Shelley O’Hara and Chantelle Ottone
The work that we did together was the MRI shared webpage for the triaging of inpatients. The idea behind that was to get the ward staff to have an idea of when their patients would go to have an MRI. MRI has been operating in this hospital for 20+ years and some of the systems in place were unfortunately no longer efficiently satisfying the workflow needs. There is no integration between the internal work-lists and the ordering system on the wards. So at times patients were waiting for an MRI for up to two weeks, but most of that time was perhaps us waiting on the correct paperwork to come down and therefore the causes of delay weren’t transparent.
At Tier 2 meetings we would find patients have been waiting 2 weeks, but there is no information as to what the delay is. The new triaging webpage openly, transparently shows you what we are waiting on. The smallest amount of time is actually between the paperwork getting down to us and the patient being scanned. We discovered a lot of double handling when we actually looked into the processes that were going on. Every craft group were working incredibly hard, but doing the same thing and there was a lot of overlap between the nurses, the receptionists, the radiographers and our doctors. That just created so much double handling – it was really hard to get a gauge of what was going on. I think the hardest thing that we did was trying to find a solution. And the solution we came up with was a webpage, which originally was the most outrageous. People were like you can’t do that but we couldn’t think of a better idea. Dave Higgins in IT was instrumental in bringing this vision to fruition. So the project hinged on us working with IT to setup this webpage.
One of our doctors started something similar on Excel which was working to an extent within our department, but we needed to give transparency to the wards. So we turned that Excel spreadsheet into something on SharePoint that everyone can access. It wasn’t that simple because there are tight restrictions around IT and what you can do in that space. We almost got there and then Dave Higgins got an email from SVHA IT saying we need to install this, we need to fill out this paperwork, and we need to have it all approved. Fortunately it indeed up going ahead. I think we lost a little bit of motivation, but we kind of had to push forward because we had to achieve what we set out to achieve. When it came to long standing processes and mindsets, it can be hard to motivate staff to engage in change.
I think the biggest win we had was the success with those staff that we thought we were going to have the least buy-in with – getting them on-board and getting them involved and excited about it. And that just takes time and patience. It’s not that people don’t want to do anything different – it’s just that when everyone turns up to work they are generally overwhelmed with all the other things they have to do, they know that their system works, and so they want to stick with that. Getting someone to step outside of their own systems and try something new, which potentially will work or won’t work, was a real challenge. Especially because they don’t want to do any more work in their day, because their day is already absolutely busy, and they are doing their very best.
We chose the people that we worked with very carefully at the beginning because we knew those people would have influence on the rest of the team. We did a lot of background work so that by the time it got to them, it was in pretty good shape and we knew what we were talking about. The craft groups were doing different primary tasks, but we found as well that the registrars and the doctors were doing a lot of admin work, as well as the radiographers. A big part of the project was pushing people back into their craft groups and what their true roles should entail, so doctors were doing medical work, radiographers were doing radiography, nurses doing nursing and admin staff doing the admin. What made it easier for us is that we have both been here a long time and we have both got the respect and the support of each of our craft groups already. But if we were coming in from somewhere brand new it just wouldn’t work in our scenario. They knew Shelley and I had done our homework, we have worked in the areas and knew the current systems. We were invested in the success of the project, and they all knew that.