patient transport

Patient transportation workers at Sunnyside Medical Center in Portland were in a tough spot: No matter how hard they scrambled, they were constantly running late to pick up patients. 

Some of the challenges were clear. The transport workers, members of SEIU Local 49, are qualified to backfill certified nursing assistant positions—and short-staffed nursing units were calling on them to do just that. 

In addition, a new computer-based dispatch system had automated patient transfer requests but required fewer dispatchers. The resulting staff upheaval, along with rumors about changes to their certification requirements, threw the unit-based team into turmoil. 

Delays and frustration

Amid frustration and mounting delays—the team was only infrequently meeting its goal of getting to the patient within 15 minutes—improvement advisor Lolita Burnette worked with the team to resolve its issues. To better understand its challenges, she created a process map of the team’s workflow. That turned up a variety of obstacles that were thwarting efforts to improve times. 

“Shadowing the team was an eye-opener. We discovered issues that were immediately actionable,” says Burnette. Because of the complexity of the situation, team members called for an issue resolution to identify solutions.

“My staff are really concerned about their patients. They had valid concerns about what was hindering our on-time performance,” says Marta Witsoe, the team’s management co-lead.

The issue resolution took place from July to September last year and helped further identify issues that were impacting on-time performance, as well as showing how delays affected imaging appointments and patient satisfaction.

As it tracked the source of delays, the team discovered that often, the patient was not ready to be moved when transporters arrived. The patient might need a different gown for imaging, or needed to take medications before being moved. Making matters worse, nurses and other staff members had gotten accustomed to transport arriving late and often put in orders ahead of time. But if the transport person arrived on time, the resulting delay had a domino effect, making it more difficult to be on time for subsequent transport requests.

New equipment, new hires

As a result of the issue resolution, the team is partnering with other units to become more efficient. Several improvements are being worked on simultaneously to increase productivity and overall satisfaction—and the team is confident the changes will lead to improved metrics. 

In perhaps the most significant change, hospital leadership agreed to hire additional transport staff. The new positions are dedicated to support the Emergency Department, a frequent source of patient transfer requests.

“With time and commitment,” says Esther Logan, the team’s union co-lead, “we agreed upon issues that needed to be addressed within the department.”

Olivia Devers, a labor partner with SEIU Local 49, added, “This IR process was the most positive that I have witnessed in many years—the team and management worked in true partnership from start to finish.”

Biggest challenges

A brisk walk by an able-bodied person from the unit to the train station takes about 15 minutes roundtrip—but struggling with an infirm patient in an outdated or inappropriately sized wheelchair could easily double that time.

Other issues included patient dissatisfaction, staff injuries and the added risk of patient treatment delays or falls, says labor co-lead Casa, noting that “we had to look at the problem from many angles.”

Background

The Capitol Hill Medical Center opened with great fanfare in 2011. Hailed as a beacon for affordable and accessible care just as the national debate heated up on these issues, the center attracted attention—and many new members. One key factor that made the new facility so attractive—its proximity to a major public transit station in the District of Columbia—also turned into a potential Achilles heel.

That was until the Adult Medicine UBT rolled in with the right solutions.

The Adult Medicine team started by using performance improvement charting tools to log the time each staff member took to transport a patient to and from the Union Station subway stop or to ancillary departments within the medical center.

The team discovered many of the elderly or wheelchair-using members struggled to make the long trek from the exit doors of Union Station to the waiting room of the Adult Medicine unit, a medical center starting point for most patients.

The team lobbied for new wheelchairs—and for a new transporter position, an OPEIU Local 2 member who transports many of the patients and coordinates the trips that staff members make to the other departments.

In addition, the team now calls ahead to the lab or pharmacy to ensure tests and medications will be ready, or nearly so, when the patient is brought in. It also gives patients red cards to signal their priority status to lab and pharmacy staff.