Real-Time Visualization To Increase
Efficiency, Effectiveness, Flow and Quality
Southlake Regional Health Centre
Newmarket, Ontario, Canada
Our Hospital – Our People – Our Patients
Fiscal 2013/14 Statistics
Southlake - A Decade of Volume Growth
Indicator 2003/04 2008/09 5 Year
Growth
2013/14 5 Year
Growth 10 Year
Growth
Inpatients 17910 20723 14% 24782 16% 28%
ED Visits 57004 70277 19% 98326 29% 42%
Cardiac
Cath
3181 5285 40% 6116 14% 48%
Angio/PCI 437 1806 76% 2176 17% 80%
CVS 133 925 86% 1050 12% 87%
Staff 2056 2771 26% 2995 7% 31%
Radiation
Treatment
n/a n/a 24867
Patient Flow
Model of Care Review
PFN Role
Daily Utilization
Data Capture
Estimated Date
of Discharge
ED Physician Initial
Assessment
ALC Strategy
Physician Related Waits
Medical Assessment and
Consultation Unit
Visualization Tools
Quality and Patient Flow
Funding Changes
A Decade of Growth Meets Patient Flow Opportunities
Information in real time at a glance - from anywhere
Overall Goal – Corporate Patient Flow Visibility
Interpreting Symbols
• The room number is 271
• The patient is female
• She is an inpatient
• She is located in the Cath lab
• She has been in the Cath lab for 1hr 44min
• Her EDD/Potential Discharge is Saturday
The Southlake Way – Changing the Culture
Real Time Transparency Across the Organization
Engaging Frontline Staff – What is in it for me?
ED & OR Staff
IP Unit will see incoming icon
We Heard You – Use the Data We Have
Desktop Solution & Large Monitor
• PHI available on desktop, details
on all patients & incoming patients
• Improved relations between units
• Elimination of daily phone time
• Reduction in interruptions
• EDD - Prioritize Patients/Workload
on unit & in other departments (DI/rehab/support services/biomed/etc.)
Incoming Icon
Engaging Staff in Real Time Tracking
• Touch Screen & Electronic Messaging
• EVS Turn Around Times
Where Is My Patient?
• Electronic Messaging
• Manual? Cardiac OR/Family
• Timer
• Hiding Beds Gone Home
< 24h OVERDUE < 48 h
Tues Thurs
> 48 h
12/27
> 7 days
YESTERDAY TODAY TOMORROW LESS THAN
7 DAYS MORE THAN
7 DAYS
Enabling Patient Flow Thru Visibility
Estimated Discharge Date – Electronic Message
Patient Flow Tracking - An Executive Lens
Patient and Staff Quality and Safety
Pushing the Envelope
• Quality & Patient Safety
Infection Control
Quality Improvement Plan (QIP)
Emergency Codes - Accessibility
• Allied Health
Pharmacy, Diagnostic Imaging, Rehab,
Lab
• Others
Biomedical Equipment, Food Services, Clinics, Finance
Initial Outcomes
Indicator Change
Patients waiting in ED 9 to 7.5 patients -17%
DTA to Admit 19.3 – 15.8 hrs. -19%
Falls with Outcomes 0.28 to 0.14
Per 1000 pt. days
-50%
Interruptions -400/day 12.2 hrs.
Phone Calls -960 minutes/day 16.0 hrs.
EDD 52% to 78% +25%
From the Staff…
“There is more ownership by all the
nurses. Before it was just the Charge
Nurse’s responsibilities, now we are all
invested in the process.”
“From my position, it’s a great tool to
manage patient flow.”
“Oh, I get it – it’s like the Board for the
whole Region – that would be fantastic.”
Independent Longitudinal Study
Perceptions of Sustained Effectiveness
Question
March
2012
(Pre)
June
2012
July
2013
It is easy to find how busy units and
departments are
30% 52% 56%
I think that using the MPV makes my job
easier
29% 50% 56%
I think that using the new MPV system
improves my job performance
26% 43% 47%
I think that using the new MPV system
increases my productivity
29% 50% 48%
I am concerned
that the MPV
system won’t
always be available
48%
Data Sources: Daily Medworxx captured by Decision Support
95% 96% 96% 95% 97% 97%
96% 98%
97%
98% 96% 97%
95% 96% 97%
96% 95% 95% 96% 96%
20%
37%
52% 56%
52%
45%
69%
74% 80% 82%
87%
84%
88% 89%
87%
85% 83%
89% 86% 85%
43%
69%
77%
82% 80%
87% 88% 92% 91% 90%
86%
89%
86% 88%
88% 85% 85%
81% 82%
84%
22%
38%
98%
97% 95% 95% 94%
92%
93% 89%
92% 95%
94%
56% 57%
62% 60% 60%
10%
30%
50%
70%
90%
110%
Pe
rce
nt
of
Cas
es
wit
h E
DD
Co
mp
lete
d
Month of EDD Completion
Medicine Program Cardiac Program Surgical Program Adult Mental Health Maternal Child
Visibility Culture Metrics
Program LOS Variance From 50th Percentile FY 2007/08 ♦ 2008/09 ♦ 2009/10 ♦ 2010/11 ♦ 2011/12 ♦ 2012/13 ♦ 2013/14
0.21 0.35
0.01
-0.32 -0.28 -0.36
-0.64
-1.5
-1
-0.5
0
0.5
1
1.5
FY 2007/08 FY 2008/09 FY 2009/10 FY 2010/11 FY 2011/12 FY 2012/13 FY 13/14
Va
ria
nc
e (
in d
ays
)
Fiscal Year
SRHC Cardiac MatChild Medicine Surgery
22
Data Source: DAD, CIHI
Sustainability and Pushing the Envelope –
Further!
Questions – Comments - Discussion