g3 rita janke - all in good time: reducing the lead time for multidisciplinary summary assessment...
TRANSCRIPT
All In Good Time: Reducing the Lead time for multidisciplinary summary assessment reports to Zero
30 days 0 days
Context Complex Developmental and Behavioral
Conditions Team (CDBC). Sunny Hill Health Centre for Children (SHHC),
Child Development and Rehabilitation Program of BC Children’s Hospital.
CDBC at SHHC is part of a Provincial Network providing multidisciplinary diagnostic assessments for children with complex needs.
Current State Process
The Problem
Team Summary n=16
27%
No Team Summary n=44
73%
Percentage of Families who received a Team Summary n=60
Sunny Hill Standard: Families will receive a Team Summary within 6 weeks of their family conference.
The Problem: Community Service Provider Voice
Telephone message: “ Hi Veena, this is Jane (Community Social Worker), you worked on a team that saw my client and I am trying to connect her to services in the community. I’ve looked through the reports and…. I can’t figure out what the diagnosis is. Can you please call me back for some clarity.”
Letter received by Sunny Hill from a Community Pediatrician: “I just received a 7 page report on the speech and language evaluation of this boy. It is difficult to use such a report when there is no summarizing of the results and simply reams of detail. To simply include long lists of things that he can and can’t do without there being an overall summary does not seem very helpful to those receiving such a report in the community. The most important point with ANY consultation/assessment is the summary.
The Problem: Family Voice
When will my child’s reports be
ready?
Actions undertaken
Team of clinicians to engage in process Value stream of process Identified opportunities for improvement Team idea to develop new process for Team
Summary Simulation to trial the process
The TEAM
Developmental Pediatrician Occupational
Therapist Psychologist Speech
Language Pathologist Social Worker Program
Manager Process
Improvement Support
Value Stream: Identifying Improvement Opportunities
Before….. Team synthesis of
assessment results and diagnosis
Aim
To develop a CDBC team summary process which supports distributing the team summary report immediately following the family/team conference. To develop a team summary process which
support team synthesis of diagnoses. To reduce lead time from family conference to
receiving the team summary report to zero.
The Idea
Specific Issue Addressed
Development of a agreed upon team summary content and format. Development of team standards for timeliness
of reports Scheduling of rounds and family conference Required Technology for real-time
documentation. Team dynamics.
Increase team completion of report during team rounds process from 0% to 100%.
UCL
LCL
0%
20%
40%
60%
80%
100%
120%
4/2/
12
4/9/
12
4/16
/12
4/23
/12
4/30
/12
5/7/
12
5/14
/12
5/21
/12
5/28
/12
6/4/
12
6/11
/12
6/18
/12
6/25
/12
7/2/
12
7/9/
12
7/16
/12
7/23
/12
7/30
/12
8/6/
12
8/13
/12
8/20
/12
8/27
/12
9/3/
12
CDAS Completed by Staff During Team Rounds Percent
Measures for Analysis & Results
Increase consistency of reports delivered to families from 27% to 100%
UCL LCL
0%
20%
40%
60%
80%
100%
120%
9/10
/12
9/17
/12
9/24
/12
10/1
/12
10/8
/12
10/1
5/12
10/2
2/12
10/2
9/12
11/5
/12
11/1
2/12
11/1
9/12
11/2
6/12
12/3
/12
12/1
0/12
12/1
7/12
12/2
4/12
12/3
1/12
1/7/
13
1/14
/13
1/21
/13
Percent of Children with a Completed Team Summary Percent
Measures for Analysis & Results
Measures for Analysis & Results
Reduce the lead time of families receiving the team summary from 30 days to 0 days
UCL
LCL
0%
20%
40%
60%
80%
100%
120%
9/10
/12
9/17
/12
9/24
/12
10/1
/12
10/8
/12
10/1
5/12
10/2
2/12
10/2
9/12
11/5
/12
11/1
2/12
11/1
9/12
11/2
6/12
12/3
/12
12/1
0/12
12/1
7/12
12/2
4/12
12/3
1/12
1/7/
13
1/14
/13
1/21
/13
Percentage of Families who received the Team Summary at the Family Conference Percent
Results……
Lessons learned
Preparation time is important Involvement of clinicians in the development
of the process Technology has to support process Champions of change-peer coaches Visible management support
Overall impacts of the work
Anecdotal feedback Decrease in family request for information related
to diagnosis Positive community feedback
Family Evaluation in progress Team Survey measure- early results
Contact Information
Lesley Howie Program Manager Complex Developmental Behavioural Conditions Network Sunny Hill Health Centre for Children [email protected] 604-453-8300
Rita Janke Quality, Patient Safety & Accreditation Leader Sunny Hill Health Centre for Children [email protected] 604-453-8300