Kaizen Implementation Reduces Paperwork for a Inpatient Unit

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Using Lean Six Sigma to Reduce Paperwork for an Inpatient Unit

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Client: An acute care facility located in the Midwest with 364 beds
Industry: Healthcare
Service: Kaizen

Challenge:

Documentation has become very cumbersome and time consuming for nurses processing patient admissions, discharges and patient care documents
Set a goal of freeing time for the clinical staff to be with patients, rather than doing paperwork

Solutions:

A Lean Six Sigma approach was utilized to analyze the volume, content, frequency and purpose of each document associated with admission and discharge
A Sigma Kaizen Breakthrough event was utilized to determine a course of action to reduce duplicated information and implement new processes to support a more streamlined approach

Results:

Reduced minutes devoted to admission documentation by two-thirds (from 60 to 20 minutes)
Reduced the number of forms from 16 to 11
The team also felt that staff satisfaction and ultimately staff turnover would be positively impacted in the future

This hospital based long-term care unit wanted clinical staff members to devote more time at the patient’s bedside, rather than completing paperwork. Multi-disciplinary staff was duplicating information and spending too much time in completing the documentation.

The analysis included observations of work, interview of staff members, research on other units and via the Internet and development of a needs analysis for what data was required. Outside experts were also consulted including those with expertise in JCAHO compliance, the internal Forms Committee Process and state regulations for this type of facility.

Following the analysis, the group decided to develop a multi-disciplinary Comprehensive Assessment for admission and ongoing charting for patients. This approach would incorporate the elements of other current forms onto one document. The following documents were among those to be altered, deleted or incorporated into another document:

Four assessments
Problem list
Side rail preference
Patient rights forms

As each element of the Assessment or new form was developed, the staff was in-serviced with the dual goal of training staff on the form and gaining feedback regarding the change. Changes were not implemented at the same time so staff could make the transition easily. During the new form trial period, feedback was received regarding usefulness of the new document and measurement of reduction of time versus the previous process.

Overall the number of minutes devoted to admission documentation was reduced from the 45-60 minute range per patient to 15-20 minutes per patient. In addition, total admission forms were reduced from 16 to 11 including all those mandated by regulatory agencies. The team also felt that, longer term, staff satisfaction would be positively impacted and this was evident in initial feedback from staff regarding the changes.

The team was able to achieve goals in terms of providing clinical staff additional time for patient care and relieving them of documentation that was proven to be redundant and/or unnecessary.