Business Case Analysis for Healthcare Improvement -D156

Problem. 

The problem that we are coming across in Interventional Radiology is communication between the nurses, Interventional Attendings and the ordering L.I.P.  

Aspects of the problem. 

Patient procedures are often delayed or rescheduled due to missing labs, radiology imaging, not being NPO and not being consent-able.  

Clustered ideas. 

1. Dedicate a Nurse to review orders, before going the interventional attending for approval. 

2. Having a dedicated Resident review the orders before the Interventional Attending receives it.  

3. Developing a power plan for the ordering L.I.P. to go thru while ordering the procedure.  

4. Send out and email and education material to the email address or ordering L.I.P. and made available on the hospital website.  

5. Improving communication between nurses, making sure that the unit nurses are aware on to properly prep the patient for procedures 

Themes. 

Improving communication between the ordering L.I.P., Interventional Attendings, and Nurses. Improving the number of delays in performing the procedures.  

Prioritized clusters. 

The priority is minimizing the delays that are occurring with performing the procedures, and to also lessen the amount of cancellations and rescheduling of procedures due to miscommunications.  

Focus of your HIP. 

The focus of the HIP will be improving communication to increase the productivity and work flow of interventional Radiology  

Goals, Objectives, and Recommendations for your HIP. 

Goal: The goal is make sure that the patient meets all credentials for the procedure that is being requested for the team.  

Objective 1: To communicate with the ordering physician, all of the labs and imaging that is required before requesting the procedure.  

Objective 2: To communicate with the ordering physician what patient would meet the criteria of a patient that is considered to be critical and need to be seen in Interventional radiology right away.  

Recommendations: To streamline the orders in the EMar to become more efficient, to make sure that all the credentials are met before the order is able to be accepted into the system.  

Justification for your HIP. 

The facility is attempting to mandate the department to expand its hours. We typical run on a schedule from 8 a.m. til 5 p.m. Off hours are considered to be on a on-call basis, which is at the on call attending discretion. They are also attempting to make the unit perform cases on Saturday mornings routinely. They are getting complaints that often the unit is not able to get procedures done in a timely manner, which is holding the discharge of the inpatients. The HIP will make the ordering LIP aware what is needed for the procedure to be performed. The ordering system that we have now does not inform the LIP of the labs and imaging that is needed before the procedure can be performed. So they often have to wait for a resident doctor or the attending to review the order, which could take hours or in some case may not happen til a day later.  

Consensus process. 

The unit as a whole is not thrilled about extending hours or working on Saturday mornings. The HIP would be a process that would help possibly eliminate this from occurring. The stakeholders are invested in developing a process to decrease the delays that are occurring in the the unit.