Creating Visibility to Strengthen Quality and Performance in Healthcare

Health systems in Canada, and worldwide, have been very slow to adopt information infrastructure and technologies that seamlessly track the processes, products, and progress of patient care services to create visibility, improve efficiency and strengthen capacity of health systems to deliver care. Proficiency in patient flow management is a key strategy to enhance delivery of services when and where needed. Advanced information technologies hold great promise as key enablers to achieve a more integrated and highly productive health system.

This project reports on the integration of innovative information technology designed to overcome gaps in information, barriers to patient flow, to streamline patient care processes at a community hospital. The McKesson Performance Visibility (MPV) information system is a patient flow tracking system that integrates information from every patient data source, and displays the progress of patient care processes on interactive  screens in the hospital. Strategically placing the screens throughout the hospital enabled all staff to have complete visibility of every care process for each patient from admission, to diagnosis, and discharge. Enhanced visibility of information that captures the progress of every care process using streamlined communication for staff members, and clinical teams, enables and supports informed decisions in “real time” and care to be delivered as efficiently as possible for each patient.

This project studied the impact of this MPV technology on: the quality of work-life for staff, the impact on decision-making processes, impact on hospital capacity (wait times), and staff experiences with adopting the new technology.

The study found that visibility of accurate, and real time information on the progress of patient care had a significant and positive impact on how teams work together, how decisions are made and how hospital capacity can be enhanced. Employee communication and teamwork was more coordinated and streamlined to support completion of tasks more efficiently. Staff collaboration was also strengthened across clinical units in the hospital as a result of access to the same information about which patient was waiting for care, and who was ready for discharge. The new information system contributed to significant, positive shifts in staff perceptions about workload, fairness of workload distribution, and job satisfaction. Hospital leader’s decision-making was better informed by visibility to patient care progress in real time, and efficiency was achieved by reducing the number of phone calls required to gather information vital for evidence based decision-making. The information technology system resulted in improved hospital performance indicators including: increased capacity (reduced patient waiting time in the emergency department and increased patient volumes), decreased length of stay in key programs such as Mental Health which demonstrated a 50% reduction in wait times, and improved quality outcomes such as decreased patient falls and a 25% increase in the number of patients with discharge plans 48 hours prior to their anticipated discharge. Evidence emerging from project findings demonstrated that innovation adoption is a dynamic, iterative process that evolves over time, when the innovation is integrated and “translated” into the day to day work processes of staff focused on achieving key outcomes that deliver value for patients and families.