Assignment:
Based on the information in the case, create a project charter for this project.
MINI CASE
Good Health Hospital Elective Admissions Project
Project Background
Congratulations! The Good Health Hospital Process Improvement Steering Committee has approved your request to study and improve the admitting process for elective hospital patients. (Elective patients are non-urgent, non-emergency patients for whom hospital admission reservations are made in advance.)
Your study has attracted the attention of Dave Wait, chief executive officer of the hospital. Recent customer survey data reveal that "long waits in elective admissions" are a major source of customer dissatisfaction. Dave regularly reviews the minutes of the steering committee and has long felt the elective admissions process was a key candidate for improvement. Apparently, Dave has been the recipient of numerous complaints from physicians and their elective patients about the long waits in admissions. He has sent your team a brief note of encouragement (see below).
Good Health Hospital, located in a rapidly growing semi-metropolitan area of northern California, is a 250-bed general hospital helping serve the medical needs of a district with an approximate population of 100,000 people. Opened in 1972, Good Health has as its mission to provide quality health care serving the inpatient disease and injury needs of the Santa Rosa community.
Your team consists of the admitting manager, two admission clerks, a physician, two nurses, and an environmental services (i.e., housekeeping) supervisor. As individuals who work in or directly with admitting, you know the critical role the admitting process plays in smooth hospital operations. The admitting function, in fact, is a hub of activity that affects almost all other hospital activities and departments.
Your project began as the result of casual lunchtime conversation among the managers of nursing, environmental services, and admitting. In recent brainstorming meetings with their individual staffs, these three had discovered that problems in processing elective patients into the hospital were particularly frustrating to each area, although for different reasons.
Nursing complained that patient records that accompanied the patients from admitting were incomplete. Patients also arrived at nurse stations unexpectedly. In addition, according to nurses, elective patients seemed to arrive at the most inconvenient times. Environmental services complained that everything is always in a rush.
Admitting department personnel are frustrated because rooms seem never to be available. Patients and their loved ones get anxious and upset when they have to wait and, as the first point of contact in the hospital, admitting personnel must interface directly with dissatisfied customers. The admitting department, in fact, had recently gathered data on average elective patient wait time and had found it to be over an hour. They defined patient wait time as the elapsed time between a patient's arrival at the hospital reception desk and his or her arrival at either a room or one of the hospital departments for tests or procedures.
Admitting personnel also experienced frustration because parts of their jobs (for example, verifying insurance and tracking down missing test results) took lots of time. And, in some instances, these tasks had to be completed the day the patient arrived for a hospital stay. Occasionally, admitting personnel had to gather additional information from the physicians' offices and sometimes patients had to wait in admitting because no escorts were available to transport them to a room or test-procedure location.
In follow-up conversations, the admitting, nursing, and environmental services staffs agreed to collaborate on a joint improvement project; they were all involved in the process in one way or another, so a cross-departmental effort seemed to make sense. The three managers submitted a request, with a list of proposed team members, to the hospital Process Improvement Steering Committee. The committee approved the project, adding a physician to the proposed team. Everyone agreed the problem was an important one. Improving this process should increase external customer satisfaction and have a positive impact on internal hospital operations as well.
Letter from the CEO
GOOD HEALTH HOSPITAL
MEMORANDUM
TO: Elective admissions process improvement team
FROM: Dave Wait, CEO
I am pleased to learn your group will be tackling the important process of elective admissions. As you may know, Good Health's increasing occupancy rate (over 85%) coupled with our successful efforts to reduce average lengths of stay, has resulted in an increasing number of admissions. I am concerned by physician, patient, and nurse complaints about the excessive time required to admit an elective patient. I understand it has taken some patients as long as two hours to be admitted. I am especially disturbed that, in a recent customer satisfaction survey, the number one most frequent source of dissatisfaction among elective patients was "long wait time in admissions." Increasing patient satisfaction is one of several key initiatives at Good Health, and improving the elective admissions process will certainly contribute to achieving this important strategic objective.
Because we have some control over the schedule of elective admissions, I am confident your team will be able to significantly reduce wait times. At recent Directions in Health Care CEO Symposium, I learned that the best hospitals in our size and occupancy category are able to process incoming elective admissions in about 20 minutes. I am disturbed that we are nowhere near that figure. However, it is critical that, in reducing elective admission times, we do not compromise the quality of admission service. The information admitting provides to the rest of the hospital must remain timely, accurate, and complete.
Finally, you may be aware that we expect a visit from the Joint Commission on Accreditation of Healthcare Organizations sometime next calendar year. Because of their interest in efforts to improve operational performance, it would be ideal if you could complete your work and be able to demonstrate some real improvement in this area within six months. Doing so would provide us an opportunity to showcase a successful improvement effort.
I have encouraged your managers to provide you with the time you need - estimated at an average of two hours a week for the duration of the project - to address this important problem. In addition, a small budget of $2,000 is available to the team to cover expenses associated with meetings, data gathering, benchmarking, and the like.
I wish you the best of luck in your efforts. I hope you will keep me informed as the project unfolds, and I look forward to reading your final report and recommendations, and to hearing your team's final presentation.