Embed Size (px)
Citation preview
A simple tool to improve patient flow:Communication design to nudge Quality Improvement
Rich Dillon, Carmen Dyck, Dr. Janet Joy, Dr. Gui Noël
Quality Forum 2016: Session D4
None of the presenters have any affiliations (financial or otherwise) with a commercial organization related to this work
1. Improving patient flow is a key priority for healthcare today
2. Timely hospital discharge is critical towards improving system flow. To address this, Richmond Hospital (RH) started the 2 x 9 initiative
3. We needed to create a new QI system to display daily discharge data
4. Many QI data reports leave staff believing that our goals are more about numbers, and less about patient care. In our display, we wanted to highlight that this work was about patient care.
Aim & Context
Our Assumptions
Nudge theory: Non-forced incentives can influence change initiatives
To transform patient flow and care, we need to break out of the typical hospital silos and find a new way to work together
It’s a new (data) world. The way you communicate and display data can change people’s behaviour, as well as how they feel about the work
Our Assumptions
Our Assumptions
Our Decision
We wanted to go beyond the typical ways of displaying data,
so we hired a designer to come up with new ideas
Design is important because it creates tools to affect the feelings, knowledge, attitudes, and behaviours of people. It can turn existing realities into better ones.
Design brings the possibility to empower people to improve health and healthcare.
Why is communication design so important?
User centred design is an approach that requires active participation in the design process of everybody involved (patients, healthcare providers, leaders).
Designing for others and caring for others both require a deep understanding of “the others.”
What is user-centred design?
Attention Memory Previous knowledgePrevious experienceExpectations
MotivationValuesCultureEmotions
Text/ContentTopicGenreWritten styleVocabularyOrganizationVisual design
Distractors
Light
Vocabulary level
Reader
Reading purposeLevel of difficultyLevel of interest
Reading environment
The patient discharge time board
Units
Date
Patient discharge times: How are we doing?
ED
DTU
2S
3S
3P
3N
4N
6N
PEU
anticipated actual
000-800 800-1000 1000-1200 1200-1800 1800-2359
Transforming
care
.......
........
........
Work toward safe and timely discharge. Patients and families will thank you for it!
# of dischargesour goal
VCH-Richmond
00:00-08:00
000-800
The biggest changes we’ve seen
We moved from a mentality of resistance and pushing, to pulling
There is a sense of ownership for patient flow at all levels – it’s transformed our teams and how we work together
Performance: Impact on our P4P numbers
Our most significant lessons learned
By reminding staff that the patient is at the heart, such displays can motivate QI in ways that accountability data do not
Providing hands on support & displaying timely data in a meaningful way can change everything
A relatively small investment ($2500) in data display can help revolutionalize how we approach our daily standard work
Where we still struggle
We need to find more ways to balance data for senior level accountability with data that also speak to unit-level staff
Using design principles to create our displays–right now, it’s often considered a ‘nice to have’ and not a ‘necessary to have’
Discussion Question
How in our health authorities can we change the way we display QI data, to engage the hearts and minds of our point of care staff?
Contact Information
Rich Dillon Richmond Hospital, Manager of Patient Flow & Care Transitions [email protected]
Carmen DyckVCH Quality Improvement Advisor [email protected]
Dr Guille NoelFrascara-Noel Visual Communication Design [email protected]
Dr Janet JoyVCH Director of Innovation and Evaluation [email protected]
