The goal of this project is to enhancing the mobilization of referral of patients between facilities by enhancing access to medical equipment.
· Minimize the number of equipment parked along the corridors.
· Set a 30 minute parking rule for non-essential medical equipment.
Phases of change
Such a large scale organizational change will require a shift in corporate culture and the relationships between the medical personnel (Burnes, 2004). The hospital will utilize Kurt Lewin’s 3-step model to change to sustaining the required operational changes.
Phase 1: The 10 most clutter prone areas will be identified and prioritized for de-cluttering with the help of the medical staff. Zoning areas will be used to prioritize regular inspections and deployment of environmental service staff for clearing of clutter.
Phase 2: Zoning areas will be clearly labeled using warning signs to notify the personnel that they are within a compliance checkpoint area. These signs will include additional information regarding safety laws that does not entertain clutter along the corridors.
Phase 3: All medical equipment coming into the hospital will be attached with radio frequency tags. Network sensors and transceivers will be installed along these sensitive zones to track unattended and idle clutter along the corridors for more than 20 minutes. This information will be communicated to the hospitals information system for immediate action.
Phase 4: The bed management system will send automated messages to the room managers for quick identification of vacant beds (Boulos & Berry, 2012). A discharge alert system will send information direct to the hospital dashboard to reduce patient wait period. This will increase the patient flow along the hallways thereby improving admission rates.
Phase 5: Patient information will be automatically captured using hospital cards or electronic health records (EHR) for easy management of referrals from other hospitals. This electronic information management system will automatically notify caregivers of any patient who has waited for too long by sending alerts to the admission dashboard.
The implementation of a patient transfer and call center will take a minimum of 6 months. The supporting tracking technologies and information systems will require a go-live period of three months to acquaint the staff to the new system. This will include a pre-implementation assessment period of one month. Thesteps to clear the hospital hallways will take a period of two months which will run from July –October 2019.
Mobilization the driving forces
The hospital staff will be increased to handle the high traffic periods such as natural disasters, fire or terrorism attacks. The disaster management plan will include an incident commander that will control the flow of new patients. The incident commander will use the hospital tracking system to assign hospital beds and medical equipment required for each emergency situation (California Healthcare Foundation, 2011). A touch screen will be installed to manage all bedside requests such as IV pumps, supply carts and oxygen tanks among others. This information will be updated directly to the hospitals information system.
Minimizing restraining forces
Lewin’s first-step to change states that employee behavior are maintained through a status quo (Burnes, 2004). Therefore, in order to create long term change such behaviors have to be destabilized, unlearnt or unfrozen before new routines are adopted. Thetracking system will require medical personnel to issue physical tags to patients. These tags will have to be worn around the wrist for easy identification of the patient at all times.Therefore,the nurses will undergo an intensive training program on the technical aspects of the new devices, their installation process and how they work (“California Healthcare Foundation,” 2011). All medical personnel will be responsible for ensuring equipment are used and stored in their set locations.
Plan of evaluation
Lewin’s second stage to change states that the motivation to adopt new technologies does not necessarily translate to long term change (Burnes, 2004). New forces can easily undo years of hard work due to difficulty in technological adoption or employee fear. Training programs will be used to assure the medical personnel of the importance of the new system in enhancing patient care rather than monitoring personnel productivity. In addition to that an environmental excellence initiative will be implemented within the institution to regularly award positive improvements (“California Healthcare Foundation,” 2011). Standards met will ensure the success of the project.
Training and education
During the roll out of the new tracking system, an in- vendor will manage the training programs for the system. A training log will be provided to all employees as part of the induction process that will be included in the professional development records. The training logs will monitor the new system for any inefficiency and provide remedies for deficit skillsets (“Medicines & Healthcare Products Regulatory Agency,” 2015). The training programs will be done regularly to keep the medical personnel up to date with any new updates to the system.
The evaluation of the tracking system will be based on usability, ease of connectivity to hospital information systems and coordination of hospital resources. Once the system reaches a stable point of adoption, the third stage of Lewin’s theory will become easier to adopt. This includes refreezing of new work behaviors to prevent a relapse into the old routines (Burnes, 2004). As a result the hospital will implement quarterly audit mechanism to reinforce any positive achievements made in the past (“Duke-Margolis Center for Health Policy,” 2016). The success of this project will enhance the hospitals certification by The Joint Commission (TJC). The new system will also reduce the regulatory burden on the hospital through active surveillance and reporting of any healthcare safety gaps.
The purpose of this plan was to reduce the level of overcrowding within St. Michael hospital emergency department. The challenges of these overcrowded hallways include the undocumented deaths due to long waiting lines (Paiva, Brito2 & Leiva-Marcon, 2018). An inefficient admission system creates cluttered hallways, long admission times, prolonged hospital stay and delayed provision of critical lifesaving healthcare. This leads to medical errors that could be easily prevented by automating the critical hospital processes.
Boulos, M. N. K., & Berry, G. (2012). Real-time locating systems (RTLS) in healthcare: a condensed primer. International journal of health geographics, 11(1), 25.
Burnes, B. (2004). Kurt Lewin and the planned approach to change: a re‐appraisal. Journal of Management studies, 41(6), 977-1002.
California Healthcare Foundation (2011). Using Tracking Tools to Improve Patient Flow in Hospitals. Accessed on July 5, 2019 from https://www.chcf.org/wp-content/uploads/2017/12/PDF-UsingPatientTrackingToolsInHospitals.pdf
Duke-Margolis Center for Health Policy (2016). Better Evidence on Medical Devices: A Coordinating Center for a 21st Century National Medical Device Evaluation System. healthpolicy.duke.edu. Accessed on July 5, 2019 from https://healthpolicy.duke.edu/sites/default/files/atoms/files/med-device-report-web.pdf