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Making Sure that Our Changes Stick

We have become adept at designing or redesigning processes in the GBMC HealthCare System. But how well are we doing at making sure that the changes we make are still around after the team that created them moves their focus to something else? 

On our Lean Management System walk this week, the Adult Emergency Department gave their monthly sustainability report. They have six processes that they check on in sustainability from redesign work since February 2020.

  1. Patient Throughput
    1. Provider In Triage (1 process)
      1. Using evidence-based practice and national benchmarking, we reallocate provider resources, which has reduced the time patients spend waiting to see a physician or other provider. Since implementing this change, GBMC’s time to the first evaluation has stayed below the national average of 18 minutes.
    2. Lab Turn Around Time (1 process)
      1. Reducing the time from the order to the specimen collection to make the diagnosis faster. Our performance has been maintained from an order-to-collect median of 19 minutes. This reduction in wasted time has allowed the ED to implement and sustain an ED protocol bay and improves patient throughput.
    3. PIVOT Nurse (1 process)
      1. This process accelerates the complete and accurate data collection on patients and reduces the wait until the first medication pass for pain and comfort, prior to patients entering the waiting room.
    4. Emergency Department (ED) to Inpatient (IP) Nursing Redesign (3 processes)
    5. With collaboration from the Performance Improvement team, EPIC, and the Inpatient Nursing leaders, we were able to design an automated process for patient movement out of the ED. We have the patient ready to move when the bed is clean and the admission orders are in. We have sustained our improvement to move the patient within 10 minutes of the ready-to-move time.   

I am so grateful for our Performance Improvement Team that has designed a process for reporting on sustainability to help reduce the probability of drift back to “the old way.” And I am so proud of our ED team for sustaining so many redesigned processes!

Are You Ready for Some Football!?!?!?
Today, our Pediatric Emergency Department treats about 900 children a month and our talented and dedicated physicians, nurses, other clinicians, and support staff, make sure that each patient is provided the care that we would want for our own loved ones. We are very fortunate to have such a great Pediatric ED team. 

Now to help them continue their work and to make sure that they have the appropriate resources to continue providing stellar care for their patients, GBMC is participating in a special promotion for you to see the Baltimore Ravens in action. Former left tackle and member of the Pro Football Hall of Fame, Jonathan Ogden, is helping us spread the word about our wonderful Pediatric ED and garnering financial support for it. 

Anyone who donates $8 (or more) will be entered for a chance to win two (2) club level season tickets and a parking pass for the Ravens 2022-2023 football season! Also, registrants will have a chance to win eight consolation prizes which are a pair of tickets to a Ravens home game.  You can help support this great cause by clicking here. Again, all proceeds will benefit our Pediatric ED.   

GBMC gets remarkable support from the community. I am sure that many will answer the call once again.  

Good luck to all participants and go Ravens!

Condolences for Queen Elizabeth II
We mourn the loss of Great Britain’s longest reigning monarch, Queen Elizabeth II. The Queen took over the crown in 1952, when Sir Winston Churchill was the Prime Minister, and her years included times of war, peace, scandal, and more. The Queen dedicated her life to public service, and throughout her long reign she was a passionate champion for her country. Our thoughts are with her family and all who loved her.


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