ELM GROVE, WISCONSIN…Compirion Healthcare Solutions, a whole-hospital process improvement firm is sponsoring a series of free webinars to help educate hospital executives, managers and clinicians in strategies for optimizing processes and procedures. Topics include patient satisfaction, nurse rounding, time-of-day discharge, core measures and bed control. The full list of webinars can be found at http://www.compirion.com/webinars along with times, dates and registration information.
Compirion’s presenters are drawn from its pool of consultants, which includes registered nurses, former C-level executives, physicians, business mangers and clinicians. The webinars are running through September and average about 45 minutes each with a question-and-answer session at the end.
According to Compirion Management, “We are presenting this series of free webinars because we truly believe that efficiency in the hospital, especially the ED, not only saves time and money, it saves lives. The faster you can get a patient to treatment, the better the outcomes you can expect. It is the premise on which Compirion was founded.”
Compirion Healthcare Solutions, LLC is based in Elm Grove, Wisconsin. Compirion is a leader in healthcare consulting firms focusing on whole hospital process improvement. They work on site, using a team approach and offer a money back guarantee that all goals are met. Client hospitals show sustainable performance improvements in billable volume, patient satisfaction, core measures, length of stay, bed control, case management, patient throughput and staff retention. Their experience includes emergency room, surgical services, laboratory, radiology, materials management, inpatient, outpatient and nursing care improvement projects. They contract only for measurable outcomes to help achieve patient satisfaction, staff loyalty and a better bottom line.
MARYVILLE, ILLINOIS…Anderson Hospital administration and their ED process improvement consulting group, Compirion Healthcare Solutions congratulate the ED Patient Throughput Team at Anderson Hospital upon its receipt of the coveted Pinnacle Award. The ED Patient Throughput Team, responsible for reducing wait times and improving patient satisfaction, was chosen from a group of three finalists to receive the award for their excellence in customer service. The other finalists were the Laboratory Department and Information Systems. The annual award was created to honor a department or workgroup.
According to hospital president, Keith Page, “Selecting the Pinnacle Award winner was very challenging as all three finalists have distinguished themselves in their efforts to improve our customer service. All three departments had equally impressive stats.”
The changes in the department were the result of a massive patient throughput improvement project initiated last year that involved every department in the hospital working together toward a common goal. The project greatly improved patient satisfaction in many areas of the hospital. The patient satisfaction baseline prior to the project was in the 4th percentile PRC (Professional Research Consultants) ranking. After a hospital initiated improvement project, in January of 2008 it was still low, in the 33.1 percentile. In February, hospital administration enlisted Compirion Healthcare Solutions out of Elm Grove, Wisconsin to assist with the project. Compirion began an intensive 6-month period of coaching, piloting, and implementing in collaboration with the ED staff, physicians and management. At the end of Compirion’s 6-month engagement, PRC rankings had climbed to the 73rd percentile when compared to other hospitals. Since then, the concepts and processes that were put in place while under Compirion’s tutelage have enabled Anderson Hospital’s ED patient satisfaction scores to continue to improve and to reach the 96th percentile PRC ranking.
“We are pleased that the Emergency Department was chosen to receive this distinguished award. We know how hard they all worked and continue to work toward providing the best patient care possible,” said Compirion Healthcare Administration.
Compirion Healthcare Solutions, LLC is based in Elm Grove, Wisconsin. Compirion is a leader in healthcare consulting firms focusing on whole hospital process improvement. They work on site using a team approach and offer a money back guarantee that all goals are completed. Client hospitals show sustainable performance improvements in billable volume, patient satisfaction, core measures, length of stay, bed control, case management and staff retention. Their experience includes emergency room, surgical services, outpatient and inpatient throughput, and nursing care improvement projects. They contract only for measurable outcomes to help achieve patient satisfaction, staff loyalty and a better bottom line.
For more information on Compirion’s sustainable healthcare solutions call 1-866-661-4677, or visit http://www.compirion.com/anderson.
Compirion Helps Baxter Regional Medical Center Achieve Patient Satisfaction Rankings in the Top 5th Percentile NationallyMay 7, 2009
MOUNTAIN HOME, ARKANSAS… Baxter Regional Medical Center has recently reached the top fifth percentile ranking for patient satisfaction, in the National Database after a 6-month long improvement project in the Emergency Department. They have also reached number one in Arkansas, number one in Region Seven, and number one in Missouri. Compirion Healthcare Solutions, a hospital process improvement firm from Elm Grove, Wisconsin helped them get there.
Baxter Regional Medical Center prides itself on providing big city, state-of-the-art healthcare with a hometown touch. However, before the improvement project, its patient satisfaction ranking of 59%, evidenced that it was struggling.
The most obvious problem seemed to be the long wait times. While the clinical performance was high, it was determined by hospital administration that the long wait times were just a symptom of other problems throughout the Emergency Department unrelated to quality of care. After several attempts to correct the situation, the ED staff was losing hope. Hospital leadership determined that outside help was needed. Compirion Healthcare Solutions based in Elm Grove, Wisconsin, was engaged to manage the improvement process.
According to hospital CEO, Ron Peterson, “Compirion was awarded the contract because they looked different from every other consulting group I had seen. They worked on site and they implemented the changes. They presented a total package for a lump sum (of money), with goals that were agreed upon beforehand…and they had the same goals we did.”
Compirion sent a team to work on site, side by side with hospital staff. The first few weeks were spent in observation of the processes and procedures in the department. Compirion provided mentoring, leadership, coaching, and problem-solving facilitation while encouraging teamwork. They identified problems and helped set up pilot initiatives for testing solutions.
Dr. Pat Black, Emergency Department Medical Director commented, “Compirion made a significant contribution to the improvement project by showing us the value of observation and helping us set up a process to deal with problems. They did a fabulous job. They never dropped the ball or minced words. They showed us how to define the problems and the benefits of solving them instead of repeating the same problems over and over.’
“One of the things Compirion’s observation process revealed was the slow response from the teams on ‘the floors’ when they were needed in the Emergency Department. Our solution was to set up an ancillary team from lab and x-ray. We made it part of their responsibility to respond to needs in the Emergency Department in under 45 minutes.’
“Another problem revealed through observation was that the Emergency Department physicians were complaining that nurses currently in triage were not up to the job. They were Fast Tracking the wrong people. As a result, jobs were reassigned putting the best nurses in triage, and Fast Track was eliminated. Next, we worked to redefine the Charge Nurse role making it more supervisory. In addition, Charge Nurses now coordinate with triage to get patients into beds.”
Dr. Black added, “Charge Nurses want to be care nurses and disappear into rooms with patients. Without constant monitoring, we have a tendency to backslide. Our teams have to be in place at all times. Even so, we could use a little booster shot once a year.”
Baxter’s Michele Pierski commented, “As Director of the Cath Lab/ARU, I knew there was a problem with chest pain patient wait times and I had been trying to fix that for quite a while. Compirion supplied the ‘oomph’ that helped move things forward. When Compirion arrived, the first thing they did was get everyone in the Emergency Department on-board. The absence of a baseline for Core Measures was the first problem we uncovered relevant to wait times. They helped us determine one so we had something to measure against. Our Core Measures baseline for the first quarter was found to be 50%.”
Previously, the process for the initial handling of chest pain patients had been to call a physician from cardiology to the Emergency Department to perform an EKG. This burned up critical minutes. Now, a quick EKG is performed by an Emergency Department technician who has a printer near by. The print is handed to the ED physician to read immediately.”
Dr. Black added, “We have implemented a “Code Stemi” where everyone is notified via overhead page. The team literally swarms on the patient. Chest pain patients are now prepped by the Emergency staff and it is the ED physician who determines whether a person goes to the Cath Lab or not.”
Additionally, during peak times, a person from the Cath Lab is in the Emergency Department to expedite cardio patients. After implementing these changes, Door-to-EKG time compliance to the Core Measure rose to 78%.
“Our ambulances now have the ability to perform twelve-lead EKGs. These EKGs are sent directly from the ambulance to the ED. In this way we can have EKG results before the patient reaches the hospital, saving those critical minutes,” said Pierski.
Other Core Measures initiatives for cardio patients were:
• Aspirin on arrival added to the standard order sheet
• Standardized procedures for Code Stemi
• Development of Code Stemi packets containing all paperwork, Med Kits, and
• Realtime data sheets that flag issues immediately
• Creation of a patient preparation board to educate ED staff on proper patient prep for cath procedures
• EMS or ED physician initiation of Code Stemi call-in
• Second IV started by EMS when feasible
Key Core Measures results over the term of the improvement project included:
• ASA at arrival from 86% to 98%
• Primary PCTA within 90 minutes from 56% to 91%
• Blood culture prior to antibiotic for pneumonia patients from 90% to 100%
• Antibiotic within 4 hours from 89% to 94%
Pierski added, “Their observation process proved to be a fabulous tool that I now use all the time. I used the tools Compirion supplied to move the whole house forward.”
The results of the improvement project were:
• Core Measures consistently above the 90th percentile
• Door-to-admission time reduced from 4.41 hours to 2.3 hours
• Door-to-discharge time for treated patients from 3.41 hours to 2.08 hours
• Percentage of those who left without being seen (LWBS) from 6.8% down to 2%
• Patient billable volume up 15%
At the conclusion of Compirion’s engagement, Press Ganey patient satisfaction rankings were in the 85th percentile. Ten months after the end of the project, scores continue to climb and are consistently in the 95th percentile ranking, making Baxter Regional Medical Center number one in Arkansas, number one in Region Seven, and number one in Missouri. They are rated in the top 5% of the national database of 1053 hospitals.
According to CEO Peterson, “It is nice to know they were here. They were committed until the goals were achieved. They are very goal focused. Now there is more teamwork (at the hospital).”
Dr. Black concluded, “Our ED Physicians have reported that the improvement in patient satisfaction has made their jobs better. What the Compirion process taught us was respect for the patient and our coworkers. That is what it boils down to.”
Compirion Healthcare Solutions, LLC is based in Elm Grove, Wisconsin. Compirion is a leader in healthcare consulting firms focusing on whole hospital process improvement. They work on site using a team approach and offer a money back guarantee that all goals are completed. Client hospitals show sustainable performance improvements in billable volume, patient satisfaction, core measures, length of stay, bed control, case management and staff retention. Their experience includes emergency room, surgical services, outpatient and inpatient nursing care improvement projects. They contract only for measurable outcomes to help achieve patient satisfaction, staff loyalty and a better bottom line.
For more information on Compirion’s sustainable healthcare solutions call 1-866-661-4677, or visit http://www.compirion.com/baxter
Compirion and Jefferson Memorial Hospital Use Accountability to Improve Patient Throughput, Patient Satisfaction in Emergency RoomOctober 7, 2008
ST. LOUIS, MISSOURI… Jefferson Memorial Hospital is a non-profit community hospital, located within an hour of St. Louis. It is the sole community provider of healthcare services for Jefferson County and other surrounding communities. With the intent of improving patient access, ed throughput and patient satisfaction, the hospital board backed by the community, invested millions of dollars into redesigning its Emergency Room. In June of 2006, the new emergency room opened. The ER had been designed without a waiting area, – a feature that leadership assumed would lower patient length of stay and eliminate wait times. It boasted 24 private, patient rooms built around a central clinical nursing core. Patient transportation, visitation, and other activities occurred via a perimeter hallway.
By December of 2006, hospital leadership learned that patient throughput times had not improved – ed throughput times had actually increased to 4.61 hours, productivity was at 4.5 hours per patient, and patient satisfaction scores were low at the 2nd percentile. Staff morale was declining. Compounding the situation, the hospital had been advertising “no waiting” for the Emergency Room. In January of 2007, hospital administration brought Jerome Ladous on board as Vice President of Operations to “fix” the Emergency Department.
By May of 2007, Ladous decided to enlist outside help to facilitate change of this size. Compirion Healthcare Solutions, a hospital consulting firm out of Milwaukee was engaged for 6 months to help the hospital staff develop tools and processes in order to effect permanent change. Goals included: improve patient throughput time from over 4 hours down to 3 hours, improve productivity, raise Press Ganey patient satisfaction scores to the 75th percentile and improve core measures scores. The Compirion team built tools to aid in the daily, real-time management of patients and resources. At the beginning of the improvement, LOS was at 4 hours, 12 minutes. At the end of the 6-month process, LOS was at 3 hours and billable patient volume had risen 6%. Productivity went from 3.5 worked hours per patient to 2.9 for a 17% improvement.
At the same time, specific goals were set for treatment of cardio and pneumonia patients: aspirin on arrival for 100% of patients with chest pain, door to PCI within 90 minutes (according to Medicare reimbursement guidelines), and door to EKG within 10 minutes. For pneumonia patients, 100% were to receive a blood culture prior to antibiotic, and an antibiotic within 4 hours of diagnosis. At the end of the engagement, aspirin on arrival, primary PCI within 90 minutes, blood culture prior to antibiotic, and antibiotic within 4 hours of diagnoses were all at the desired 100%.
Prior to the improvement, Jefferson Memorial Hospital did not have a patient satisfaction procedure in place. The team’s first step was identifying baseline percentile Press-Ganey rankings, which turned out to be lower than the 20th percentile, and setting goals for increasing scores. At the end of 6-months, Press-Ganey scores were in the 74th percentile.
Unexplained waits in the lobby averaging 23 minutes were looked at next. Initial door-to-treatment time was 59 minutes, and door-to-EKG time was at 35 minutes. Decreasing door-to-treatment time became a primary objective. A Quick Registration process was established. Nine additional standardized triage protocols were instituted based on ESI guidelines. A water cooler and a clock were placed in the lobby for patients, their families and friends. Door to treatment time decreased to 37.5 minutes and door to EKG dropped to 15 minutes.
According to V. P. Operations, Ladous, “What I liked about Compirion was that they used the resources of the hospital, specifically the front line managers, to come up with customized answers to fit Jefferson’s needs. Once-a-week we held and still hold Core Team meetings of accountability with the hospital CEO.”
E.D. Director, Shelley Layton added, “From my perspective, the accountability was the biggest piece Compirion brought to the table and was worth every penny!”
As part of their Sustainable Results Program, the Compirion team returns twice during the year, at no charge to the hospital, to review and make any adjustments.
Compirion Healthcare Solutions, LLC is based in Elm Grove, Wisconsin. Compirion focuses increasing client hospitals’ billable volume, staff retention and recruitment, core measures and patient satisfaction. Their experience includes Emergency Services, Case Management, Surgical Services, Laboratory, Diagnostic Imaging and Inpatient Nursing Care improvement projects. They contract only for measurable outcomes to help achieve patient satisfaction, staff loyalty and a better bottom line. For more information on Compirion’s sustainable healthcare solutions call 1-866-661-4677, or visit http://www.compirion.com/jefferson.cfm
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Compirion and Meriter Hospital Achieve an Extraordinary Improvement in Emergency Services Department Patient SatisfactionMarch 13, 2008
- Patient wait times and through-put times continued to climb above acceptable levels creating a risk of patients leaving without being seen and ambulance services diverting patients to other facilities
- Patient satisfaction levels had fallen significantly below the 75th percentile using a national survey tool comparing Meriter to over 700 other hospitals nationally; Overall hospital inpatient activity continued to climb, making timely inpatient admissions from the ES very difficult
- Employee satisfaction and morale were falling and turnover increasing as the stress of a busy ES and employee overtime took its toll
- A key competitor, UW Hospitals and Clinics, the only Level 1 Trauma facility in the region, was planning the grand opening of their new state-of-the-art Emergency Services Department in June 2007.
- Sustain the Emergency Services market leadership position
- Improve patient satisfaction rankings to the Top 10 percentile
- Decrease patient throughput times to Top 10 percentile performance