Improving patient care by making small sustainable changes: a cardiac telemetry unit's experience

With the introduction of each new drug, technology, and regulation, the processes of care become more complicated, creating an elaborate set of procedures connecting various hospital units and departments. Using methods of Adaptive Design and the Toyota Production System, a nursing unit redesigned w...

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Bibliographic Details
Published inNursing economic Vol. 25; no. 3; pp. 162 - 166
Main Authors Braaten, Jane S, Bellhouse, Dorothy E
Format Journal Article
LanguageEnglish
Published United States Jannetti Publications, Inc 01.05.2007
Anthony J. Jannetti, Inc
Subjects
Biotelemetry
Care and treatment
Colorado
Coronary Care Units - organization & administration
Coronary Care Units - standards
Design techniques
Efficiency, Organizational
Hospital administration
Hospital wards
Hospitals
Humans
Learning
Nurses
Nursing
Nursing Staff, Hospital - organization & administration
Organizational Innovation
Patient satisfaction
Patients
Problem Solving
Quality management
Scientific method
Supplies
Systems Analysis
Task Performance and Analysis
Telemetry
Total Quality Management - methods
Colorado
United States
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Summary:With the introduction of each new drug, technology, and regulation, the processes of care become more complicated, creating an elaborate set of procedures connecting various hospital units and departments. Using methods of Adaptive Design and the Toyota Production System, a nursing unit redesigned work systems to achieve sustainable improvements in productivity, staff and patient satisfaction, and quality outcomes. The first hurdle of redesign was identifying problems, to which staff had become so accustomed with various work arounds that they had trouble seeing the process bottlenecks. Once the staff identified problems, they assumed they could solve the problem because they assumed they knew the causes. Utilizing root cause analysis, asking, "why, why, why," was essential to unearthing the true cause of a problem. Similarly, identifying solutions that were simple and low cost was an essential step in problem solving. Adopting new procedures and sustaining the commitment to identify and signal problems was a last and critical step toward realizing improvement, requiring a manager to function as "teacher/coach" rather than "fixer/firefighter".
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ISSN:0746-1739
2995-4053