Improving The Human
Experience Through
Technology
Reducing Patient Wait Times Through Connexall
Portering Software
Trillium Health Partners
Footprint: An Opportunity
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– Second level
• Third level
– Fourth level
» Fifth level
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Various Portering Models
• Centralized Portering
– Could increase flexibility and utilization of porters
• Decentralized Portering
– Unit specific or area specific
• Hybrid Model
– Unit specific and centralized
OUR JOURNEY – PHASE 1
Background and History:
Prior to this project, there were separate paging and portering processes utilized by
departments to request patient transportation by Trillium porters. Each Area operated
independently of the other, functioning in a “silo” manner. THC porters respond to
approximately 16,000 tasks per month
The Diagnostic Imaging Department had dedicated portering resources. Various different
methods of directing work to the porters were used, with very few calls to the central 2700
number. It was a manual, paper-based process. There were a high percentage of patients
who were “not ready”.
The Emergency Department (ED) relied upon an overhead paging system to call for transport
assistance. This was very noisy and disruptive to patients and staff, and could be unreliable
if portering staff were out of the department on another call. In addition, there was no way
to track response times or acknowledgement of a request.
The “Float Pool” for portering has always been dispatched through the Customer Support
Centre (2700). The customer would call and request patient transport, and the Customer
Service Representative (CSR) would dispatch calls via a page to the most appropriate
resource through a service desk tool
.
Interdisciplinary Team Members
•
Elena Pacheco
Director, Corporate Services
• Michael Brunner
Manager, Corporate Services, Customer Support,
Transportation, Linen
•
Sandy Balappa
Team Leader, Corporate Services
•
Mike Lindsay
Director, Diagnostic Imaging
•
Merideth Van Oene
Manager, Infrastructure Services
•
Clifford Docanto
Quality Analyst, Corporate Services
•
Sean Cassidy
Quality Analyst, Corporate Services
Porter Value Stream Map
Process Defects and Improvement Summary
Time/Motion Study results:
Average Porter Calls by Hour ED
Call Location Breakdown Main Float Porter Pool
Data for the start and end location of the task
% of Calls starting from:
Ground = 25.3%
Main = 44.2%
2nd = 21.4%
Other = 9.1%
Showed a
need to
relocate
Porters to
Main Floor
% of Calls ending at:
Ground = 5.8%
Main = 41.3%
2nd = 35.9%
Other = 17.0%
Call Location Breakdown
Main Float Porter Pool
Changes Implemented
Data for the start and end location of the task
% of Calls starting from:
Ground = 25.3%
Main = 44.2%
2nd = 21.4%
Other = 9.1%
Showed a
need to
relocate
Porters to
Main Floor
% of Calls ending at:
Ground = 5.8%
Main = 41.3%
2nd = 35.9%
Other = 17.0%
OUR JOURNEY – PHASE 2
Aim
•Improve patient safety and quality care through
reducing transportation wait times
•Develop and implement an organization-wide quality
process improvement and redesign for timely delivery of
services to our Patients
•Build on existing technology and apply lean
methodology to new process
Project Measures/Indicators
•
Process Indicators
Porter response time from time request made to time request
completed.
Before project initiated, no request detail reporting system was in
place to measure response time, productivity or performance
•
Outcome Indicators
Routine Process Audits
Statistical analysis and transparency in posting stats in public space
on Quality Board
•
Balancing Measures
Health Workplace Survey Results
Routine huddles with Portering Staff
Anecdotal feedback from Patients
Audits
Corporate Services active participation in daily Bed Meetings
Changes Implemented
•
•
2009 - Developed partnership with GlobeStar Systems, maker Connexall
software platform.
• Process Mapping in ED, DI and trial commencement, training of Call Centre
Staff
• Cisco phone training with Portering Staff
• Extensive training sessions with UCA’s and Nursing Staff
• “Go Live” Organization Wide in August
2010 - Hospital Wide Standardization
• Establishment of benchmarks and performance monitoring
• Process transparency through posting of Portering statistics in public space
on Corporate Service’s Quality Board
PORTERING STATISTICS JANUARY 2014
14441
16000
14000
NUMBER OF CALLS
12000
10000
6901
8000
6000
4000
953
2000
0
STAT
ROUTINE
STAT CALLS
Total Activations
Average Duration
Average First Acknowledgement
OTHER
ROUTINE CALLS
6901Total Activations
OTHER CALLS
14441Total Activations
953
0:13:23Average Duration
0:16:29Average Duration
0:24:17
0:02:16Average First Acknowledgement
0:04:02Average First Acknowledgement
0:14:29
AVERAGE TOTAL CALL TIME (STAT & ROUTINE H:M:S)
0:14:56
7000
6069
6000
5000
3462
4000
3000
2000
1000
0
2043
Charts and Tables
Charts and Tables
Previous Model
Exchange
of info
2700
Dispatch to
Porter
CSR make
Decision
Go & complete
request
Requests PUSHED to Portering
• Time added due to not knowing where the Porter is located in the hospital
Connexall Model
Requests PULLED by Portering – No intermediary Call Centre
Value added as Porters can respond to calls geographically
which reduces wait times! CSR’s and Nurses are now in
DIRECT contact with Portering!
Connexall Screen
Connexall Screen
Phone Technology
Engagement of Clinical/Organization
VERY IMPORTANT!!!!!
• Everybody will be on board if the service is
improving
• Co-lead should include a clinical representative
• Process mapping to understand current state
• Ensure training champions are available around the
clock
Engagement of Clinical/Organization
• Train the trainer approach
• THP focused first on unit clerks who then trained
nursing
• KEEP IT SIMPLE
Outcomes
Health Workplace Survey Results (Portering)
10% improvement in satisfaction with workload.
5% improvement in satisfaction with materials (wheelchairs, stretchers) needed to do the job.
“Pull” System
Allows Porters to respond to requests by geography reducing steps needed to arrive and reduce
wait times
Customer Support Can Better Meet Your Needs
Over 2000 calls diverted per day from Customer Support
Turnaround Time Improvement
Less than 5 minute response time to ALL request types with a 13 minute total turnaround!
Customers Are Thrilled!
During Accreditation, Patients spoke of the high level of service and personable quality of care
they received from Portering. This was even mentioned at the report out!
Accountability Increased
CSR’s and Clinical Staff can now track the status of their requests in real time.
Routine audits and stat tracking helps identify areas of high performance and opportunities for
improvement!
Outcomes
Outcomes
Sustainability Plan and Next Steps
Sustaining Improvements
- Routine auditing of process, rapid response to any issues identified
and transparency of our stats.
Monitoring our Measures
- Corporate Services Quality Analysts run monthly reports to monitor
response and turnaround times.
- By listening to our Customers!
- Team Leaders attend the daily Bed Meeting to help identify and
address any issues that arise.
Huddles
- Communication is the key to sustaining any process improvement
and by listening to Staff and raising awareness of our commitment
to our Customers and Patients we can ensure the momentum and
change will be long term.
Sustainability
Sustainability Plan and Next Steps
Sustainability
Lessons Learned
• Staff respond well when they have control over their
workload
• Technology, when used right, can improve the human
experience.
• The Quality of Patient Care has improved with no needless
wait
• Communication and monitoring of performance is critical for
any process improvement.
• There is no cookie cutter approach and tweaks along the
way – Don’t give up – do what works for your facility
Thank you