August 4, 2006

Process improvement implementation enhances services

The MGH is among a growing number of hospitals that have applied methods developed by the automobile manufacturer Toyota to improve work processes. Implemented at the MGH in 2004, this approach to process improvement integrates four key capabilities: work redesign, continuous improvement, sharing knowledge about process improvement and organizing the workplace to facilitate the first three components. In the last 18 months, the system has been used in more than a dozen MGH departments including several primary care practices, Biomedical Engineering, Nutrition and Food Services and the Emergency Department.

Recently, MGH Health Information Services (HIS) staff used the Toyota approach to improve the compliance rate for delivering medical records on time. Prior to implementing this method, any HIS Record Control staff member could answer the telephone, take medical record requests, create orders and retrieve and deliver the charts. Approximately 750 medical record requests were being handled each day using this process, and statistical reporting indicated that delivery rates seemed to be declining. Using the improvement methods, both workflow and statistical reporting were evaluated. The process revealed both duplication and discrepancies of record requests and job functions, which were directly related to the decline. Now each of these tasks are handled by staff members dedicated to single portions of the medical record request process.

"Overall the net effect of a handful of small changes has improved our workflow," says Claudia Sayer, manager of Health Information Services. "Currently the retrieval rate for Operating Room cases remains at 99 percent and for all other record request areas the rate is 93 percent, and we are continuing to improve."

For more information about process improvement, call Sally Iles at (617) 726-8283.