CASE STUDY Moreno Medical Center (MMC) is a 600-bed, full-service acute care facility located in the Northwest Kelsey community. The hospital is a physician-owned, for-profit hospital that takes pride in the provider-patient relationship. With recent changes in managed care, every dollar, process, and interest of the patient serves as a common ground for making an organization more efficient. To remain competitive in the marketplace, the management team at MMC decided to take a look at various processes within the hospital and noted that the overall patient experience in the outpatient surgical clinic was less than satisfactory. The main problem seems to focus on long delays throughout the entire admission to discharge process. If the hospital wants to maintain its competitive position, the administration will have to redesign the current process to improve patient satisfaction. The hospital administration appointed an internal quality consultant to facilitate the planning process. The quality consultant for this new organizational role is an experienced intensive care RN with a business degree. She understands that health care is a personal encounter and that patients and families expect to have their priority needs met when experiencing a health care issue. The quality consultant decided to work closely with the surgical department RN administrator who would be a powerful change agent in leading the improvement process. During the review of the surgical department processes, the administrator and consultant identified several major issues: Surgeons delaying surgery times causing backlog of surgery schedule Other hospital departments (e.g., admitting, finance, lab) conducting separate encounters with surgical patients without regard to the surgery schedule Long wait times for patient transportation from surgical area to recovery room Ancillary staff providing patient discharge instructions when nurses are busy Nursing staff displaying a culture that the procedure, not the patient, is the priority The surgical department RN administrator acknowledges that changes need to occur and the new process must be guided by what is in the best interest of the patient. He developed a new vision statement for the department with its first priority to provide a patient and family focused quality care culture.

Introduction

In healthcare organizations, providing a positive patient experience is crucial for maintaining competitive advantage in the marketplace. Moreno Medical Center (MMC), a physician-owned, for-profit hospital, recognized that the overall patient experience in its outpatient surgical clinic was less than satisfactory. Long delays throughout the entire admission to discharge process were identified as the main problem that needed to be addressed. The hospital administration appointed an internal quality consultant, an experienced intensive care RN with a business degree, to lead the improvement process. The quality consultant chose to collaborate closely with the surgical department RN administrator, who would serve as a powerful change agent in implementing the necessary changes. Together, they identified several major issues in the surgical department processes, including surgeons delaying surgery times, other hospital departments conducting separate encounters without regard to the surgery schedule, long wait times for patient transportation, ancillary staff providing discharge instructions when nurses are busy, and a culture that prioritized procedures over patients. The surgical department RN administrator recognized the need for change and developed a new vision statement that prioritized a patient and family-focused quality care culture.

Analysis of the Situation

The first step in dealing with the identified issues is to understand their root causes. Surgeons delaying surgery times and causing a backlog in the surgery schedule indicates a lack of accountability and adherence to proper time management practices by the surgical team. This could be due to various factors such as poor communication, lack of coordination, or individual surgeon preferences. It is essential to address this issue by implementing protocols and guidelines for surgery scheduling, ensuring clear communication among the surgical team, and holding surgeons accountable for adhering to the schedule.

The separate encounters conducted by other hospital departments without considering the surgery schedule indicate a lack of integration and coordination among different departments. This can lead to inefficiencies and delays in patient care. To improve this situation, it is necessary to establish a multidisciplinary team approach, where all relevant departments collaborate and communicate effectively to ensure smooth patient flow throughout the admission to discharge process.

Long wait times for patient transportation from the surgical area to the recovery room highlight a bottleneck in the patient flow process. This could be a result of insufficient resources, inadequate staffing, or inefficient logistics. It is important to identify the specific causes of the bottleneck and address them accordingly. This may involve increasing resources, optimizing staffing levels, improving communication and coordination between departments, and streamlining the transportation process.

The issue of ancillary staff providing discharge instructions when nurses are busy suggests a lack of clarity in roles and responsibilities. It is essential to clearly define the roles and responsibilities of different staff members involved in the discharge process and ensure that tasks are delegated appropriately. Additionally, proper training and education should be provided to ancillary staff members to ensure they can effectively handle discharge instructions when necessary.

The culture within the nursing staff that prioritizes procedures over patients indicates a need for a shift in mindset and values. It is important to foster a patient-centered culture that emphasizes the importance of individualized care, empathy, and patient satisfaction. This can be achieved through education, training, and fostering a supportive work environment that values patient-centered care.

Conclusion

Improving the patient experience in MMC’s outpatient surgical clinic requires addressing the identified issues and implementing necessary changes. This includes addressing the root causes of delays, improving coordination and communication among different departments, addressing bottlenecks in patient flow, clarifying roles and responsibilities, and fostering a patient-centered culture. By implementing these changes, MMC can improve patient satisfaction, enhance its competitive position in the marketplace, and ensure the overall success of the organization.