The document discusses the importance of change management and stakeholder engagement throughout the design and transition process for new healthcare facilities. It provides examples from Akron Children's Hospital's expansion projects including a new emergency department (ED) and neonatal intensive care unit (NICU). Surveys of ED and NICU staff before and after the moves assessed levels of involvement in the projects, knowledge of the new spaces and processes, and perceptions of preparedness and ability to adapt. Results showed that greater involvement in facility design increased later perceptions of preparedness and adaptation for both groups. However, the new NICU design more significantly impacted workflows, so involvement was more important for feeling prepared ahead of time. The findings emphasize tailoring change engagement strategies to
1. The document describes a survey of anaesthetic trainees in Merseyside that found they collectively spent over 1000 hours on audits but only 16% resulted in recognizable practice changes.
2. It then outlines the formation of MAGIQ (Mersey Anaesthetic Group for Improving Quality) to help trainees collaborate on quality improvement projects and overcome barriers like lack of time, resources and support.
3. One such project was a Mersey-wide initiative to increase the use of pre-intubation checklists, which through rapid audit and feedback across 11 hospitals was able to increase checklist use from 51% to 87% over 8 weeks.
First steps towards quality improvement: a simple guide to improving servicesNHS Improvement
This document provides guidance on taking initial steps towards quality improvement projects within healthcare services. It discusses key concepts for defining the scope and aims of a project, as well as tools and methodologies for planning, testing, implementing and evaluating changes.
The document recommends following established improvement models, such as a five step approach involving preparation, launch, diagnosis, implementation and evaluation phases. It also describes the Model for Improvement, which emphasizes setting clear aims, measuring baselines, testing changes using PDSA cycles before implementing solutions more broadly.
Getting the right people involved, understanding different perspectives on the problem, and having a clear aims statement are some of the factors highlighted as important for a successful quality improvement project. Tools like process mapping
Improvement training - Presentation from the Winterbourne Medicines Programme Launch held in London on 10 September 2014
Ensuring safe, appropriate and optimised use of medication for people with learning disabilities who demonstrate behaviour that can challenge
This document outlines plans for quality improvement (QI) initiatives across Luton and Bedfordshire. It discusses:
1) Developing a QI culture through leadership, empowering frontline staff, increasing transparency, and balancing quality control and improvement.
2) Aligning QI projects to aims of reducing harm by 30% annually and improving access to the right care, in the right place, at the right time.
3) Examples of QI work in other regions to reduce violence and improve access, and how the lessons learned could be applied in Luton and Bedfordshire.
The document discusses the importance of will and leadership in driving quality improvement efforts in healthcare. It notes that some clinicians express discomfort with quality improvement data and initiatives. It emphasizes that creating the right culture where people feel safe to change is important to encouraging improvement. Measurement is discussed as a key part of improvement work. Leadership must establish a clear mission and strategy to align improvement projects and individual goals. Auditing practices and implementing changes is part of the ongoing improvement cycle.
This document provides an overview of the annual quality improvement conference. It outlines how attendees can interact with presentations and polling using the Slido app with event code 6789 on their mobile devices. The agenda includes presentations on quality improvement work over the past two years, including building improvement capability through training initiatives, aligning projects with priorities, and over 155 active quality improvement projects across reducing harm and providing the right care.
The document outlines strategies for improving quality and safety at a children's hospital, including engaging patients in improvement activities, reducing serious safety events over time, and providing training to staff on quality improvement methods and change management approaches. It also presents data showing reductions in serious safety events and medical errors from baseline years.
Informing our third leadership report, we surveyed NHS professionals to understand their views on the quality of patient care and leadership in delivering improvements.
1. The document describes a survey of anaesthetic trainees in Merseyside that found they collectively spent over 1000 hours on audits but only 16% resulted in recognizable practice changes.
2. It then outlines the formation of MAGIQ (Mersey Anaesthetic Group for Improving Quality) to help trainees collaborate on quality improvement projects and overcome barriers like lack of time, resources and support.
3. One such project was a Mersey-wide initiative to increase the use of pre-intubation checklists, which through rapid audit and feedback across 11 hospitals was able to increase checklist use from 51% to 87% over 8 weeks.
First steps towards quality improvement: a simple guide to improving servicesNHS Improvement
This document provides guidance on taking initial steps towards quality improvement projects within healthcare services. It discusses key concepts for defining the scope and aims of a project, as well as tools and methodologies for planning, testing, implementing and evaluating changes.
The document recommends following established improvement models, such as a five step approach involving preparation, launch, diagnosis, implementation and evaluation phases. It also describes the Model for Improvement, which emphasizes setting clear aims, measuring baselines, testing changes using PDSA cycles before implementing solutions more broadly.
Getting the right people involved, understanding different perspectives on the problem, and having a clear aims statement are some of the factors highlighted as important for a successful quality improvement project. Tools like process mapping
Improvement training - Presentation from the Winterbourne Medicines Programme Launch held in London on 10 September 2014
Ensuring safe, appropriate and optimised use of medication for people with learning disabilities who demonstrate behaviour that can challenge
This document outlines plans for quality improvement (QI) initiatives across Luton and Bedfordshire. It discusses:
1) Developing a QI culture through leadership, empowering frontline staff, increasing transparency, and balancing quality control and improvement.
2) Aligning QI projects to aims of reducing harm by 30% annually and improving access to the right care, in the right place, at the right time.
3) Examples of QI work in other regions to reduce violence and improve access, and how the lessons learned could be applied in Luton and Bedfordshire.
The document discusses the importance of will and leadership in driving quality improvement efforts in healthcare. It notes that some clinicians express discomfort with quality improvement data and initiatives. It emphasizes that creating the right culture where people feel safe to change is important to encouraging improvement. Measurement is discussed as a key part of improvement work. Leadership must establish a clear mission and strategy to align improvement projects and individual goals. Auditing practices and implementing changes is part of the ongoing improvement cycle.
This document provides an overview of the annual quality improvement conference. It outlines how attendees can interact with presentations and polling using the Slido app with event code 6789 on their mobile devices. The agenda includes presentations on quality improvement work over the past two years, including building improvement capability through training initiatives, aligning projects with priorities, and over 155 active quality improvement projects across reducing harm and providing the right care.
The document outlines strategies for improving quality and safety at a children's hospital, including engaging patients in improvement activities, reducing serious safety events over time, and providing training to staff on quality improvement methods and change management approaches. It also presents data showing reductions in serious safety events and medical errors from baseline years.
Informing our third leadership report, we surveyed NHS professionals to understand their views on the quality of patient care and leadership in delivering improvements.
Health care huddle iu health evaluationTyler Wysong
Daily interdisciplinary huddles were implemented at a hospital to improve communication and collaboration among healthcare providers. The researchers observed huddles from several units and interviewed staff. They found that while huddles facilitated information sharing, their effectiveness varied due to inconsistencies in facilitation and participation. Recommendations included using electronic whiteboards to standardize the huddle process, engaging all providers, and incorporating bedside nurses' input. Implementing goal-setting and team-building could help maximize huddles' impact on patient outcomes.
Bringing Lean to Life" provides a basic introduction and overview of Lean; the culture, principles and tools to understand, tackle and resolve issues within healthcare. It is not intended as a complete guide to implementing Lean as a management system. (May 2010).
Building Efficiency Into Care DeliveryKyle Greaves
This document discusses how to bring more efficiency to healthcare delivery. It emphasizes focusing efforts on where care is directly delivered to patients, as that is where many inefficiencies exist. Leaders are encouraged to engage frontline staff and prioritize a few key metrics that can change behaviors and drive improvements. The document also recommends that leaders lead by example by freeing up their own and others' time currently spent on unnecessary tasks in order to reinvest that time into making improvements.
Change Management in an HIVAIDS Research ProjectJOE THEU
The document analyzes the forces that influence an HIV/AIDS research project (RP) to change its primary objectives. It finds that emerging studies, new WHO recommendations, new epidemics, and regulatory pressures threaten the RP and force it to change. A survey of employees found that most accepted the necessary changes but had some concerns about the change process and impacts on their jobs. Recommendations are provided for improving future change management.
Qualtrics experts will share with you new advanced methods to measure leadership traits and highlight individual strengths and weaknesses. Multi-rater assessments, 360-degree employee or student feedback provides a holistic view of an individual by gathering feedback from peers, direct reports while comparing the results with their own self evaluation.
Building a Peer Evaluation Program: Best practices for beginners
What is peer evaluation
Why run peer evaluation
Peer evaluation workflow / process
Competencies & items
Reports
What to do with results
Introduction to Lean Principles
Planning of your work processes to improve flow
Amy Hodgkinson and Trevor Taylor
National Improvement Leads, NHS IQ
Presentation from the Productive Endoscopy Workshop, Tuesday 15th October 2013 at Ambassadors Bloomsbury , London, WC1H 0HX
This meeting brought together teams from around the country, and embarked on creating and testing the productive endoscopy toolkit. The aim of the day is to allow time with your team for sharing of experiences and exchange of good practice, learn how to apply lean techniques and hear the impact of successfully implemented case studies.
A3 Thinking:
A3 thinking is a structured technique of working through problems or opportunities for improvement. The ‘A3’ itself is literally just that: a piece of A3 paper summarising the logical thought processes that have been agreed by the team in defining the opportunity for improvement or solving the problem they face.
This document discusses how Lean principles from manufacturing, originally developed by Toyota, can be applied to healthcare settings to improve quality, efficiency and staff satisfaction. It provides examples from pathology and day surgery departments in the UK where mapping processes identified unnecessary steps and waste. Relocating equipment and redesigning workflows reduced sample processing times from 24-30 hours to 2-3 hours in pathology. Lean implementation typically provides improved safety, timeliness of care, throughput and staff morale by engaging frontline staff. The benefits come in waves as principles become embedded in the organization's culture and ways of working.
The document discusses ageing and its effects on the body and cognition from biological and workplace perspectives. It notes how life expectancy is increasing but illness and disease rates rise with age. Common physical effects of ageing include changes to the cardiovascular, musculoskeletal and cognitive systems. The document then examines age discrimination in the workplace and provides strategies for supporting older workers, such as task variety, load reduction, modified equipment and consulting workers on their needs. Case studies demonstrate providing accommodations for older workers with injuries like allowing role changes, sit-stand desks and trialing modifications.
Part 4 of 4. David Fillingham of AQuA presents 'Building an improvement movement' through the alliance's key learning and priorities, looking in this part at leadership and decision making.
Within GP practices, just as in any organisation, a better safety culture is associated with greater satisfaction and engagement from staff – the safer the culture, the better the care. This presentation aims to promote a safety culture in the primary care setting through the use of incident reporting, while supporting the GP practices involved in cohort 2 with tools and training in quality improvement methodology.
This document outlines Redland City Council's approach to employee wellbeing. It discusses how the council has focused on specific hazards affecting its workforce like an aging workforce and sedentary work. Programs developed include strategies on psychosocial safety, aging workers, sedentary work, mental health and occupational health. The council takes a holistic approach and evaluates its programs annually. Current offerings include yoga, mindfulness courses, physiotherapy, massages and fitness classes. The goal is to address risks and listen to employees to develop an effective and sustainable wellbeing program.
Bottom Up, or "Tarte Tatin" strategy for implementing Lean in St Elisabeth Ho...Henk Veraart
Bottom up approach for implementing lean in a large Dutch hospital, pro's and con's.
presentation held at "Lean Healthcare Transformation Conference" in Brussels
Risk analysis and control
FMEA: Failure Mode and Effects Analysis (FMEA) is often the first step of a system reliability study. It involves reviewing as many components, assemblies, processes and subsystems as possible to identify failure modes, and their causes and effects. For each component, the failure modes and their resulting effects on the rest of the system are recorded in a specific FMEA worksheet. - more at http://www.nhsiq.nhs.uk/improvement-programmes/patient-safety/learning-and-resources.aspx
EHS Manager's Guide: 7 Tactics for a People-first WorkplaceAntea Group
If you have a role in risk management, you’re probably motivated by people first and compliance second. Whether an environment, health, and safety (EHS) manager, facility manager, or HR professional, you need to be proactive about EHS issues to keep employees safe and healthy while also managing business operations to maintain a light environmental footprint.
By following these seven actionable tactics, you’ll increase EHS program development and deployment success, foster a safe and healthy work environment, minimize impact on the environment, and facilitate the growth and sustainability of your business.
A new survey finds a conflict between what employees claim they value (a safe environment) and what they’re willing to do to get it (speak up about workplace safety concerns).
Ideal Candidates Exist - Strategies to Hire and Retain StaffOnShift
The ability to hire and retain employees in long-term care is challenged by caregiver shortages, high turnover and an aging population with more sophisticated care needs. This session details how a consistent staffing & hiring strategy is the keystone for building staff stability.
Ed Morrison explores a new approach to developing and implementing regional economic development strategies called "Strategic Doing". Traditional strategic planning processes for regions have proven ineffective due to their linear nature and assumption that strategies remain stable over long periods of time. Strategic Doing emphasizes transparency, agility, and experimentation to better address the complex, fast-changing nature of today's regional economies. It allows for continuous strategy refinement in loosely connected networks, unlike rigid hierarchical strategic planning models.
PDC_2011_Building Smart Without Compromising EfficiencyUpali Nanda
The document discusses how larger inpatient bed units can be designed to efficiently use nursing time through optimized flow and reduced walking distances. Two case studies, Summerlin Hospital and Texoma Medical Center, incorporated racetrack unit designs that reduced travel distances and times spent walking compared to national benchmarks. Post-occupancy data found the units' time distributions across tasks and activities, as well as walking distances, were similar to other top performing hospitals, demonstrating how larger bed counts can be achieved without compromising efficiency.
This document discusses how field research and parametric analysis were used to inform the design of a new patient tower for ProMedica Toledo Hospital. Researchers conducted observations and activity analysis of a current med-surg unit to understand issues like wasted walking, limited visibility, and unused space. A parametric model was developed to simulate different design configurations and sequences of staff activities. Key findings included that multi-tasking did not reduce time and point-of-use supplies could improve efficiency. The research helped define targets for the future state design focused on decentralization, proximity of supplies, and improved care coordination.
Health care huddle iu health evaluationTyler Wysong
Daily interdisciplinary huddles were implemented at a hospital to improve communication and collaboration among healthcare providers. The researchers observed huddles from several units and interviewed staff. They found that while huddles facilitated information sharing, their effectiveness varied due to inconsistencies in facilitation and participation. Recommendations included using electronic whiteboards to standardize the huddle process, engaging all providers, and incorporating bedside nurses' input. Implementing goal-setting and team-building could help maximize huddles' impact on patient outcomes.
Bringing Lean to Life" provides a basic introduction and overview of Lean; the culture, principles and tools to understand, tackle and resolve issues within healthcare. It is not intended as a complete guide to implementing Lean as a management system. (May 2010).
Building Efficiency Into Care DeliveryKyle Greaves
This document discusses how to bring more efficiency to healthcare delivery. It emphasizes focusing efforts on where care is directly delivered to patients, as that is where many inefficiencies exist. Leaders are encouraged to engage frontline staff and prioritize a few key metrics that can change behaviors and drive improvements. The document also recommends that leaders lead by example by freeing up their own and others' time currently spent on unnecessary tasks in order to reinvest that time into making improvements.
Change Management in an HIVAIDS Research ProjectJOE THEU
The document analyzes the forces that influence an HIV/AIDS research project (RP) to change its primary objectives. It finds that emerging studies, new WHO recommendations, new epidemics, and regulatory pressures threaten the RP and force it to change. A survey of employees found that most accepted the necessary changes but had some concerns about the change process and impacts on their jobs. Recommendations are provided for improving future change management.
Qualtrics experts will share with you new advanced methods to measure leadership traits and highlight individual strengths and weaknesses. Multi-rater assessments, 360-degree employee or student feedback provides a holistic view of an individual by gathering feedback from peers, direct reports while comparing the results with their own self evaluation.
Building a Peer Evaluation Program: Best practices for beginners
What is peer evaluation
Why run peer evaluation
Peer evaluation workflow / process
Competencies & items
Reports
What to do with results
Introduction to Lean Principles
Planning of your work processes to improve flow
Amy Hodgkinson and Trevor Taylor
National Improvement Leads, NHS IQ
Presentation from the Productive Endoscopy Workshop, Tuesday 15th October 2013 at Ambassadors Bloomsbury , London, WC1H 0HX
This meeting brought together teams from around the country, and embarked on creating and testing the productive endoscopy toolkit. The aim of the day is to allow time with your team for sharing of experiences and exchange of good practice, learn how to apply lean techniques and hear the impact of successfully implemented case studies.
A3 Thinking:
A3 thinking is a structured technique of working through problems or opportunities for improvement. The ‘A3’ itself is literally just that: a piece of A3 paper summarising the logical thought processes that have been agreed by the team in defining the opportunity for improvement or solving the problem they face.
This document discusses how Lean principles from manufacturing, originally developed by Toyota, can be applied to healthcare settings to improve quality, efficiency and staff satisfaction. It provides examples from pathology and day surgery departments in the UK where mapping processes identified unnecessary steps and waste. Relocating equipment and redesigning workflows reduced sample processing times from 24-30 hours to 2-3 hours in pathology. Lean implementation typically provides improved safety, timeliness of care, throughput and staff morale by engaging frontline staff. The benefits come in waves as principles become embedded in the organization's culture and ways of working.
The document discusses ageing and its effects on the body and cognition from biological and workplace perspectives. It notes how life expectancy is increasing but illness and disease rates rise with age. Common physical effects of ageing include changes to the cardiovascular, musculoskeletal and cognitive systems. The document then examines age discrimination in the workplace and provides strategies for supporting older workers, such as task variety, load reduction, modified equipment and consulting workers on their needs. Case studies demonstrate providing accommodations for older workers with injuries like allowing role changes, sit-stand desks and trialing modifications.
Part 4 of 4. David Fillingham of AQuA presents 'Building an improvement movement' through the alliance's key learning and priorities, looking in this part at leadership and decision making.
Within GP practices, just as in any organisation, a better safety culture is associated with greater satisfaction and engagement from staff – the safer the culture, the better the care. This presentation aims to promote a safety culture in the primary care setting through the use of incident reporting, while supporting the GP practices involved in cohort 2 with tools and training in quality improvement methodology.
This document outlines Redland City Council's approach to employee wellbeing. It discusses how the council has focused on specific hazards affecting its workforce like an aging workforce and sedentary work. Programs developed include strategies on psychosocial safety, aging workers, sedentary work, mental health and occupational health. The council takes a holistic approach and evaluates its programs annually. Current offerings include yoga, mindfulness courses, physiotherapy, massages and fitness classes. The goal is to address risks and listen to employees to develop an effective and sustainable wellbeing program.
Bottom Up, or "Tarte Tatin" strategy for implementing Lean in St Elisabeth Ho...Henk Veraart
Bottom up approach for implementing lean in a large Dutch hospital, pro's and con's.
presentation held at "Lean Healthcare Transformation Conference" in Brussels
Risk analysis and control
FMEA: Failure Mode and Effects Analysis (FMEA) is often the first step of a system reliability study. It involves reviewing as many components, assemblies, processes and subsystems as possible to identify failure modes, and their causes and effects. For each component, the failure modes and their resulting effects on the rest of the system are recorded in a specific FMEA worksheet. - more at http://www.nhsiq.nhs.uk/improvement-programmes/patient-safety/learning-and-resources.aspx
EHS Manager's Guide: 7 Tactics for a People-first WorkplaceAntea Group
If you have a role in risk management, you’re probably motivated by people first and compliance second. Whether an environment, health, and safety (EHS) manager, facility manager, or HR professional, you need to be proactive about EHS issues to keep employees safe and healthy while also managing business operations to maintain a light environmental footprint.
By following these seven actionable tactics, you’ll increase EHS program development and deployment success, foster a safe and healthy work environment, minimize impact on the environment, and facilitate the growth and sustainability of your business.
A new survey finds a conflict between what employees claim they value (a safe environment) and what they’re willing to do to get it (speak up about workplace safety concerns).
Ideal Candidates Exist - Strategies to Hire and Retain StaffOnShift
The ability to hire and retain employees in long-term care is challenged by caregiver shortages, high turnover and an aging population with more sophisticated care needs. This session details how a consistent staffing & hiring strategy is the keystone for building staff stability.
Ed Morrison explores a new approach to developing and implementing regional economic development strategies called "Strategic Doing". Traditional strategic planning processes for regions have proven ineffective due to their linear nature and assumption that strategies remain stable over long periods of time. Strategic Doing emphasizes transparency, agility, and experimentation to better address the complex, fast-changing nature of today's regional economies. It allows for continuous strategy refinement in loosely connected networks, unlike rigid hierarchical strategic planning models.
PDC_2011_Building Smart Without Compromising EfficiencyUpali Nanda
The document discusses how larger inpatient bed units can be designed to efficiently use nursing time through optimized flow and reduced walking distances. Two case studies, Summerlin Hospital and Texoma Medical Center, incorporated racetrack unit designs that reduced travel distances and times spent walking compared to national benchmarks. Post-occupancy data found the units' time distributions across tasks and activities, as well as walking distances, were similar to other top performing hospitals, demonstrating how larger bed counts can be achieved without compromising efficiency.
This document discusses how field research and parametric analysis were used to inform the design of a new patient tower for ProMedica Toledo Hospital. Researchers conducted observations and activity analysis of a current med-surg unit to understand issues like wasted walking, limited visibility, and unused space. A parametric model was developed to simulate different design configurations and sequences of staff activities. Key findings included that multi-tasking did not reduce time and point-of-use supplies could improve efficiency. The research helped define targets for the future state design focused on decentralization, proximity of supplies, and improved care coordination.
Medexline is a company that provides various medical examination room furniture and accessories including cabinets, stools, tables, mat platforms, parallel bars, storage solutions, pediatric exam tables, bariatric equipment, electric lifts, power tables, exercise balls, medical carts, and exam room lighting. They offer specific products from other companies including sheet metal cabinets, gooseneck exam lamps, wall-mounted cabinets with mirrors, parallel bars, bariatric tables at different heights, and hampers.
This document summarizes a presentation on how emergency department design impacts safety and efficiency. It discusses 14 domains of physical design that were studied, including entry/public waiting, patient intake, configuration, care-giver work areas, and physician work areas. Certain design elements like visibility, queuing, and security provisions in the entry area significantly affect both safety and efficiency. The study's findings can help hospitals optimize their emergency department design.
This document discusses using parametric modeling to optimize nurse walking distances and enhance workflow in hospital unit design. It presents a theoretical framework for how walking distance as a driver can impact environmental quality, human outcomes like time in patient care, and organizational outcomes. A case study compares centralized and decentralized nurse stations in a 36-bed unit, finding decentralized reduced distances by up to 36%. Future research opportunities include building parametric tools to automatically generate and evaluate design alternatives based on user-defined criteria.
This document summarizes an internship project on the employee life cycle at Sandvik Asia Private Limited in Pune, India. It discusses the importance of understanding the employee life cycle and describes the key stages an employee progresses through from recruitment to retirement. The document outlines Sandvik's profile and operations. It then describes the research methodology used in the study, which included a questionnaire and analysis of company documents and records. Charts are presented analyzing different aspects of the employee life cycle such as notice periods, submission of documents, reasons for employee separations, and processing of retirement benefits. In conclusion, the study provides insights into managing the various stages of an employee's tenure.
JOB SATISFACTION OF NURSES AND THEIR PRODUCTIVITYMD DILNAWAZ
This document discusses a study on job satisfaction among nurses and its relationship to productivity. It begins with an introduction explaining the importance of job satisfaction in predicting worker motivation and retention. The objectives of the study are then outlined as determining nurses' level of job satisfaction, measuring the relationship between satisfaction and productivity, and identifying factors influencing satisfaction. The methodology section notes that a questionnaire and interviews were used to collect data from nurse participants. Most of the document consists of tables displaying nurses' responses about different aspects of their jobs and levels of satisfaction in various areas. These include work environment, autonomy, relationships, recognition, promotion opportunities, supervision, pay, and factors like staffing and development. The references cited research on the topics of employment and the influence
The document discusses Pekka Silvén's background and work in evaluation, quality and feedback processes. It notes some common problems with traditional evaluation methods and introduces the "Zef-method" as an alternative that provides clearer results and facilitates improvements. The Zef-method is used in various feedback questionnaires and evaluation engines to analyze responses and compare views of different stakeholders.
Impact Evaluation of Milken's ISCOPES ProgramAashna Panjwani
- The document discusses the ISCOPES program, a 25-year old service-learning initiative that places interprofessional student teams in the Washington D.C. community.
- An evaluation was conducted of ISCOPES participants graduating in Spring 2020 compared to non-ISCOPES participants. It assessed competencies in areas like community health education, program management, and interprofessional collaboration.
- The evaluation found no significant differences between ISCOPES and non-ISCOPES participants in competency scores. It did find those currently working in health education scored higher than those not working in the field. The document provides recommendations like better integrating competencies into the program and engaging alumni.
3 Strategies for Maximizing Service Line Efficiency, Quality and ProfitabilityWellbe
Maximizing service line efficiency, quality and profitability is a hot topic, particularly with rising patient care demands, changing reimbursement models, and estimated physician shortfalls. This webinar takes a look at three solutions beginning in the operating room and expanding to the entire patient care journey.
1st solution: A unique clinical and operational service model focused on the specialization of qualified, reimbursable clinical labor to optimize surgeon involvement and reduce OR costs.
2nd solution: Taking a holistic view of the service line through the patient care journey to produce a value stream map to understand the current state. Assisting staff with comparing this current state to the ideal future state, comparing national benchmarks and clinical best practices helps your staff innovate and co-create an individualized plan to get your service line to a higher level.
3rd solution: Utilizing dashboard metrics of the critical to success factors, to sustain and improve your service line.
As a participant, you will be able to:
• Identify key operational and clinical indicators of orthopedic service line efficiency
• Describe how Surgical First Assists can add value in the OR
• List the steps in developing and/or evaluating or building an orthopedic service line
• Describe how metrics/dashboards assist in sustaining change and improvement of orthopedic service line
About the Speaker:
Miki Patterson, PHD ONP, Senior Director of Orthopedics in Intelligent CareDesign at Intralign
Dr. Patterson is a certified orthopedic nurse practitioner and brings over 25 years of clinical experience in healthcare, consulting, direct advanced orthopedic patient care, teaching, NIH level, qualitative and quantitative research and publishing. She is a past president of the National Association of Orthopedic Nurses (NAON) and continues to be nationally recognized for leadership and advancing orthopedic care.
This document provides an overview of a project to improve the onboarding process for new Resident Care Technicians (RCTs) at the Central Wisconsin Center. The Center currently uses an inconsistent approach to onboarding RCTs across different living units after they complete mandatory training. The goal of the project is to evaluate the current onboarding process and provide recommendations for developing a standardized, systematic approach to onboarding RCTs onto their assigned living units. This will help increase retention and engagement of new RCTs during a critical phase of joining the organization. The document outlines the organizational profile, current onboarding process, and provides a literature review on best practices to help inform recommendations.
Achieving behaviour change for patient safety, Judith Dyson, Lecturer, Mental Health - University of Hull
Presentation from the Patient Safety Collaborative launch event held in London on 14 October 2014
More information at http://www.nhsiq.nhs.uk/improvement-programmes/patient-safety/patient-safety-collaboratives.aspx
1) The document provides an overview of the Shingo Model for Operational Excellence and the HCVLN assessment process.
2) It introduces the HCVLN assessment team and their goals of establishing an assessment process using the Shingo Model to help members identify gaps and progress towards lean enterprise.
3) The benefits of the assessment process are outlined for both network members and volunteer assessors, including understanding organizational progress and unique development/learning opportunities.
Measuring “Culture of Safety” Tawam’s Experience
Discovery:
Tawam Hospital’s Executive leadership realized the need to establish a “Culture of Safety” within the organization and implemented the Johns Hopkins Medicine “Comprehensive Unit based Safety Program” (CUSP). CUSP was introduced as a pilot project in the Intensive Care Unit (ICU), Neonatal Intensive Care Unit (NNU) and Paediatric Oncology Unit (Peds Onc).
Prior to implementation the leadership decided to measure staff perception of safety using evidence based tool.
Solution:
Tawam partnered with Pascal Metrics to implement the Safety Attitude Questionnaire survey. The SAQ was administered to all Tawam Hospital staff in three phases (2008, 2010 and 2011). In 2010 the pilot CUSP units were also resurveyed to determine the status of safety culture since its introduction in 2008.
An email from the CEO was sent to the participants encouraging them to participate in the SAQ survey.
Physicians, nurses, ward-clerks; respiratory therapist, physiotherapist, dieticians etc were included in the survey.
Those who spent at least 50% of their time in the identified units were only included to participate in the survey.
Survey was administered during departmental meetings to increase response rate.
Conducted separate sessions of physicians.
Staff dropped the completed surveys in an envelope.
82% of staff in the patient care areas of the whole hospital participated in the overall 3 phases of SAQ Survey.
The three CUSP pilot units were re-surveyed in 2010.
Anonymity, privacy and confidentiality were maintained from the beginning till the end.
Outcome:
The survey results were graded against percentage positive responses. Responses that were less than 60% mark were graded in the danger zone and anything above the 80% mark were graded in the goal zone. Teamwork climate and Safety climate scale scores are considered to be primary dependent variables, because they are important in preventing patient harm.
The overall hospital score on all the domain scores were in the danger zone, less than 60%. 20 clinical locations in 2010 and 7 clinical locations in 2011 had less than 60% scores in the primary dependent variables.
The SAQ results were disseminated department wise in the presence of a hospital Senior Executive. Every department did an action plan using the SAQ de-briefer tool. The hospital administrators to bring about the change played a facilitators role and helped the departments to come up with their actionable plans.
The hospital leadership in their pursuit to continuing the culture of safety journey, identified six more units for CUSP implementation based on the Phase 2 SAQ scores of 2010. Accordingly the Medical 1, Medical 2, Surgical 1, Surgical 2, Day Case and OBGYN Units were identified for the CUSP roll out. Senior Executive leaders were assigned to each of these new CUSP units to ensure leadership commi
The document summarizes a pilot of single session therapy that was conducted at the University of Cumbria. Key points:
- Referrals to the university's mental health and wellbeing team had been increasing year over year. The team implemented a pilot of single session therapy to help reduce wait times for students.
- Data was collected before and during the pilot to evaluate outcomes. The pilot appeared successful in reducing staff stress, shortening wait times for students, and maintaining or improving student outcomes and experience based on measures.
- Unexpected benefits included lower rates of students missing appointments and evidence that single session therapy helped improve mood and retention for some students. Overall, the pilot seemed to meet its goals of helping staff cope
Young CPAs Research Summary & RecommendationsCarolyn Hook
This document summarizes research conducted by the NJSCPA Young CPAs Council regarding the needs and expectations of young CPAs who are members of the NJSCPA. Key findings from a survey of 275 young CPAs and focus groups with employers include that young CPAs rely most on the NJSCPA for networking opportunities and career resources. They are interested in volunteering for leadership development and career growth. While open to volunteering, they cite lack of time as a barrier. The research aims to help the NJSCPA better serve young members and their employers.
Lean leaders need to commit to a long-term vision of adding value for customers by eliminating waste, participate in rapid improvement events to generate quick results, and make Lean part of their organization's overall strategy in order to successfully implement and sustain Lean practices.
SAFE 1 - Introducing Quality Improvement - a presentation.pptxJABEED P
This document provides an introduction to quality improvement methods. It discusses key quality domains, defines quality improvement, and outlines some common QI tools like the Model for Improvement, PDSA cycles, driver diagrams, and stakeholder maps. Deming's profound knowledge theory emphasizes systems thinking, variation, psychology, and knowledge theory in quality improvement work. The document advocates applying these methods to assess and enhance microsystems of care delivery.
This document discusses quality improvement in healthcare. It defines quality improvement and outlines its core principles, including that quality improvement is a cyclical process of planning, doing, studying, and acting. It also discusses strategies for testing and implementing changes. Additionally, it outlines Ethiopia's quality structures, provides guidelines for clinical audits, and discusses defining and measuring quality standards. The overall purpose is to encourage a culture of continuous quality improvement in healthcare facilities and ensure national policies around quality are reliably implemented.
The document summarizes recommendations for improving the onboarding process for new RCTs at a living facility. It conducted interviews, focus groups, and surveys that found inconsistencies in onboarding across units. It recommends: 1) Applying best practices used by some units consistently, 2) Developing a comprehensive new employee toolkit with checklists and timelines, and 3) Modifying training to address information overload and better prepare RCTs. The goal is to standardize the process, increase consistency, and improve the experiences and retention of new RCTs.
PowerPoint slides used in a seminar held in the University of Calcutta to familiarise the members of Parthib Basu's Ecological Research Unit with the Centre for Pollination Studies Planning, Monitoring and Evaluation System.
The document summarizes ThedaCare's efforts to lead a healthcare lean transformation through various initiatives. It discusses:
1. ThedaCare's healthcare delivery system which includes multiple hospitals, physician offices, behavioral health locations, and other facilities.
2. ThedaCare's approach to transforming healthcare through applying lean principles and creating better value for customers. This includes identifying value, value streams, flow, pull, and continuous improvement.
3. Examples of ThedaCare's lean projects and initiatives to redesign processes like ICU space and workflows, implement collaborative care, and achieve measurable improvements in outcomes, costs, and patient/staff satisfaction.
The document outlines ThedaCare's system-wide strategy to apply
Building capacity for evidence-informed public health decision makingHealth Evidence™
From 2009-2013, Health Evidence partnered with three Ontario health departments on a Canadian Institutes of Health Research (CIHR) “Partnerships for Health System Improvement” grant, studying the impact of tailored, knowledge translation and exchange interventions on evidence-informed decision making in public health. On June 10, 2014, Dr. Maureen Dobbins presented the results from this study and lead an interactive discussion on the implications for this work to a broader public health and knowledge translation audience.
For a recording of this webinar, visit: https://www.youtube.com/watch?v=PbQR-cRgrKI&feature=youtu.be.
Insights from the National Diabetes Registry: User SatisfactionArunah Chandran
The document discusses a study on user satisfaction with the National Diabetes Registry (NDR) system in Malaysia. It found that while overall satisfaction with NDR was high, there is room for improvement in training. Most users were men aged 31-40 working in health clinics. The study assessed satisfaction in three domains: ease of use, training, and design. Overall satisfaction was positive in all domains, with the highest for ease of use. Stratifying by age and occupation found no significant differences in satisfaction levels. Improving training was recommended to better support NDR users.
This document summarizes a forum on demonstrating the impact of volunteering. The agenda includes speakers on why measuring impact is important, planning impact assessments, undertaking impact assessments of volunteering, and challenges and tools for impact assessment. Breakout group discussions are included. Speakers will also discuss the impact of volunteering in care homes and on health and wellbeing based on research. The goal is to help organizations better understand and communicate the impact of volunteering.
This document summarizes a study examining the impact of decentralizing nursing units at MD Anderson Cancer Center. Data was collected before and after the transition to new units with decentralized nurse stations, medication rooms, and supplies. Findings included an increase in time spent walking and documenting for nurses, though collaboration was mixed with some improvements but staff also feeling more isolated at times. Overall, the study found that simply changing the physical design did not automatically achieve the desired outcomes and that operational processes and culture change are also needed to fully realize benefits from decentralization.
1. The document summarizes a study on wayfinding in hospitals that sought to understand what environmental cues people use to navigate.
2. Interviews and tracking of patients, visitors, and employees at a large hospital campus found that people primarily rely on maps, signs, and developing familiarity with landmarks.
3. Other design elements like architectural features, artworks, and furniture arrangements can also serve as landmarks to help orient people and develop familiarity with an unfamiliar environment.
This document discusses the importance of perception in resolving human factors and change management issues during design projects. It provides an overview of a project to design a new patient care tower at Akron Children's Hospital that used an integrated project delivery approach involving clinical staff. The project employed various tools and techniques to manage staff perceptions and expectations during the design process, including value stream mapping, mockups, and pulse surveys. The presentation emphasizes that perception is reality, and change starts with addressing initial perceptions. It also discusses how involving staff voices, managing expectations, and closing gaps between perception and reality are key to leading successful transitions during change.
This document discusses research on defining the design characteristics of a successful adaptable inpatient unit. The research studied six hospitals to understand what flexibility means to different stakeholders and how physical design influences flexibility. Key findings include that flexibility was found to mean adaptability, convertability, and expandability. Design characteristics like proximity of support spaces, lines of sight, and adjustable core spaces promoted flexibility by accommodating operational changes.
1. The study examined the influence of view duration and content on nurse stress and arousal levels. It found that arousal levels significantly decreased over the course of a shift while acute stress levels significantly increased, supporting the hypotheses.
2. Exposure to an external view, particularly a nature view, was associated with higher arousal levels and lower acute stress levels at the end of the shift. Those without a view or with a non-nature view saw greater deterioration in arousal and acute stress.
3. View duration and content had a small but statistically significant influence on arousal and acute stress levels, after controlling for other stressors. A nature view was most beneficial in maintaining arousal levels over the course of a shift.
TRADELINE_2007_Academic Medical Center ConferenceUpali Nanda
This document summarizes a conference presentation on designing workplaces to enhance collaboration in academic medical centers. It discusses how knowledge workers in these environments generate new ideas through both planned and spontaneous interactions. The presentation explores different dimensions of interaction and how physical workplace strategies like proximity and visibility can encourage both conservative sharing of knowledge as well as more generative collaboration. Examples are given of design features that support informal meetings and serendipitous connections between colleagues in medical centers.
The document discusses findings from observations of critical care units at a hospital. Key findings include:
- Medical staff spent most of their time at the patient bedside or gathering information at the nurses' station. Nurses spent most of their time on patient care or documentation tasks at the bedside.
- Ideal room designs were proposed with equipment and supplies organized around the patient bed to minimize staff walking distances and improve ergonomics.
- Future trends may include larger, flexible critical care rooms designed around patient needs and staff workflows.
The document discusses a study examining the association between view duration and content on staff stress and alertness levels. The study was conducted at a children's hospital and measured the chronic stress, acute stress, and alertness of 32 medical personnel over 12-hour shifts. Results showed no statistically significant difference in chronic stress levels before and after shifts. However, alertness levels were significantly lower after shifts, indicating that view may influence staff stress and alertness.
The document summarizes a study that assessed how different room configurations in adult medical-surgical units impact patient care activities. Participants ranked 23 criteria and evaluated 6 room layouts. Non-designers and designers had some differences in criteria rankings. Layouts B and F received the highest suitability scores while layouts with inboard toilets received negative ratings. The findings could help programming and design but questions remain about reliability and validity. Performance-based evaluation frameworks may improve traditional decision-making.
This document summarizes a study comparing medical gas booms to traditional headwalls in ICU patient rooms. Clinicians participated in simulations of various patient care scenarios using both systems. Physicians and respiratory therapists generally preferred booms for flexibility and ergonomics. Nurses preferred booms to reduce clutter and improve access to the patient's head. Family access and visibility were not significantly impacted by either system in most situations. The document outlines factors to consider when deciding between booms or headwalls, such as anticipated acuity level and procedures. Further research is suggested to enhance understanding of impacts on patient safety and day-to-day care delivery.
The document summarizes key findings from a study examining the impacts of patient room handedness on nursing care delivery. The study involved observing 20 left-handed and 20 right-handed nurses performing common nursing tasks like taking vitals and suctioning in different room configurations. The study found:
- There were predictable patterns of behavior among both left-handed and right-handed nurses within each group.
- There were statistically significant differences between left-handed and right-handed nurse behaviors.
- For the vitals task, the location of the IV and overhead table determined what side nurses positioned themselves on relative to the patient. For suctioning, nurse handedness and equipment locations influenced positioning.
1) The study examined the effects of positive distractions on the attention, behavior, and activities of pediatric patients waiting in dental and cardiac clinics.
2) It found that multi-sensory distractions like ambient art with sound were most effective at focusing patients' attention, and resulted in patients being calmer with less movement.
3) The type of distraction that worked best varied between the two clinics, suggesting that factors like a patient's illness or disability can influence their response to different distractions. Overall, positive distractions helped improve the waiting experience for pediatric patients.
BIM Forum_2010_Beyond a Reasonable DoubtUpali Nanda
1) Evidence-based design (EBD) emerged in healthcare to improve safety and outcomes using research-informed design decisions.
2) Studies found EBD strategies like decentralized nursing units reduced patient falls by 75% and transfers by 90%.
3) Other research linked factors like patient visibility and private rooms to lower mortality and infection risk.
4) For BIM to be truly evidence-based, it needs an empirical evidence base from built project performance and linkage to organizational goals, not just cost savings.
HCD_2010_Inflexibility in Flexible DesignUpali Nanda
The document summarizes research into nine domains of design decision-making that impact operational flexibility in acute care medical-surgical units: peer lines-of-sight, patient visibility, multiple division/zoning options, proximity of support, resilience to move services, inter-unit movements, service expansion options, adjustable support core, and expandable support core. The research identified several factors that can impede designing for optimal operational flexibility, including systemic, cultural, human, financial, and physical factors. Examples of impediments discussed include unanticipated consequences of information technology, lack of standardized communication platforms, and assumptions about IT implementation timelines not being realized.
Decentralizing nursing units at MD Anderson Cancer Center was intended to improve efficiency, teamwork, and the patient and caregiver experience. A study collected data before and after decentralizing three nursing units to evaluate the impact. Key findings included a decrease in time spent on documentation and at the centralized nurse station, and an increase in time spent at decentralized medication and supply areas and on the unit. Walking distance for nurses also increased with the decentralized design. The consistency of these changes across the three units provides evidence that decentralization can impact how nurses spend their time and perform tasks.
This document discusses using design projects as laboratories for research. It outlines three initiatives - technology, sustainability, and human and organizational behavior. For each initiative, it provides examples of research projects, including one that used computational fluid dynamics to study airflow in exam rooms and another that examined the impact of view duration and content on nurse stress. It advocates conducting field research and simulations on a project to study human behavior, energy performance, and other factors. The goal is to integrate research findings into design to improve individual, organizational and environmental wellbeing while overcoming resistance factors like billability and time.
This document discusses how design often focuses on vision while neglecting other senses like smell, sound, and touch. It provides an overview of each sense and how they differ in range, directionality, and distance. The historical hierarchy of the senses placed sight and hearing above smell, taste, and touch. New research suggests smell allows for richer emotions and memory associations than previously thought. The document calls for greater consideration of all the senses in design to improve sensory experiences and coherence. It provides examples of how senses interact crossmodally and the potential for designing spaces that concur, correspond, and cohere across the sensory modalities.
Research based practice: Field Research + Parametric Analysis in Medical Planning and Design
The document discusses how field research and parametric analysis were used together in the design process of a medical-surgical unit renovation. Field research involved observing nurse activities and spatial utilization. Parametric analysis modeled walking distances, visibility, and other metrics. This informed the design by identifying issues like wasted walking and limited visibility. It also helped set targets for the future design like decentralized nursing stations and point-of-use supplies to decrease nurse travel time and improve outcomes. Post-occupancy the research approach helped evaluate if design goals were achieved.
The document provides information about a session on neuroarchitecture and aging. It begins with welcome and CE information. It then describes how the aging brain undergoes changes that impact sensory perception and cognitive function. As people age, their senses of hearing, vision, smell, taste and touch decline. The session will discuss research on the aging brain and senses, and explore design strategies that can address sensory changes and support brain health for older adults. These include addressing visual challenges through lighting, color contrast and glare reduction, as well as fall prevention through clear wayfinding and safe circulation.
The document discusses lessons learned from a study on applying lean thinking and integrated project delivery (IPD) to healthcare construction projects. It found that full-scale mockups were the most effective lean strategy. It also found that learning was an important implicit benefit not tracked. While IPD led to benefits like collaboration, some challenges included perceived imbalance of influence and optimal use of lean strategies. To fully evaluate the costs and benefits of lean-IPD approaches, factors like time costs for additional participation and documentation need to be accounted for.
Discovering the Best Indian Architects A Spotlight on Design Forum Internatio...Designforuminternational
India’s architectural landscape is a vibrant tapestry that weaves together the country's rich cultural heritage and its modern aspirations. From majestic historical structures to cutting-edge contemporary designs, the work of Indian architects is celebrated worldwide. Among the many firms shaping this dynamic field, Design Forum International stands out as a leader in innovative and sustainable architecture. This blog explores some of the best Indian architects, highlighting their contributions and showcasing the most famous architects in India.
International Upcycling Research Network advisory board meeting 4Kyungeun Sung
Slides used for the International Upcycling Research Network advisory board 4 (last one). The project is based at De Montfort University in Leicester, UK, and funded by the Arts and Humanities Research Council.
Practical eLearning Makeovers for EveryoneBianca Woods
Welcome to Practical eLearning Makeovers for Everyone. In this presentation, we’ll take a look at a bunch of easy-to-use visual design tips and tricks. And we’ll do this by using them to spruce up some eLearning screens that are in dire need of a new look.
1. The People Side of Change
Managing Expectations Early to
Eliminate Workarounds Post
Occupancy
Informing the transition process
2. Jennie Evans, RN, BS, EDAC, LEEP AP,
Lean Six Sigma CE
Associate Principal and Sr. Vice President
HKS Architects
Adeleh Nejati, PhD, MArch, EDAC
Architect and Design Researcher
HKS Architects
Meredith Slosberg, MBA, FACHE, CSC
Lean Six Sigma Green Belt
Deployment Leader
Organizational Effectiveness
Akron Children's Hospital
Acknowledgment: Center for Advanced Design Research and Evaluation
Principal Investigator: Upali Nanda
3. 1. Articulate the relationship between project
planning and transition planning for people.
2. Identify opportunities to deploy change
engagement directives during the project
planning and implementation process.
3. Identify why change engagement is necessary,
and effective, in all planning and design projects,
based on systematically collected data.
4. Learn about three key talking points to begin
conversations about implementation in your
organization.
4. 275,000 sf patient care tower
75 bed NICU
39 room emergency department
6-OR outpatient surgery center
High risk delivery area
Continuing to deliver on the
promises that were written in
1890, our campus expansion
will enhance the high quality,
compassionate and family-
centered care that we have
delivered to the communities
we serve for over 120 years.
5.
6. Pre-Design Design Transition Occupancy
Visioning
Emerging Trends
Current to Future State
Site Visits
Site Visits
Dept. Mock Ups
Spaghetti Diagrams
Expectation
Check Survey
Ambassadors
Pulse points
Leadership Training
Ambassadors
Trials
Post Design Mock-up
Pulse Points
Expectation
Check Survey
Akron: Integrating Design and Change Management
9. • Preparedness must consider model of care and work flow differences in
• Team Collaboration
• Visibility
• Walking distances
• Care delivery processes
• Post-occupancies identify spaces are not always used as intended
• Communication pathways are not established
• Team collaboration / Devices are under utilized
• Decentralized work stations are not used
• Visibility of peers
• Nurse servers are not used
• Walking Distances
Recent survey of healthcare administrators cites failure to create buy-in as one of
the top 2 barriers to sustainable change.
• American College of Healthcare Executives, Journal of Healthcare Management
11. Pre-Design Design Transition Occupancy
Visioning
Emerging Trends
Current to Future State
Site Visits
Site Visits
Dept. Mock Ups
Spaghetti Diagrams
Expectation
Check Survey
Ambassadors
Pulse points
Leadership Training
Ambassadors
Trials
Post Design Mock-up
Pulse Points
Expectation Check
Survey
Akron: Integrating Design and Change Management
12. Survey 1
Survey 2
June 2013
Oct 2013
May 2014
ED Timeline
Survey 3
Survey 4
Jan 2015
June 2015
1. Leader Training Starts
2. Trials Start
3. Town Halls
4. Pulse Points Start
5. Trauma Room Mock up
6. Ambassadors
Design Phase
Complete
13. 1. Leader Training Starts
2. Focus Groups
Survey 1
Survey 2
Design Phase
Complete
June 2013
Oct 2013
June 2014
NICU Timeline
Trials Start
Survey 3
Survey 4
Nov 2015
June 2015
14. • Awareness
• Language and storytelling
• Messaging
• On-going dialogue
• Values and Key Behaviors
• Pulse Points
15. Formalize it
Overt communicate
Venues
− Daily Huddles
− Staff meetings
− Department meetings
− Governance councils
− Town halls
− Focus groups
− Email and intranet
− Ambassadors
− Surveys
16. NICU Focus Groups, Focused Voice
Fears
• Loneliness
• Lack of help from fellow nurses
• Increased dependence on technology
• Looking incompetent for asking for help
Leadership Advocacy
• Communication technology
• Simulation time
• Parent/family expectations
Single room line of sight and patient safety
17. When town halls don’t work
Prn/evenings/week-ends/tight shifts
1:10 ratio
Flash drives or intranet
Consistent regular messaging from leadership to staff and back
Regular meetings for Ambassadors
18.
19. • Respiratory
• Fast Track
• Distance to Transport
• Suture Cart
• Communication devices
• Pulse Ox
• Staffing Model
• Supply carts
20. Stake holder Issue Action
RN -Develop/implement new FT/triage
process
-Development of staffing model for new
ED
-Develop education and communication
plan
-Continue use of ambassadors, tours
and behaviors/values role out
Physicians -Staffing
-New roles/interactions with fellows
-Room assignments
-Even flow of patients through entire ED
-Develop education and communication
plan
-Recruitment
-Consider flow/teamwork when
developing new FT/triage process
NPs
Registration/Secretaries
Respiratory Integrating Transport in ED operation -continue presence at huddles in ED
-Global plan around integrating into
services in new building
Mental Health Technicians -maintaining consistent processes with
new and revolving staff
-developing guidebook for RN/MHT staff
-scripting to communicate what to
expect to families
MAs
Suture Staff -integrating suture staff in FT
-geographic separation creates some
challenges in
communication/touchdown space
-uncertainty around change at satellites
-continue to monitor, remind ED staff of
where suture staff may reside
21. To do a regular check in with the staff
to assess their perceptions,
expectations and level of
preparedness for the move
To use the survey results to inform
specific change engagement
initiatives
To analyze the survey to understand
how involvement in the design of the
new facility, and new processes,
contributes to staff preparedness and
adaptation for the new move
22. ED 1: N= 47
ED 2: N= 88
14.9
51.1
31.9
4.34.5
9.1
68.2
18.2
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
Leadership Medical staff Clinical staff Non-clinical staff
%ofParticipants
Job Role
ED 1 ED 2
12.8
6.4
48.9
10.6
8.5
2.1
10.69.1
11.4
42.0
9.1 8.0
10.2 9.1
0.0
10.0
20.0
30.0
40.0
50.0
60.0
< 6 mths < 1 yr 1-5 yrs 6-10 yrs 10-15 yrs 15-20 yrs > 20 yrs
%ofParticipants
Years of Experience
ED 1 ED 2
ED Survey Demographic
24. Level of
Involvement and
Knowledge
Type of
Involvement in the
Facility Design
Type of
Involvement in the
Process Design
Perception of Preparedness
How prepared do you feel to work in the new environment?
Perception of Adaptation
To what extent do you feel your involvement in/ knowledge of design
will help you adapt to your new environment?
Preparedness
Make ready ahead
of time
Adaptation
Adjust to a new
state
25. 3.4
1.4
1.8
1.6
2.2
2.5
3.7
0.9
1.7 1.6
2.6 2.6
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
Years of
Experience
Level of
Involvement
Level of Facility
Knowledge
Level of Process
Knowledge
Preparedness Adaptation
ED1
ED2
Summary Results for ED and NICU Surveys – Mean Comparison
T-test: Significantly different from Survey 1 to 2
NICU 1: N= 49
NICU 2: N= 43
ED 1: N= 47
ED 2: N= 88
4.6
1.4
2.0
1.4
1.9
2.6
4.5
1.4
2.2
1.5
2.1
2.7
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
Years of
Experience
Level of
Involvement
Level of Facility
Knowledge
Level of
Process
Knowledge
Preparedness Adaptation
NICU1
NICU2
26. Importance of involvement in design
phase will be a recurring theme today
For ED, a range of activities informed
preparedness including:
10 trials
Ambassadors
Leadership training
Interactive mock-up of trauma room
Some leadership/staff trust issues were more
pressing. Only a small core group involved.
Leadership matters!
27. 27.7
31.9
29.8
10.6
8.0
36.4
39.8
15.9
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
Not at all A little bit Moderately so Very much so
%ofParticipants
ED1
ED2
32.7
44.9
18.4
4.1
14.0
65.1
16.3
2.3
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
Not at all A little bit Moderately so Very much so
%ofParticipants
NICU1
NICU2
NICU 1: N= 49
NICU 2: N= 43
ED 1: N= 47
ED 2: N= 88
28. 23.4
21.3
36.2
19.1
10.2
39.8
33.0
17.0
0.0
10.0
20.0
30.0
40.0
50.0
Not at all A little bit Moderately so Very much so
%ofParticipants
ED1
ED2
10.2
42.9
28.6
18.4
7.0
39.5
30.2
23.3
0.0
10.0
20.0
30.0
40.0
50.0
Not at all A little bit Moderately so Very much so
%ofParticipants
NICU1
NICU2
NICU 1: N= 49
NICU 2: N= 43
ED 1: N= 47
ED 2: N= 88
29. Level of
involvement in the
facility design
Level of
Knowledge of
New Facility
Level of
Knowledge of
New Process
Preparedness
Make ready ahead
of time
Adaptation
Adjust to a new
state[S1, S2]
[S1]
ED Survey Result
Level of Involvement & Knowledge
[S1]
[S2]
Correlation
Prediction
Survey 1
Survey 2
30. Preparedness
Make ready ahead
of time
Adaptation
Adjust to a new
state[S1, S2]
Level of
Knowledge of
New Facility
Level of
Knowledge of
New Process
Level of
involvement in the
facility design
NICU Survey Result
Level of Involvement & Knowledge
[S1]
[S2]
Correlation
Prediction
Survey 1
Survey 2
31. Level of
involvement in the
facility design
Preparedness
Make ready ahead
of time
Adaptation
Adjust to a new
state
Level of
Knowledge
Process
Facility
ED only
Summary Result
Level of Involvement & Knowledge
32. Being involved in facility design was key:
• To increase knowledge of process and knowledge of environment
• To increase ED’s perceptions of both preparedness and adaptation
• To increase NICU’s perception of adaptation but not preparedness
This points to how the future design configuration affects
the current model of care. The new NICU design has a huge
impact on current model of care. The new ED is a larger space
but has less impact on the model of care. Preparedness and
adaptation seem to be more closely aligned when the new model
of care is similar to the old model of care.
33. Knowledge of facility and knowledge of process did not have the same
impact on each group.
• Knowledge of process and facility increased NICU’s perception of
their ability to be ready ahead of time.
• Knowledge of facility increased ED’s perception of their ability to
adjust to the new space.
• Knowledge of process increased ED’s perception of their ability to
be ready ahead of time.
Since our goal is to have our employees ready to utilize the
space in a way that is congruent with intended use we need to
pay attention to providing them with both types of information.
However, one group may need a certain type of information
more than the other and at different times in the transition process.
34. Pre-Design Design Transition Occupancy
Part of design team
Tour mock up
Patient care processes
Choosing design options
Workshop report outs
Regular communication
Part of design team
Tour mock up
Patient care processes
Choosing design options
Workshop report outs
Regular communication
Trialing new equip/ tech
Trial new equip/tech
Leadership training
Focus groups
Regular communication
Trial new equip/tech
Leadership training
Focus groups
Regular communication
35. 13
23
9
6 7
27
7
20
4
9 11
69
0
10
20
30
40
50
60
70
80
Part of the
Design Team
Tour Mock-up Create Patient
Care Processes
Choose Design
Options
Attend
Workshops
report outs
Regular
Communication
NumberofParticipants
ED1
ED2
10
13
10
16
8
38
5
13
7 6
3
39
0
10
20
30
40
50
60
70
80
Part of the
Design Team
Tour Mock-up Create Patient
Care Processes
Choose Design
Options
Attend
Workshops
report outs
Regular
Communication
NumberofParticipants
NICU1
NICU2
NICU 1: N= 49
NICU 2: N= 43
ED 1: N= 47
ED 2: N= 88
36. NICU 1: N= 49
NICU 2: N= 43
ED 1: N= 47
ED 2: N= 88
46.9
14.3
28.6
44.2
9.3
34.9
0.0
10.0
20.0
30.0
40.0
50.0
60.0
Trial of New
Equipment &
Technology
Leadership Training Focus Groups
%ofParticipants
NICU1
NICU2
23.4
21.3
31.9
35.2
6.8
12.5
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
Trial of New Equipment
& Technology
Leadership Training Focus Groups
%ofParticipants
ED1
ED2
37. Involved in
trialing new
equipment and
technology
Preparedness
Make ready ahead
of time
Adaptation
Adjust to a new
state
Involved in
leadership
training
Involved in
focus groups
Part of the
design team
Toured the
mock up
Involved in
creating the
patient care
processes in
the new
department
Involved in
choosing unit
design options
for the new
department
Attended the
workshop
report outs
either in
person or via
webex
Receive and
read regular
communication
on your unit
design
TypeofInvolvementin
FacilityDesign
TypeofInvolvementin
ProcessDesign
[S1]
[S1]
[S2]
Prediction
Survey 1
Survey 2
ED Results
38. Preparedness
Make ready ahead
of time
Adaptation
Adjust to a new
state
[S2]
Involved in
trialing new
equipment and
technology
Involved in
leadership
training
Involved in
focus groups
Part of the
design team
Toured the
mock up
Involved in
creating the
patient care
processes in
the new
department
Involved in
choosing unit
design options
for the new
department
Attended the
workshop
report outs
either in
person or via
webex
Receive and
read regular
communication
on your unit
design
[S1]
[S2]
Prediction
Survey 1
Survey 2
TypeofInvolvementin
FacilityDesign
TypeofInvolvementin
ProcessDesign
NICU Results
39. Part of the
design team
Preparedness
Make ready ahead
of time
Adaptation
Adjust to a new
state
Touring the mock up
Creating the patient
care processes
Attending the
workshop report outs
ED
Trialing new equip/
tech
Leadership training
Focus groups
NICU
ED & NICU
Summary Result
Type of Involvement
Process design
involvement is more
critical when the model
of care changes
40. Key Learnings: Type of Involvement
• Being part of design team led to both more adaptation and
preparedness for ED and NICU
• ED’s involvement in design activities led to more adaptation
• NICU’s involvement in process activities led to more
preparedness
We’ve said this multiple times. Being actively involved in the design
phase of the project matters when it comes to being prepared and
adapting to a new space.
Type of involvement produces different results. Understanding the type of
involvement that leads to either adaptation or preparedness help leaders select
the best activities for change engagement.
41. Summary of ED Qualitative Results
ED1 and ED2 ED1 ED2
Excited about
Newness, clean
environment, more space,
better patient flow and
processes.
Concerned about
Proximity to main hospital,
adjusting to changes,
staffing issues
Lack of involvement in
design, not enough
computers.
Communications
Facility designers
Should have
Involved more staff,
considered PICU and or
locations, design issues.
Management/ senior
leadership should have
Involved more staff,
considered PICU and or
locations
Design issues
Comments
Looking forward to prepare
for move, see new building,
staffing.
42. Summary of NICU Qualitative Results
NICU1 and NICU2 NICU1 NICU2
Excited about Private rooms, clean and
new environment
Windows New equipment
Concerned about Staffing, patient safety Size of unit vis-à-vis
response time, not able to
see babies constantly,
how to get help in
emergent situations, not
having enough time with
babies (parent
satisfaction), distance
between patients and
supplies
Nurse safety, staff
morale, proximity of staff
Facility designers
Should have
Involved more staff
members
Designed private rooms
and pods
Made rooms smaller
Management/ senior
leadership should have
Considered staffing Involved more staff Be concerned about staff
concerns
Comments Familiarize with space and
processes before moving,
tour facility, staffing
Have concerns addressed Discuss workflow and
processes, practice on
new communication
system
43. Pre-Design Design Transition Occupancy
Akron: Integrating Design and Change Management
Visioning
Emerging Trends
Current to Future State
Site Visits
Site Visits
Dept. Mock Ups
Spaghetti Diagrams
Expectation
Check Survey
Ambassadors
Pulse points
Leadership Training
Ambassadors
Trials
Post Design Mock-up
Pulse Points
Expectation Check
Survey
45. Design Team
Recommend the need for pre-
design operational planning
with cross-functional teams
Choose design team members
who will serve as ambassadors
- Provide job descriptions
Implement initiatives to engage
staff who are not at design table
- Collect responses to specific
questions
- Post images / drawings
- Communicate
- Solicit constant feedback
Healthcare Leadership
Integrate Change Engagement
concepts into the design/project
plans
Create early dialogue with all
staff and continue through post
go-live
− go to the people
− use many modalities
Establish ambassador program
− how to get many voices
while maintain a small
decision-making group
Establish pulse point checks and
continue three to six months
post occupancy
46. • What interventions help staff prepare and
adapt and when should they be implemented?
• What kind of ripple effect do these results
(with the staff) have on the patient and family?
• What role does leadership play in the staff’s
willingness to adapt and be prepared?
• What design process is the most effective for
preparing staff for their new environment?