Emergency Room

Team Educates Patients and Saves $1 Million
  • Team members learning about their own benefits and researching which Emergency Departments Kaiser Permanente prefers to have members use
  • Analyzing claims data for patients with the highest number of Emergency Department visits
  • Educating patients about Emergency Department use

What can your team do to improve its own business literacy? And help patients make better decisions about their care? 

 

Laureen Lazarovici Wed, 07/05/2017 - 17:31

Savings From Around the Regions

Submitted by Laureen Lazarovici on Sun, 06/18/2017 - 11:42
Topics
Hank
Request Number
sty_Hank51_around the regions
Long Teaser

Find out how innovations such as eSignatures are helping teams save money while boosting quality and service in every KP region. 

Communicator (reporters)
Tracy Silveria
Editor (if known, reporters)
Tyra Ferlatte
Photos & Artwork (reporters)
Only use image in listings (editors)
not listing only
Status
Developing
Tracking (editors)
Story content (editors)
Headline (for informational purposes only)
Savings From Around the Regions
Deck
eSignatures and more from coast to coast
Story body part 1

Northern California: Staff laptops make life easier 

Even in a fast-paced Emergency Department, change doesn’t always come swiftly.

“I’m old school,” says Jacinta Laupua, a clerk and SEIU-UHW member, who was one of the last holdouts when her team decided to try using laptop computers to gather member signatures. 

“I thought of every excuse in the book. But now I love it,” she continues. “If I don’t have a laptop assigned to me, I ask other clerks if they are using theirs, because I want one. In fact, we need more.”

The laptops, provided through a regional initiative, are at the heart of a successful unit-based team project to reduce paper and copying costs in the Emergency Department at the South Sacramento Medical Center. The total savings came to more than $88,000 in 2016. 

The Level 5 UBT’s project got under way in late 2015, when clerks and the team’s co-leads—Bianca Ruff, a clerk and SEIU-UHW member, and managers Susan Velasquez, administrative services manager, and Neeta Kumar, administrative clerical supervisor—brainstormed ways to improve cost savings and efficiency. Their first goal was to save $27,820 over four months. 

Soon team members were trying out the use of laptops with signature capture pads. The technology makes it possible for clerks to register patients at their bedside and record their information and signature electronically. Not only does this eliminate the need for paper registration forms, it also increases the clerks’ mobility and efficiency.

There were many small tests of change needed before everything was working smoothly, but the project has been so successful the department has invested in nine laptops on wheels. And all Emergency Department clerks are trained on
the computers. 

“It’s almost too painful to remember how we used to process forms,” jokes Ruff.

—Tracy Lee Silveria

Northwest: Pharmacy team ‘owns’ its inventory, saves thousands

When team members at the Community Care Pharmacy in the Northwest region did a routine inventory, they were astounded at the value of their expired medications that no longer could be returned. 

“We took a $70,000 loss,” says Rob Yancey, the pharmacy’s manager. The pharmacy serves patients in extended care facilities and often fills prescriptions for costly and uncommon drugs.

Susan Luu, an inventory technician and member of UFCW Local 555, spearheaded a successful project that drew on the free-to-speak culture and collaborative spirit that helps make this a Level 5 team. 

“I knew it was too much to do by myself,” Luu says. “I felt comfortable talking with my manager, and his response was, ‘Let me see how can I can help.’” 

Different staff members “owned” a section of the pharmacy to check for outdated or slow-moving medications. By the time the team did its next inventory, losses had dropped to $7,000.

—Jennifer Gladwell

Mid-Atlantic States: Tackling unwanted side effect of a computer upgrade

When the South Baltimore County Medical Center laboratory in the Mid-Atlantic States region upgraded its computer system in December 2015, it inadvertently increased lab costs. 

The problem? While the new system has many great features, it doesn't have a way to alert staff when providers add a new test to an existing order. In May 2016, the lab missed 32 percent of these “add-ons,” a total of 30 tests, says Samuel Endalew, the lab’s lead technician, a UFCW Local 27 member and the team’s labor co-lead. 

The mistake inconveniences members, who must return to the lab to provide a new specimen. Each missed add-on costs Kaiser Permanente about $35 in extra supplies and employee time. 

The solution: a system to check the lab’s inbox for add-on tests and a team binder to track their progress. By February 2017, the team was missing only 2 percent of add-ons and saving about $1,050 a month.

Leaders from other area labs are considering adopting the process.

—Otesa Miles

Obsolete (webmaster)
Migrated
not migrated
Right Setting, Lower Costs, Better Care Laureen Lazarovici Fri, 06/16/2017 - 18:12
Migrated
not migrated
Region
Topics
Hank
Headline (for informational purposes only)
Right Setting, Lower Costs, Better Care
Deck
Team improves care and helps save $1 million by educating patients about Emergency Department use
Request Number
sty_Hank51_emergency room
Long Teaser

How one behavioral health team improves care and helps save $1 million by educating patients about Emergency Department use.

Story body part 1

When the Ridgeline Behavioral Health team members in Colorado decided to tackle outside medical costs, even they were surprised at how their small touch on a huge issue could result in such significant savings.

Team members identified two ways they thought they could have an impact—including finding out which of their patients were being seen frequently in the Emergency Department—while helping their patients get appropriate care. 

“We know from evidence-based medicine that if patients are seeking care in the Emergency Department for mental health issues, it’s unlikely to provide a long-term improvement in symptoms,” explains Amy Martin, manager of Ridgeline Behavioral Health. 

Team members began the project by researching which outside hospitals Kaiser Permanente prefers to have members and patients use. Armed with the new information, they created a flier explaining the options and shared it with the rest of the staff, who then shared it with patients. This way, when patients did access care, they were more likely to go to a facility that KP has a contract with and thus, cut costs.

The results were remarkable. The team’s patients’ visits to emergency departments decreased by 8.25 percent, which in turn reduced ED costs by 26 percent. The total impact for 2016: $1 million in soft-dollar savings. 

Communicator (reporters)
Jennifer Gladwell
Editor (if known, reporters)
Tyra Ferlatte
Only use image in listings (editors)
not listing only
Status
Developing
Take Action: Take Credit Where Credit Is Due

Quality or service improvement projects often lead to more cost-effective care. Be sure you track the financial impact of your team’s performance improvement work and log it in UBT Tracker. 

These tools will help: 

ED Takes a Group Approach to Skill Building

Submitted by anjetta.thackeray on Tue, 11/01/2016 - 14:43
Request Number
sty_SCAL_Panorama City_ED_careerRx1
Long Teaser

When you’re busy with day-to-day patient care, tending to your personal career goals isn’t easy.

Communicator (reporters)
Non-LMP
Editor (if known, reporters)
Non-LMP
Notes (as needed)
Photos taken/8/26 AMc
Photos & Artwork (reporters)
From left, Rebecca Linares, ward clerk transcriber and SEIU-UHW member, emergency room assistant Richard Rowland, SEIU-UHW, and assistant department administrator Sylvana Hrovatic.
Only use image in listings (editors)
not listing only
Learn more (reporters)

Sylvana Hrovatic, Sylvana.C.Hrovatic@kp.org

Additional resources

For more information on the SEIU-UHW Joint Employer Education Trust, visit www.seiu-uhweduc.org.

Collaborate (reporters)
Collaborate
UBT Tracker
Highlighted stories and tools (reporters)
Spreading the Word

As a union steward, Becky Linares is spreading the word by:

  • talking to her co-workers about the education trust programs.
  • bringing LMP Workforce Planning and Development materials to union stewards’ meetings.
  • posting fliers about the trust in her department and others.

“I don’t just keep it in the emergency room,” Linares says. “I want people to know there is money there to support their careers.”

For more information or career counseling, visit www.kpcareerplanning.org. Or, for SEIU members, www.seiu-uhweduc.org.

Status
Released
Tracking (editors)
Flash
Story content (editors)
Headline (for informational purposes only)
ED takes a group approach to skill building
Deck
UBT takes charge of its own career development, improves patient service
Story body part 1

Most people think about advancing their careers as a personal goal—if and when they get the time and support to map out a plan. But Panorama City’s Emergency Department unit-based team saw that boosting the team’s skills also matters to KP members, patients and the department. It used collaboration—and LMP trust funds—to improve the workflow and put several staff members on a solid career path.

“It’s not just about making more money. It’s also about being able to provide the best care possible,” says Richard Rowland, one of two emergency room assistants finishing courses needed to earn promotions to emergency service technician positions.

Early last year, the unit-based team started a “door-to-doc” project aimed at moving patients more efficiently through the ER. Results soon stalled because many staff members lacked the training or official certifications to help nurses with such triage duties as drawing blood and organizing labs. About that time, Sylvana Hrovatic arrived as assistant department administrator and management co-lead. She was focused on improving patient service and care, and says it was her labor partners who steered the conversation to career development.

With the help of ward clerk transcriber Becky Linares, labor co-lead and an SEIU UHW steward, the UBT reached out to the SEIU UHW-West & Joint Employer Education Fund to create a plan for employee career advancement in the department.

Obsolete (webmaster)
Migrated
not migrated

Putting Emergency Room Patients on the Fast Track

  • Setting up a fast track area with four patient rooms at the front of the department
  • Agreeing to use standardized criteria for triage
  • Keeping patients in treatment rooms only while being treated; waiting occurs in the fast track waiting area

What can your team do to identify areas that need improvement? What else could your team do to shorten the time patients have to wait for service?

 

 

Teams That Created a Culture to Get Results

Submitted by Laureen Lazarovici on Mon, 07/08/2013 - 16:15
Tool Type
Format
Running Your Team
ppt_virtual UBT fair_team culture for results

Presentations from three UBTs that successfully created team cultures and achieved strong results. They were presented at a June 24, 2013 virtual UBT fair.

Laureen Lazarovici
Tool landing page copy (reporters)
Creating a UBT Culture

Format:
PPT

Size:
39 slides 

Intended audience:
UBT co-leads, sponsors, UBT consultants, improvement advisors

Best used:
This PPT features presentations from three teams on creating a UBT culture: Rancho Cordova eye surgery team, Sunnyside (Northwest) emergency department and Northwest regional laboratory. Use to learn how three teams used UBT and performance improvement tools to create a team culture and get results.

Released
Tracking (editors)
Obsolete (webmaster)
not migrated

Game Changer: Putting the Patient First

Submitted by tyra.l.ferlatte on Mon, 10/18/2010 - 16:21
Topics
Taxonomy upgrade extras
Request Number
sty_gamechanger_hankcoverstory_fall2010
Long Teaser

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.

Communicator (reporters)
Non-LMP
Notes (as needed)
note: there are links in "highlighted stories and tools" section.

caption for second photo (hank25_coverstory3):
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.

caption for third photo (hank25_coverstory6):
Improving service: Terry Caballero, a surgery scheduler and SEIU UHW member, helped spark the work that led to a streamlined surgery-scheduling process.
Photos & Artwork (reporters)
Making things easier: Members of a San Diego Medical Center turn team help KP patient Deborah Allen shift in her bed.
Only use image in listings (editors)
not listing only
Highlighted stories and tools (reporters)
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.

Status
Released
Tracking (editors)
Story content (editors)
Headline (for informational purposes only)
Game changer: Putting the patient first
Deck
Teams in South San Francisco and San Diego work to keep patients front and center
Story body part 1

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?

Obsolete (webmaster)
Region
Northern California
Southern California
Vehicle/venue
hank
Migrated
not migrated