Based on the assessment, a project plan was established that focused on front-end redesign, streamlining of documentation, and improvements in the admitting process. Two consultants were utilized to support the project. One consultant focused on the process improvement activities, leadership development, and triage training. The other, serving as interim director, provided department leadership to support the needed changes. A new organizational structure was put into place with robust leadership development training for all existing ED leaders.
To design the process changes, staff-driven work teams were utilized. The Philips Blue Jay Consulting process improvement consultant facilitated the teams and guided the staff through the redesign process. Staff champions were identified and they assisted with the implementation. A different team was established for each improvement project and the efforts were sequenced such that staffing demands on the unit were tolerable and the pace of change was sustainable.
Project updates were provided at biweekly steering committee meetings that alternated with updates to the executive team. Metric performance was reviewed daily and posted in the department. The data was also discussed in pre-shift huddles.