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Clarkson Students Conduct Efficiency Study at Canton-Potsdam Hospital
[A photograph for media use is available at http://www.clarkson.edu/news/photos/iem-cph.jpg]
In fact, the extra personnel hanging out in the ED were students from Clarkson University's Interdisciplinary Engineering & Management, Pre-Med and Pre-Physical Therapy programs. They were at CPH to observe the day-by-day workings of emergency room process flow in order to better understand and add value to the patient's experience when visiting CPH's ED. After more than 400 hours of observation of the patient, nurse, physician and information/data flows and intensive training in patient confidentiality, the six Clarkson students have developed Performance Improvement Projects (PIPs) for the hospital staff to consider.
CPH and Clarkson embarked on the ED study as part of CPH's ongoing mission to improve overall patient satisfaction. The University students applied Six-Sigma modeling and Supply Chain Concepts to develop three specific PIPs for the ED, including streamlining the nursing documentation, developing a surge management plan and developing a plan that will aid in medication reconciliation.
As indicated in the report students presented to the CPH Management Team, a patient's satisfaction is directly correlated with the perceptions regarding waiting time, information delivery and expressive quality. The good news for CPH is that the average wait in their ED is less than the national average. However, the study did point out things the hospital can do to improve the patient's ED experience. One observation the students made is that patients are typically not engaged by hospital staff until they reach triage. The study suggests engaging patients earlier in their visit and providing them with information and increasing their participation to create a more positive experience.
Other suggestions from the group included changes to the triage procedure, physical changes to the ED configuration, increased training for nurses on the hospital's Computers-On-Wheels (COWs) and better utilization of volunteers in the registration process.
Students also introduced a branch of operations research to the Clarkson/CPH project known as queuing theory, a study of waiting that can be used to make business decisions about the resources required to provide service. Queuing theory is applicable in a variety of situations that may be encountered in business, commerce, industry, engineering and public service. Although obvious to many in the health care field, the study reiterated the behavioral responses people experience while in queues:
1. Unoccupied time feels longer than occupied time. 2. Process-waits feel longer than in-process waits 3. Anxiety makes waits seem longer. 4. Uncertain waits seem longer than known, finite waits. 5. Unfair waits are longer than equitable waits. 6. The more valuable the service, the longer the customer is willing to wait. 7. Solo waits feel longer than group waits.
This study was very detailed and carefully documented, remarked Michael Ensby, Clarkson's director of Interdisciplinary Engineering & Management, director for the Center for Global Competitiveness and advisor to the students on the project. "The students came at the study from different disciplines and perspectives and have provided a valuable outside perspective for CPH to use in continuing to provide the very best care available in the region. Our students were impressed with the compassion, the high degree of professionalism exhibited by CPH staff and the level of care given to the patients. We think the observations made during the project will help make the emergency room process at CPH even more efficient, which will ultimately take the facility from its current level of excellence to 'world class'. I especially want to thank Janice Knickerbocker, director of the Emergency Department at CPH, for the extraordinary amount of work and coordination she put in to make this project a success.
Clarkson's Interdisciplinary Engineering & Management program is well known for preparing students who can tackle difficult challenges, remarked J. Christopher Williams, MD, a specialist in emergency medicine at Canton-Potsdam Hospital and president of North Star Emergency Physicians PC. "The professionalism and knowledge level of the students performing this study was truly impressive. The standardization, metric tracking and theoretical models the team developed will help us achieve world-class patient care. We are looking forward to a long-term collaboration with Clarkson and we anticipate that the practical suggestions and analytical resources resulting from this partnership will continue providing an even more positive emergency room experience for CPH patients."
PHOTO CAPTION: Clarkson University students (L-R) Trey J. Keller, Jessica L. Lemieux, Caitlin E. Reed, Brian R. Brostko, Ashley N. Pence and Daniel A. Stevens have completed 400 hours of observation at the Canton-Potsdam Hospital Emergency Department (ED) and have made suggestions to improving the ED experience for patients. Reed is a senior, the other five students graduated in May.