1 year of Lean management at the Victoria Hospital

“I think this has become a license to print money for these U.S. consultants. And the problem is it's the Saskatchewan taxpayer that's really on the hook,” Broten said earlier in the month.

Broten cited two examples of what he calls out of control spending: Japanese sensai being brought in at a cost of $3,500 a day plus $2,000 a flight, and a deal between the provincial government and a U.S. consulting firm, John Black and Associates, worth $40 million over four years.

On Friday at the Victoria Hospital, representatives from both of those groups were present.

However, Cecile Hunt, CEO of the Prince Albert Parkland Health Region, (PAPHR) said on the ground level they are seeing some improvements and efficiencies being made.

“We really have seen some very positive outcomes and yes we’ve had a few solutions that needed to be re-worked, but it is about testing small improvements and some will work and some will not work but we have to have the courage to go forward,” Hunt said.

This is the 17th RPIW in the PAPHR over the past year.

“I think we are preparing ourselves to do this as an independent organization, but also part of a provincial system,” Hunt said.
Lynnda Berg, vice-president of primary care, was part of one of Fridays’s two RPIW presentations.

This is the second time she’s participated and said she can see the Lean project debate from both sides.

“I think it’s a process that allows us to step back and look at things because that’s all we do for this period of time, whereas in my other job I’m going to be fighting fires all the time. Whereas this focus time allows us to really step back and look at that program with external eyes. So I think that’s the gain,” Berg said.

Berg said a lot of things they are doing with the program could be done anyway, especially because of the time and cost that goes into the effort.

But she admits they are often immersed in their daily work they would not be able to get to it.

“The second thing that Lean does is it measures. We don’t always measure things … with the Lean management system you’re constantly measuring … so you can show improvement and I think that’s a good thing for staff.”

As for the future of RPIWs, Hunt said there will be a further 15 to 20 over the next year, which will aim at improving patient care.

Friday RPIW works to reduce wait and overtimes

In the surgery department Sharon Griffin, director of acute care nursing, said they get about 5.71 add-on patients a day, which are patients that weren’t originally scheduled for surgery but were added to the listed after an emergency. This results in staff overtime and more after-hour surgeries.

To shorten after-hour surgery Griffin, said more communication is needed. One way this is done is through adjusting a booking form to make it more applicable to surgeons and anaesthesiologists.

“We took the tool and we tried to create what we actually needed; the information we actually needed. Got rid of some redundant categories and we included the information that would prompt anaesthesiology to know whether or not they needed to do a full consult before surgery,” Griffin explained.

They also created a board that will show where add-on patients can be fit in that all staff can see.

In addition, communication with patients needed to improve.

Griffin said there’s a gap is communicating to add-on patients about when to expect surgery or why there is a delay.

“Every care provider, what we found doing the data collection, is that they all thought that someone else had told the patient…What we know to be true, is patients are told ‘you need emergency surgery.’ What they don’t understand is that there’s different categories of medical emergency,” she said.

So, by explaining what kind of emergency situation the patient is in, it eases their mind to ensure they understand they haven’t been forgotten.

“We’ve built in a mechanism now to ensure someone goes back and explains to the patient … to give them a best guess scenario … to know that they’re waiting is better than to have no information at all.”

Griffin said she hopes by increasing communication they can move some of things done in the afterhours into the day-time space.

Results were also presented from the Therapies Outpatient department. Berg said they have made 17 referrals to the Co-operative Health Centre to reduce the wait time for patients accessing their services at the hospital.

Another change that was made was having repeat patients “self-room.” This allows the patient to direct themselves to a room based on a map as opposed to being escorted, which frees up to 14 minutes per patient.

By using “self-rooming” it will save time and reduce wait-times, according Berg. “It’s worked out very good.”

“The one concern that was raised is that during the walking time there is a lot of good conversation, as well they can watch the patient walk … but there are other ways to look at that as well,” Berg said. “But we definitely looked at the therapist’s time as being important in the roll as therapist over conversation.”

Several other changes were made in both departments. Some may continue to work, and others may have to be tweaked, according to Hunt. She said Lean management is a “marathon” that constantly reviews and improves itself.

Lean is a development of improving processes by using things like visual cues to save staff time.

– With files from Lisa Schick

sstone@panow.com

On Twitter: @sarahstone84

by Sarah Stone

1 year of Lean management at the Victoria Hospital

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