Hospital - Emergency Room (ER) Call Triage
The emergency room was constantly being interrupted with phone calls. They wanted to be able to answer the calls that they should deal with and not be interrupted by calls that weren't meant for them.
Hospital Emergency Room
While critically sick or injured patients required attention, the outside world was phoning the ER asking questions such as, who was on call, I have a headache should I come down to the emergency room? While each call was very important to the caller, the fact is that the emergency rooms are not allowed to give out certain confidential information or consulting over the phone on what ails you. These calls were particularly bothersome on the off-shifts when the staff is greatly reduced. The nurse didn't know how important the call was and in many cases had to make a decision on whether to stay with a patient or answer the phone. To exaggerate the problem even more, the calls were also coming to the ER from all areas/departments within the facility. It could be call from a ward wanting to know who the attending physician was or it could be the front desk inquiring about one of the emergency room patients. The emergency room had no way to triage the phone calls to determine what the priority was.
The challenge facing the emergency room was they were being interrupted constantly and always at the wrong time. This created a great deal of stress/pressure on them and the incoming calls amplified the problem. So, ultimately they wanted to be able to answer the calls that they should deal with and not be interrupted by the calls that that should have been directed to others. In addition they wanted to ensure the caller was responded to with little or no delay.
This emergency room discovered this issue during the Enterprise Value Stream Mapping ™ (EVSM®) process. EVSM® is a Lean tool that allowed the emergency room team to look at their process from end to end and identify the areas with the most opportunities for patient improvement.
The opportunities were prioritized during the development of a detailed Implementation Plan using the Future State Map as a guide.
Using specific problem solving techniques the staff identified the main causes of call interruptions. The team found that more than 50% of the calls should be handled in another area.
Lean Healthcare Inc. helped the emergency room teamwork through a Kaizen event aimed at reducing the number of wrong calls to the emergency room. They identified a solution that would route the calls and direct them to the proper area.
At the completion of the event the team had met their goal of reducing the calls by over 50%. The success of the event amazed the employees who were accustomed to changes taking weeks or months to complete, and even then not necessarily getting the dramatic results they expected.
They were also impressed with the cooperation from the support departments such as the information technologies department that helped them quickly set up the phones to properly direct calls. With the Current State map in hand, the ER team was able to show the IT department, and other support groups, exactly the problem they were having and what they required for their Future State. With this information, the IT team was able to design a solution quickly and make the modifications to the system with very little effort.
As for potential patients that were calling in for advice, the results were seamless. One of the major impacts of this change was the improved service to the client/patient. In the past, they would be told by the emergency department that they could not give out advice on the phone and would be given another number to call. This was a source of much patient frustration as well as frustration for the staff.
Now, with the new 'process', the patient receives the desired medical advice immediately and the staff are able to remain focused on what they were professionally trained to do - provide medical assistance to those that need it.