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Game Changer: Putting the Patient First

Submitted by tyra.l.ferlatte on Mon, 10/18/2010 - 16:21

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A team in South San Francisco that improved the surgery-scheduling process for patients and teams in San Diego that took a hard look at their service scores demonstrate what things look like when teams truly consider what's best for the patient as they make decisions.

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Streamlining the process: The new pre-surgery checklist developed by a South San Francisco UBT has helped patients and improved communication for everyone involved. Dr. Brian Tzeng (center) helped lead the work.

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Improving service: Terry Caballero, a surgery scheduler and SEIU UHW member, helped spark the work that led to a streamlined surgery-scheduling process.

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Benefits to teamwork

In South San Francisco, Dr. Brian Tzeng, who’s an anesthesiologist, and others on the team say that working on the project through the unit-based team allowed them to understand each others’ roles and responsibilities better—and also gave them an opportunity to hear and contribute an opinion from that perspective.

“One of the great benefits of this group was it was an outlet for multiple providers at different levels to voice their concerns and actually be heard,” Dr. Tzeng explains. “The greatest frustration for many individuals is we all had great ideas but didn’t know how to make that happen. We realized through this group we had a means to make those changes.”

Dr. Tzeng is certain the team’s accomplishments are the result of every team member’s commitment to working out the best solution in the patient’s best interest. There were no politics, just concern for the member.

“To us, this is not a job,” says Debbie Taylor. “We come here to serve a patient.”

And what about Caballero’s initial concern, that patients weren’t getting enough advance notice about when they have to be at the hospital? The team has been slowly chipping away on that as well. In October, they expect to start giving patients two days’ advance notice of their arrival time at the hospital.

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10/01/2010 - 12:00

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Game changer: Putting the patient first

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Teams in South San Francisco and San Diego work to keep patients front and center

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What happens when teams truly walk a mile in their patients’ shoes? They often discover their own actions are making that mile a rocky one for patients—and as a result make huge breakthroughs in the way they deliver care.

In the case of South San Francisco’s multidepartmental pre-admission team, observing their processes from the other side of the gurney spurred them to dramatically streamline the pre-surgery and admitting process for patients. With the member at the forefront of their thinking, the team members turned a two-inch-thick packet of confusing, redundant information into a streamlined, one-page checklist. And a funny thing happened—while redesigning the process to help patients, the team improved the way it works.

“Patients would often get confused and weren’t sure what the next step in the process was,” says Brian Tzeng, MD, the Peri-operative Medicine director. “We realized we didn’t have a clear path for the patient to follow.”

Other teams throughout Kaiser Permanente are making similar realizations, framing their performance improvement work by asking the question, “What’s best for the patient?” If a possible solution doesn’t work well for the member and patient, then there’s more brainstorming to be done. These teams are taking the Value Compass to heart—organizing their work not just around the four points but examining what they’re doing from the patient’s perspective.

What does that mean for frontline teams? At the San Diego Medical Center, the Emergency Department sees up to 300 patients every 24 hours. Physicians and staff members are always on the go, delivering on the ultimate bottom line—saved lives. What could be more important? Clinical quality is high; patients are seen in a timely manner and the rate of unscheduled return visits is good.

Yet the results of a recent patient satisfaction survey bothered the team. The department scored well overall, but their patients gave it only 63 percent approval on one question: While you were in the Emergency Department, were you kept informed about how long the treatment would take?

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