I started out this morning "In Your Shoes" with the preoperative staff before patients went to surgery. I had a chance to serve as a Patient Representative and follow Dr. Scott and Dr. Norm's patients through surgery, into Recovery and then paid them a visit once they were settled on the inpatient unit. I did try to go incognito, with scrubs and a badge with just my first name showing. Word got around fast - a family member asked if I was the CEO...they still agreed to let me observe the surgical flow process for the patient. Thank you to Lois, Sean and Dr. Norm for explaining things throughout the surgery.
Every step of the way, critical steps were followed with constant communication across all parties like a well conducted symphony. Of course, that is a key element when things go well and a key breakdown when things don't go smoothly.
Talking about the right communication needed, let me take you back for a minute to to the charity event with my kids. I parked the car and met my wife at the end of the line. She then took our kids to the back to get them ready. I noticed several people giving what I considered evil stares. After a few minutes, I was still at the end of the line with no one behind me and my son asked if he could walk around. He said since we were at the end it would be easy to regain our spot. Just then it hit me like the end of The Usual Suspects with Kevin Spacey...I went back and found the glares were still on me and, you guessed it, the "end" of the line was actually the front of the line. I confirmed with the person now behind me who had probably camped out since last night. Yes, my son and I headed to the real back of the line.
The point being, sometimes processes are not so obvious and we all need to speak with each other more freely to ensure we don't miss anything. As we enter these next few years, we are not only challenged with the changes with healthcare reform but with the overall new world as we now realize. We must continue to provide incredible care and an exceptional patient experience at a lower cost than we provide today. That will come from constant communication with each other and standardizing processes where we can. In addition, those process improvement competencies will be more critical than ever before.
Check out this initial flow chart for getting a patient from the emergency department to the inpatient floor. By involving the right people around the table, the new process will probably take out 40-50% of steps, getting patients to the most appropriate level of care in a very timely manner.