When we learnt that almost 70 per cent of delayed discharges
between June and December 2015 could have been prevented, a multi-disciplinary
team was formed to find ways to improve the situation. With guidance from Tan
Tock Seng Hospital’s Kaizen Office, we employed a combination of Design
Thinking and LEAN methodology to develop interventions to improve the discharge
process.
As part of Design Thinking, they spoke with about 40 families
to better understand their care needs based on the condition of their loved
ones, family dynamics, values and knowledge of the local healthcare system. The
information helped the team to discern three caregiver profiles which they used
to review the admission-to-discharge journey using LEAN methodology.
Interventions put in place by the team include modifying the
hospital admission kit to incorporate more useful information for the
caregivers, creating a simple visual progress chart that nurses can use to
explain the patient’s rehabilitation progress to the caregiver and improving a
competency checklist that assesses the caregiver’s confidence level and
readiness to care for their loved ones after discharge. As a result of these
interventions, the number of avoidable discharge delays dropped from 22 to 2 in
2016 while caregiver satisfaction improved by 10 per cent.
Lean and Design Project Team
Ren Ci Community Hospital
Winner of the Best
Team - Service Initiative Improvement (ILTC) Award, Singapore Health Quality
Service Awards 2018
