Group 4 Problem Statement : The CEO asks us to set up an Office of Patient Experience. We are tasked to develop 2 projects focusing on superb customer service. Staff & infrastructure support is available as necessary. In order to plan well, our priority is what the patient wants, what the patient wants, what the patient wants. So we conducted a patient satisfaction survey with the help of an expert in formulating questions & gathering data. We found 2 opportunities for improvement that impact customer satisfaction : waiting time in ER which is 6 hours & poor flow of communication between family & responsible physician in ICU.

Our projects therefore are : 1. Reduce waiting time in ER to at least 4 hours as per international average data. ( 33%) Goal: 95 % of patients seen in ER are satisfied with the waiting time 2. Improve flow of communication between patient’s family & responsible physician in the ICU Goal: No patient/family complaints regarding communication. 95% of ICU patients/family are satisfied with flow of information/communication in ICU

Issues raised: 1. Definition of : waiting time – from start of registration to discharge from ER to home communication – conversation/flow of information between the family & physician regarding who is responsible for the care of patient, patient’s status & plan of management; 2. Inclusion criteria – only patients who were discharged from ER ; ICU patients within the hours of stay. 3. What period of time should we re-evaluate – after 3 months 4. Strategies to reduce waiting time & improve flow of communication 5. Process flow chart 6. Technology/system to facilitate gathering of data

Solution: 1.Organize a team ( composed of patient, staff from different department who are involved in the project: reception/registration, IT, nurse- ER & ICU, ER & ICU physician, laboratory, radiology, QI, customer service/patient relation,/patient advocate ). Project owners NOTE: Patient’s input is important 2. Hire a Customer service /patient relation staff if not available. 3. Install suggestion/complaints boxes in strategic location of the hospital ( to be collected by customer service) 4. Provide telephone boxes & contact number that patients/family can call if they have any concern. 5. Implement chosen strategies :

ER waiting time : a) fast track system to expedite diagnosis & treatment for patients with minor illness & injuries b) hire patient advocates to improve communication, increase flow of information & better address patient’s concern 3. Streamline the process beyond ER : speed up delivery of specimen to lab or a full time phlebotomist 4. Make recommendation to the top leadership to implement computerized order entry (if not available) to speed patient’s ability to get blood test, diagnostic test & prescriptions)

ICU communication issues : 1. Create patient/family /physician interaction time : 2 hours in the morning & 2 hours in the evening ( ex: from 10 am to 12 noon ; 5 pm to 7 pm) 2. Ensure 24 hours availability of ICU physicians to address patient/family concerns as needed 6. Re-survey after 3 months to assess improvements.

Potential enablers/barriers in implementing solution Enablers: 1.availability of staff, resources & infrastructure support as necessary 2. enthusiastic, motivated & committed team( project owners) 3. clear goals 4. commitment & support of top leadership 5. Good information campaign about the project plan Barriers : 1. Poor communication 2. Patient categories such as cash & insurance patients that requires approval for tests

Next Step: 1. Continue monitoring waiting time in ER 2. Evaluate effectiveness of solutions through patient satisfaction survey. ( Go back to the patient ) 3. Sustain the improvements noted & re-plan when needed (look for opportunities for improvement) 4. Communicate results within the hospital. 5. Celebrate success ( incremental improvements) – rewards & incentives. (congratulations & thank you letter, small gathering of staff & others.)

Measurable element: 1. 95% of ER patients are satisfied with waiting time in ER. 2. Waiting time reduced to 4 hours 3.. No patient’s/family complain regarding communication/f;ow of information 4. 95% of ICU patients/family are satisfied with the flow of information/communication in ICU