Engineering professor Chinweike Eseonu meets with a committee of hospital staff who are working on process improvement.
Thanks to television shows like Grays Anatomy, most Americans are familiar with the way a surgery suite is organized: a nurse oversees a tray of instruments that have been laid out in a precise order, so when the surgeon says, ‘Scalpel!’, she can slap the instrument into his hand. It’s good drama, but it also makes sense medically; it lets the surgeon focus on the patient, and it minimizes opportunity for infection. That method of organizing a surgery was developed by an engineer named Frank Gilbreth, who was a pioneer in motion studies.
At the OSU Veterinary Teaching Hospital, medicine and engineering meet again through OSU Professor Chinweike Eseonu and the graduate students in his Process Improvement Group (PIG).
Eseonu has developed a system of goals called the ‘Quadruple Aim’. Health care organizations across the country have been using the Triple Aim for years; it seeks to improve patient experience, improve patient health outcomes, and reduce the cost of care. “What they have found is that there is a missing component in the drive to measure all those things and get reimbursed,” says Eseonu, “That component is employee experience. With the Quadruple Aim, our primary focus is on improving employee experience, and then working backwards.”
Eseonu believes that to improve employee experience, you have to give them ownership of their processes. “Then, in spite of whatever happens, even if there is a total breakdown in management, people want to make things work well.”
Phase one of process improvement began at the hospital in November when Eseonu and his team met with staff from reception to get their ideas for improving front desk processes. “One thing we don’t want to do – that a lot of process improvement folks have done in the past – is come in and say, ‘Based on our previous knowledge this is what needs to happen here — do this.’ In three months we would be back at square one. So our new approach, which has yielded success elsewhere, is very, very collaborative.”
From those early meetings, the PIG team was able to identify one of the staff suggestions as being vital to process improvement. “We realized we needed to create dedicated receptionists for each hospital service,” says Eseonu. “This was based on feedback from the technicians and residents. Patients need to talk to someone who knows enough about a service to relay information accurately.”
Mandy Seals, Client Services Coordinator, worked with the PIG group to assign each reception specialist to a specific service and adapt their schedule accordingly. They will now be trained, and work as part of the service team, meeting regularly veterinary technicians and doctors.
“Clients will like knowing they are specialists,” says Seals. “It will give them confidence. And I think it will give the specialists pride and create more job satisfaction.”
Eseonu adds: “For employee satisfaction, it’s important for them to be able to measure progress and to own something.”
The PIG team also did time studies in the hospital’s Internal Medicine service, and helped Seals modify schedules to provide less overlap, and less waiting time for patients.
“We are now at the end of the first phase,” says Eseonu. “The next phase is to start meeting with individual services. The goal is to have customization where necessary, but also figure out where things can be standardized throughout the hospital.” For example, a committee has been formed to evaluate the open invoice process, and they have decided to modify ‘circle sheets’ (forms that document patient costs) to have as little variation as possible, while still meeting the needs of each service. “That makes closing out appointments a lot easier,” says Eseonu.
“The thing I am most excited about is the participation level of the people who work here,” says Seals. “The flow of ideas that Chin was able to get out of people was amazing. He was able to get people talking about problems, and then come up with solutions they think will work.”
The next phase of process improvement will include doctors. “They are very busy, so we wanted to have something to show them, so they know the process works,” says Eseonu. “Now the technicians are telling them, ‘Yes, this is great; you need to participate.’“
Eseonu has worked with Samaritan hospital and several coordinated care organizations, as well as with manufacturing companies. He finds his work very rewarding. “I get to conduct research and try out new methods. I am fortunate to have clients like the Vet Hospital, who are very open to trying things that they may not have initially been comfortable with. I love the opportunity to be innovative in the way we solve problems, and to make a difference.”
