Process improvement projects often lack the structure and buyin to achieve their goals. The Rapid Process Improvement Workshop (RPIW) is one quality improvement tool to make QI projects more effective.
To utilize RPIWs to address QI issues on inpatient medicine: blood culture contamination, the macro discharge process, and the micro discharge process.
In an RPIW, representatives from all parties that touch a process come together for an intensive, highly structured week of process observation, process mapping, and eliminating waste to ultimately create a future state. Through rapid cycle change, participants trial potential solutions to move toward this future state and reach their aim. Our institution identified a higher than acceptable blood culture contamination rate, which created excess work for the microbiology lab and exposed patients to unnecessary antibiotics and bed days. The RPIW implemented standard procedure for blood culture draws, leading to reduction of the blood contamination rate by over 100%, which is now even lower than the national standard. By identifying waste in the microbiology process, hundreds of work hours were also saved. The macro discharge RPIW aimed to more efficiently have the right patient in the right bed at the right time. The group identified that a small patient population with specialized needs accounted for the bulk of excess bed days. Through the creation of an Advance Disposition Team which meets weekly, these challenging cases are proactively identified. To date, 13 patients have been placed in contract nursing facilities, saving an estimated >100 acute inpatient medicine bed days. The micro discharge RPIW focused on increasing morning discharges to reduce the number of patients waiting excessive hours in the emergency department, and also create beds for direct admissions and transfers to improve continuity of care within the VA system. By creating shared communication tools regarding each patient’s discharge plan, the various members of the multidisciplinary team can now prioritize workflow to expedite discharges.
The RPIW is an effective tool to address challenges that are common to inpatient medicine. The structure of the RPIW process, active participation of all invested disciplines, and rapid cycle change allow for greater success of process improvement projects.
To cite this abstract:Breckenridge J, Allaudeen N, Helgerson P. Quality Improvement Through Rapid Process Improvement Workshops. Abstract published at Hospital Medicine 2012, April 1-4, San Diego, Calif. Abstract 97748. Journal of Hospital Medicine. 2012; 7 (suppl 2). https://www.shmabstracts.com/abstract/quality-improvement-through-rapid-process-improvement-workshops/. Accessed July 21, 2019.