduling, healthcare facilities need to continuously assess and adjust for the demand for services and match them appropriately with the tools and personnel needed to meet that demand. A plan for alternative options such as, telemedicine, patient portals, and web-based services.
The main goal is to develop and implement guidelines to follow from the Six Sigma process and identify the problems that are burdening the reduction of wait times. The Six Sigma process is a five-step project.
Measuring, this phase is for determining current performances and identify root problems. Tools in this phase include things such as patient feedback and expectations for the delivery of services. One method to gathering this data is the use of questionnaires. They can be helpful gaining the views and experiences from patients. Also, creating a process flow chart for activities performed can give clues on how to improve performances and changing process on how things are done.
The next stage is analysis, which gives a in-depth look into the primary causes of these problems throughout the whole system. Some Six Sigma tools used int his stage would be, Fishbone, which is a diagram which gives a cause and effect matrix. It is a methodology tool designed to help organization teams identify potential causes of specific issues. From there operations can be simplified. Another tool under analysis is regression analysis, which is useful in determining input processes directly related to out-put process. For example, if there isn’t enough room for accommodations, this implies long wait times. Lastly, the Pareto chart is used to analyze the frequency in which the problem occurs.
Improve is the third step in the Six Sigma process. This stage shows the strategic plan for improvement to the current program. The plan involves methodologies that prove to be effective and the tools work by eliminating defects and the root problem. Examples of these are: DOE (Design of Experiments) which can solve complex processes or systems where there can be a considerable number of factors involved that influence outcome rates and can isolate one factor or variable from one another.
The second tool under improve category is error proofing which is implementation of mechanisms that prevent a process from producing defects. The concept is, that even the smallest defect is not acceptable, and prevention is better than a cure. The scope of the plan is to ensure all factors fall inline to prevent defects in the process from happening at all costs in patient’s safety and confidence in the program.
Control, this phase involves creation of a standard process that requires a new way of doing things and monitor future performances. A couple Six Sigma tools to help continuous monitoring is implementation of a control plan. A control plan contains data needed to keep track of improved processes. Another tool under the control category is a statistical process control program that monitors behavior by improving the quality of services. Lastly, implementing standardized work, which helps achieve efficiency and consistency.
As a part of quality improvement team, I would implement a Six Sigma program for improvement. Areas that show deficient performances such as, patient registration, patient health status in the ER, and providers focused care can be greatly improved through revamping the current system used to treat patient in the ER.
In conclusion, a patient’s wellbeing is a sensitive and critical issue that should not be juggled or tossed around and needs consistent attention to provide high quality care. I believe by implementing the Six Sigma process we will achieve a treatment process that ensures quality, timeliness, and satisfactory results.
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