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