Staff within nursing wards A5 and B5 have been working with Operational Excellence since its introduction in 2009. At first, this was done in the form of small projects focusing mainly on improvements, though as time went by the projects started to get bigger. Now, Operational Excellence is an integral part of the culture and nearly all projects are carried out in line with the A3.
The first steps
The staff on the wards have all completed the Yellow Belt training course, which lays the foundations for the application of the methods. Subsequently, we turned our focus onto our everyday duties. How can you work optimally? How should you structure your work process? How do you get from A to B as quickly as possible without skipping anything? How do we avoid having to wait for each other? In what areas are we wasting time and/or energy?
These efforts have really borne fruit. Minor projects and improvements have made a difference, such as stock labelling, establishing structures, and giving everything a specific place to make it easier to find. We've also introduced smart methods and tools, such as notifications when stock levels of certain items are running low. We also laid the foundations to raise awareness among employees: the methods facilitated the successful resolution of identified problems and therefore yielded measurable results.
We used this momentum to initiate a wonderful project in A5 focusing squarely on patients: bedside visits with the doctors. In the past, the whole treatment team would hold a meeting in the office, and then the doctor would visit the patient alone. During these meetings, you are talking about the patient while he/she isn't there, which resulted in a miscommunication rate of 30%.
To allow patients to participate more in their own treatment, we now schedule bedside visits with both doctors and nurses. There are no more preliminary meetings, which means you don't have to discuss things twice as the patient is directly involved the first time. As a result, the project achieved time savings of 1.5 hours per 12 patients per day without this even being a project objective! We are therefore very enthusiastic about this method.
In the meantime, this approach has also been introduced within B5 and we now conduct two visits per week that also involve the family. The goal is to reduce complaints, boost family participation, and reduce the number of discussions in the evenings.
"If you are convinced about something and can visualize the reasons why, then you can clearly and tangibly demonstrate its added value.”Erwin Vanderhoeft Head of Nursing Wards A5 and B5
Lean and methodical working has become part of the ward culture, although that doesn't mean all 80 employees are constantly walking around with an imaginary A3 in their head. And of course, there is natural cross-pollination of these ideas between different departments via working groups within other projects.
New projects are almost exclusively conducted with the aid of Operational Excellence. What is the current state of affairs? What do we want to achieve? What are the possible obstacles? What are our primary sources? And because OE gives you tangible statistics on all of these aspects, you can easily visualize the information for your colleagues and clearly demonstrate the added value.
Anyone can take part in projects: the more the merrier! Working groups usually consist of five nurses who volunteer for the role. The project manager has ownership of and autonomy regarding the project. The head of the ward plays a primarily coaching role and makes decisions together with the project manager based on substantiated expectations. New projects are often managed by recent higher vocational education graduates who will have gained experience with Operational Excellence during their studies and can therefore give their team an important boost.
Nursing wards A5 and B5 projects
Bedside visitsPassengers The project was set up by specialists together with the ward supervisorsDirections Patient participation|January 2015|Project complete and implementedJourney
The entire visit takes place in the patient's room: nothing is discussed outside it. The goal of the project was to increase patient involvement in the process and give them a greater say in medical and nursing policy. As a result, the quality of the visits increased.
Collaboration between A5 and B5 service desksPassengers Desk clerks from wards A5 and B5, the quality coordinator and the HR consultantDirections Start September 2017|implementation May 2018Journey
This improvement process was set up to standardize the work processes of both the A5 and the B5 service desks in order to facilitate more effective collaboration..
Bedside visits together with a partner/informal carer within ward B5.Passengers The project manager (a nurse with a higher vocational education nursing degree) was supported by the ward supervisor and the team of nursesDirections January 2018|The project received a positive evaluation and is now being implemented.Journey
Twice a week (on Tuesdays and Thursdays), the partner/informal carer can be present during the bedside visit. The nursing staff must be notified of their attendance in advance. The evaluation shows that patients' families really appreciate this opportunity and that the number of family consultations in the afternoon has declined as a result.