Decreasing Average Time from Assign to Occupy
Marisa Streelman, MSN, RN, CMSRN and Emily Sermersheim, DNP, MPH, RN-BC
Hospital leadership wanted to address the lag time affecting patient throughput throughout the organization. It was evident, through interdisciplinary interviews, that the handoff process lacked standardization and was bogged down by human elements, including back and forth phone calls between floors and the ED or PACU.
For FY 2016, the average time from assign to occupy was greater than 97 minutes. The goal of the process improvement initiative was to decrease the assign to occupy time to 60 minutes.
Process Improvement leaders held an eight-hour rapid improvement event. They completed a SWOT analysis, benchmarked handoff processes, and created detailed process maps prior to the event. A large inter-professional team validated the process maps, outlined additional improvement opportunities, reviewed pertinent data, completed quality tools, brainstormed, and then voted for viable solutions resulting in the creation of an electronic handoff tool.
A smaller team convened to streamline and standardize the nursing handoff workflow and devise an electronic handoff tool. The team of bedside nursing staff, an Epic representative, a bed manager and unit leadership created the SBAR Handoff Report, which pulls from existing documentation in Epic and aligns with the organization’s preferred communication method of SBAR (Situation, Background, Assessment, and Recommendation). A large rollout and communication plan was completed to create an environment for success.
The current assign-to-occupy metric is approximately 56 minutes. A key strategy for success was engaging bedside nursing staff to create and then promote the revised process to fellow nursing colleagues, thereby facilitating integral end-user buy-in.