Process Improvement: A Multi-Disciplinary Approach to Advance Patient Care

Establishing processes and standards of practice has proven to be an effective method to elevate overall patient experience. The Canadian Cardiovascular Association has identified that having an efficient wait list is an indispensable element of a functional health care system. With the ultimate goal of rising above the Canadian standard, a multidisciplinary Arrhythmia Services Team at the Mazankowski Alberta Heart Institute was established to look for opportunities and implement solutions. The key concerns were: a long wait list, disorganized work flow, lack of team engagement and inadequate quality assurance. Through various Plan, Do, Study, Act (PDSA) cycles the team implemented a number of solutions. They revised procedure requisitions challenging current wait time standards with well defined patient priorities. Through following the patient's journey improvements were realized including standardized equipment packs, case mix, redefining operating hours and defined consent and start times. Most importantly, a standard of work was established providing the patient with an elevated level of care. Since this work has begun the team has been able to decrease inpatient urgent wait times from 7 days to 3 days. The scheduled outpatient wait time has also seen a significant decrease from 41 weeks to 16 weeks. Over a 2 year course, the patient waiting list went from 256 patients in September 2010 to 141 as of February 2013. By working in a collaborative environment the team was able to decrease care delay and thereby improve patient safety and satisfaction. The focal point is now to continue improving the quality of care delivered.