The Big Picture: Patient Care

Have you ever been admitted to hospital and wondered what people or processes are put in place to ensure a smooth transition throughout your health-care experience? Or, have you ever wondered how various members of your health-care team communicate with each other regarding your care?

An electronic system consisting of multiple television screens, known as the visual management system, has been put in place at the Health Sciences Centre to help members of the patient’s health-care team plan patients’ care from admission to discharge.

New Visual Management System for patient care at the Health Sciences Centre

New Visual Management System for patient care at the Health Sciences Centre

Patient flow’ is a concept commonly used in hospitals to describe the movement of patients throughout the health-care system. The entire process: from being seen by a physician, to being admitted on a hospital unit, to the services received during the patient’s stay like X-rays and other diagnostic test…and even the discharge plan (which may include community supports), is referred to as patient flow.

As with other Canadian health organizations, maintaining patient flow within Eastern Health can be challenging. One of the main challenges is maintaining continuous communication among the numerous health teams that play an integral role in the patient’s care.

In November 2017, a group of 21 Eastern Health employees from nursing, medicine, paramedicine, social work, community, placement services, rehabilitation, admitting and analytics, came together to study the current process of a patient’s journey through the health-care system.

“Our task was to understand and potentially improve how information was shared between acute care, rehabilitation, long-term care and community,” says Matthew So, the admission discharge manager at the Health Sciences Centre.  “Our goal was to improve patient satisfaction – and outcomes – by ensuring that patients in hospital receive the appropriate services at the appropriate time.”

A patient’s hospital stay often involves coordination among several departments

A patient’s hospital stay often involves coordination among several departments

As well, the team considered ways to decrease a patient’s length of stay in hospital, so that individuals in emergency departments, recovery rooms or outpatient clinics could readily receive beds when needed, while also ensuring that they have everything they need to return home safely when discharged.

The result? A Visual Management System – an electronic system that has been developed to help visualize patient flow for the benefit of patients.

But just how to make this all happen? In December, several of the original 21 employees worked with staff on three medicine units at the Health Science Centre to develop an ‘electronic’ tool to help assist with patient flow. In other words, to come up with a way to ‘see’ a patient’s journey before, during and after admission to hospital.

Prior to this project, each nursing unit was using a whiteboard to manually share patient information and discharge plans with the entire health-care team. Within three months, the team, along with front-line staff helped design an innovative, real-time, global electronic system that links acute care, community, long-term care and rehabilitation.

The new visual management system automatically pulls information from various sources, which allows any member of the health-care team to quickly look at the unit television screen and find any or all of the following patient information:

  • patient’s demographics,
  • diagnosis and/or surgery,
  • most up-to-date physician or nurse practitioner notes,
  • any recent blood work or diagnostic test, and/or
  • expected date of discharge,

Important information is also colour-coded, so with one quick glance the team can tell if the patient is awaiting a bed in long-term care or another hospital. The team is even able to tell if a patient was receiving care in the community prior to their admission, in case follow-up is needed.

The Visual Management System control centre takes shape

The Visual Management System control centre takes shape

The ability to see this information at a glance has allowed for more in-depth discussions amongst team members early in the patient’s journey – which helps keep the patient on track for their predicted length of stay, and ensures that other individuals who require hospital beds are able to receive them.

The building of the electronic tool has also meant greater communication between acute (hospital) care and community care – resulting in a more concrete discharge plan for patients, according to Annette Pardy, the care facilitator of 5NA (Orthopedics), at the Health Sciences Centre, who’s been helping to roll out this system to her nursing unit.

“Since implementation of the Visual Management System on 5 North A, the team has become extremely focused in identifying any discharge concerns when the patient is actually admitted,” says Annette. “We are able to ensure that when the patient is ready for discharge home, all the patient’s needs are met by his or her expected discharge date, which helps improve efficiency and ‘flow’ on our unit.”

Recently, the team has also started building a patient flow “control centre” at the Health Sciences Centre, which resembles an air traffic control centre, an accessible and efficient tool for any member of a patient’s care team.

It’s all about improving patient access to services. The television screens are truly changing how health-care professionals do their work – across the full continuum of care – not just today, but well into the future.

The long-term goal is to see this patient flow system on television screens in patient units throughout all Eastern Health facilities. It’s exciting to watch an electronic system that was built from the ground up, become a tool that will improve patient flow, access to services…and ultimately, the quality of patient care we provide.

For health-care professionals like me, this is certainly ‘television worth watching,’ and the program is just beginning – so stay tuned!” ■

This story was written by Courtney Kendall, program manager of Clinical Efficiency at Eastern Health and project lead of the Visual Management System.

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