Target hospital workflow to identify waste, guide process improvement

Taking a closer look at workflows can help hospitals reduce wasted time, primarily for tasks involved in indirect patient care, such as preparing medications, documenting care and collecting supplies, according to a new white paper.

Time is often wasted as staff travel between departments to pick things up, take phone calls and search for supplies and equipment, according to the paper, published by management consultancy Huron Healthcare. The latter two alone account for 60 percent of the time nurses spent on errands.

In addition to determining where time is wasted, workflow observation also identifies tasks that could be handled to staff with lower levels of licensure and can pinpoint flawed processes, according to the paper. "Problems are about processes, not people," notes author George Kis, the consultancy's managing director.

By documenting areas where processes can be improved, hospitals can redirect resources in ways that improve outcomes and patient satisfaction, the paper contends.

Examples of time-saving results included:

  • Training nurses and nurse assistants to perform post-surgical breathing tests. The tests added minimal time to the nurses' schedules, since they were already checking on the patients, but free up respiratory therapists to focus on higher-priority procedures.
  • Reducing errors in patient meals by simplifying menus and reducing the tray line speed by 1 second led to better accuracy, higher patient satisfaction scores and less wasted food.
  • Automating a time-wasting manual records process.

"Initially focusing on areas which have low quality and satisfaction metrics, high overtime, high employee turnover and staffing above comparative and historical performance can provide the greatest benefit in the short-term," the paper concludes.

There are plenty of examples of how redesigning workflows can improve efficiency.

At Johns Hopkins Kimmel Cancer Center, observing workflows for doctors and nurses helped the center determine which care tasks could be reassigned to support staff. After redesigning workflows, clinic volume increased by 31 percent per day, and doctors were able to see twice as many patients per day on average during the clinic's busiest season, FierceHealthcare previously reported.

Meanwhile, process improvements helped Mayo Clinic surgeons eliminate the need for repeat lumpectomies in 96 percent of cases, versus 87 percent nationally. And Intermountain Health Group has improved outcomes and reduced per-patient costs for mental and behavioral-care cases by implementing its own process improvements.

For more information:
- read the white paper