New High-Tech Hospital Addition Requires Processes to Match

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When its new state-of-the-art in-patient facility was being developed, management at a prominent Midwestern community hospital knew they couldn’t rely on existing processes to deliver the enhanced patient care they envisioned. The new Patient Care Tower would consist of a 24-bed intensive care unit, three floors of 32-bed medical/surgical units with completely private rooms, all connected with advanced technology. This was a unique opportunity to combine cutting-edge facilities with improved clinical operations and to incorporate industry thought leadership to deliver 21st-century patient-centered care.

To help encourage fresh thinking, management conducted detailed work sessions with all hospital stakeholders—and incorporated input from patient surveys—to define and prioritize projects that would redesign clinical processes within the new facility. Participants identified 12 workstreams, several of which were highly innovative, to achieve their goals.

Management recognized that implementing new clinical operations processes and ensuring their sustainability would require the disciplined planning and orchestration provided through professional project management. Already familiar with Integrated Project Management Company, Inc. (IPM) from other work within the hospital system, they selected IPM to lead the planning and execution of the redesigned clinical operations program.

IPM began collaborating with workstream leaders to develop detailed project schedules, document project issues and risks, establish communication plans, and create the overall governance structure needed to manage the program/projects and stakeholders. IPM also provided coaching and tools to the leads, each with varying experience in managing large initiatives, so they would succeed and become more proficient in project management. Finally, IPM helped develop a sustainability plan to ensure that the many changes would be institutionalized, regularly evaluated, and continue as intended.

Each of the 12 workstreams identified by the hospital defined key measures for success, such as reducing time to discharge and improving patient satisfaction survey scores. These would serve as measures to gauge performance during and after project completion.

IPM helped the subject matter experts leading each of the workstreams facilitate discussions and resolve “log jams” as each team reviewed its current state and planned for the new tower.

Changing long-standing practices required strong communication and change management skills. For example, most hospitals dispense medication from a centrally located pharmacy to supply rooms on each floor with automatic dispensing machines (ADMs). The new, less centralized workflow supplemented the use of ADMs with patient server (sometimes called nurse server) storage cabinets, which bring supplies and some pharmaceuticals into the patient’s room. This decentralized model changed workflows for both nurses and the pharmacy and initially caused some disruption. While nurses could now bypass the supply room and get some drugs directly from the server in the room, the pharmacy, in coordination with other staff, had to stock individual servers. To help support the transition, the IPM consultant worked closely with the head of pharmacy and senior hospital leadership to create a process that would work well for all stakeholders.

IPM’s involvement extended nine months through the critical planning phase. The execution phase was successfully transitioned to hospital system resources tasked with this role.

When the new facility opened, the hospital invited IPM back for a special tour to see firsthand how the project efforts contributed to the new facility’s success with a new model for patient care.

  • All 12 workstreams were implemented without disruption to patient services, and they have been sustained one year after opening.
  • Key metrics, defined during the project, continue to be routinely reviewed to refine and reinforce compliance.
  • The facility successfully completed a complex collaboration in project improvement.