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If Disney Ran Your Hospital

martzj
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I found this article on the level 2 hospital where my heart attack was treated in 1996, etc. Looks like they've made some major changes since 2007... based on the book "If Disney Ran Your Hospital: 9 1/2 Things You Would Do Differently" by Fred Lee. I've never seen this personally. Now I just need to hound them into learning radial cath procedure!! : )

http://www.riversideonline.com/about_riverside/news/dp011309.cfm

In February 2007, under the contract management group, it took an average of two hours after walking in the door to see a doctor. Over 18 months, the hospital started building a team of American Board of Emergency Medicine-certified doctors, who came on board last August.

The door-to-doctor time immediately fell to 74 minutes. In November, it dropped again to 45 minutes, while the door-to-nurse number was down to 30 minutes, Rountree said.

The extra money it cost to pay the contract management group — "the middle man" — was reinvested by adding more physicians, increasing physician staffing 30 percent, Kavit said.

"That means I have that many more doctors here each day," he said.

Some of the changes Riverside made were based on the book "If Disney Ran Your Hospital: 9 1/2 Things You Would Do Differently" by Fred Lee.

The color-coded scrubs system came from the book, for example: Doctors wear navy blue, nurses wear red, registration clerks wear green, greeters who are certified nursing assistants wear yellow and paramedics wear khaki. The system met some resistance at first, but it was later embraced as a badge of honor to work toward for those rising through the ranks, Rountree said.

And there are more changes in the works. The emergency department's goal is that within 15 minutes of walking in the door, patients will be triaged by a nurse, who will take their vital signs and help prioritize cases.

"It's not like the DMV, where you can come in and take a number," Rountree said.

They also aim to keep emergency room patients better informed. If a patient needs a time-consuming CT scan, for example, he or she will be told that it's a lengthy process so that the wait isn't unexpected.

Riverside is also testing a new procedure that would further reduce wait times. Riverside is one of 10 hospitals across the state trying out a new emergency department check-in process. Instead of getting duplicated questions from a nurse, followed by a doctor, a patient would be triaged by a doctor and a nurse at the same time. Riverside tested the new protocol a few days in December and again this month.

For the 64 nonemergency patients who were checked in using the pilot procedure Dec. 8, turnaround time — from the time a patient enters to the time the patient leaves — was slashed to 103 minutes. The average turnaround time for all patients, emergency and nonemergency, was as high as 300 minutes in 2007 and down to 214 minutes in November 2008, Rountree said.

It's hard to compare Riverside's wait times with other local emergency departments because hospitals calculate wait times differently.

Sentara, for example, calculates arrival-to-provider time, which could mean a doctor or nurse. At Sentara CarePlex in Hampton in 2008, the average arrival-to-provider time was 43 minutes. It was 39 minutes at Sentara Williamsburg Regional Medical Center in York County and 34 minutes at Sentara Port Warwick in Newport News.

At Mary Immaculate in Newport News, door-to-provider (which could be a physician, physician's assistant or nurse practitioner) time averaged 38 minutes the week of Dec. 21. It was 32 minutes at Bon Secours Health Center at Harbour View.

Riverside officials said it's also hard to compare Riverside to other emergency departments because it's the Peninsula's only level 2 trauma center. That means it's required to have nearly all the major specialists on call, and it's a referral center, taking the region's worst cases.

"All of the bad stuff that happens from Williamsburg to Hampton, Isle of Wight to Mathews, comes here due to the water boundaries" of taking patients to the nearest level 1 trauma center, Sentara Norfolk General Hospital, Kavit said.

Riverside's changes are making it a better place to work and receive treatment, Kavit said.

Before, the long wait time made it hard to retain nurses.

"How would you like to be a nurse in an environment where the patients are all mad because they have to wait for three hours to see a doctor?" he said.

The experience of nurses and patients are closely tied. If patients are happier, then nurses are happier, and if nurses are happier, patients will be happier. That turnaround is starting to happen, he said.

"We're definitely in a different place than we were a year and a half, two years ago," Kavit said.

On Monday, a day when Riverside tested the quicker check-in system, Maritza Rodriquez brought in her 19-month-old daughter, Neffatierre, who had a high fever and was vomiting and coughing.

After being whisked through registration and triage and then being placed in a room, a doctor was there within 15 minutes, Maritza Rodriquez said.

"It was really different. It was real fast," the 32-year-old mother said. "One of the reasons you don't like coming to the hospital is because it takes so long. Thank God it's different. Someone's trying to make it faster and easier."

Published: January 13, 2009

Explore topics in this discussion:

Surgery Heart attack Bypass surgery Palliative care Fever Xanax

13 replies

MMaslek

I could be wrong but I'm pretty sure Goofy was the administrator of the hospital I was in last summer...

Winglover

This will give me something to laugh about each day now that I have returned to work at the hospital. Must be Disney that chose my new scrub color!

martzj

Hey Winglover,

Sure hope it is a color you enjoy....or at least won't get sick of too quickly : ) !! Has your son felt like making it to the pool yet? I've been hoping for him..... : )

cheers, Jaynie

Winglover

Jaynie,
The weather here has been pretty unpredictable. Either cool and rainy or hot and steamy.He always seems to give me an excuse not to go. Now that school is out he doesn't have much ambition (or energy) to do anything. Just looks tired all the time. He returns to the transplant clinic on the 13th for another echo. We are both dreading that. He finished driver's ed so we have been practicing driving around town. I think I'll need to take out stock in either Xanax or Dramamine! It's going to be a long summer.
Scrubs went from a nice calming ocean blue to eye piercing royal blue. And they fade like crazy! Ha!
Lisa

martzj

Driver's ed sending a parent racing for the Xanax!! What could be more normal than that?!!! : )

I'm drawing a big heart on my calender on the13th. Will be sending out a 'wonderful things' wish that your son is on the fast track to a new life soon...with an improved heart function!

Hugs to you both,
Jaynie

Queen_E

Ha, don't forget to add the time it took to get to these hospitals if:
1) you had to wait to go thru the tunnel
2) it was a summer Saturday/Sunday and you were trying to go on I-64 past Williamsburg
Still it's good to read about a hospital using the techniques that work in other industries to improve the customer experience. Despite the Disney reference, it sounds like the biggest impact was from figuring out how to manage the department from within!

martzj

Hi Queen_E,

Oh yes, the tunnel....which is blocked now due to an overturned semi......and the James River bridge, still closed due to power lines ripped off during last night's ferocious electrical storm burst.

Are you a member of the Northern VA WH support group? I'm thinking it may be in Fairfax? The Williamsburg WH spokeswoman travels to Fairfax for all her cardiac testing and elective procedures.

I found this email address from 2006 when I was searching for a WH support group here in Tidewater. Little did I know, I would have to start my own : ) But I'm sick to death of listening to myself talk....want to hear from other women!! : )

cheers, Jaynie from NN

northernva <northernva@womenheart.org>

Winglover

Jaynie,
Big thanks for all your good wishes for "wonderful things" for my son. He says you are a special lady and sends his thanks as well.
Hugs to you,
Lisa

TooYoung

The hospital for which I work will be attending If Disney Ran your Hospital Conference. We are looking forward to the positive enlightenment this program has to offer.

How are all my wonderful heart friends. Sorry, I have not written in a long time. Life has been busy. We sent our foriegn exchange student back home after her school year was complete:-( Our daugther who got married last year, has made us grandparents of a beautiful baby boy Austin Riley. He was born June 15th. Austin and family are doing well. I have been traveling a lot for work. I spent a week in Seattle, WA for a Healthcare Financial Management conference. This was a major milestone for me to get on a plane again and travel by myself after recovering from my quad bypass surgery one year ago. Work has been hectic for me, but I truly enjoy it. I am now the controller for our hospital. It has helped me realized I can conquer whatever obticals are thrown my way. Our youngest daughter is busy traveling with 4H and FFA functions this summer and working. She is visiting our nations capital as we speak and will be there to celebrate the 4th of July. She has found a lovely boy friend Donovan. He is the sweetest, kindest, most polite young man and really cute!! My husband and I will be celebrating our 25th wedding anniversary next week July 7th. July 21st we will be flying to San Francisco for eight days of vacation to celebrate 25 years.

I hope all of you are doing well and enjoying life. Live each day to the fullest, because each day is a gift from God.

Love to all my heart sisters,

Too Young

Kennarina

Too Young: If Disney Ran Your Hospital CONFERENCES? That is so fabulous!

I'm thinking we might be missing an opportunity to put Disney know-how to other good use...

If Disney Ran Your Hair Salon

If Disney Ran City Hall

If Disney Ran Our Federal Government

The list is endless....

XOXOXO



http://www.myheartsisters.org

Queen_E

K -- Ha! I think my hair salon may be getting tips from Disney - yesterday they gave me a barcoded pass to swipe vs. speaking my name. My pool did this too!

TooYoung - please write again after the conference, really keen to hear about it!!

Jaynie - I was one of the culprits clogging up I-64 and 664 tunnel to/from OBX in June.
I've not attended a WH group in Fairfax, but there were signs up in Cardiac Rehab for meetings at a restaurant near Fairfax Hospital about 1x month in the evening. I just couldn't bear to be out another night when rehab was taking so much of my time. I really like the accessibility of the online support experience - better chance of a group for "Under 50, full-time career woman with husband and 2 little kids - post-heart attack and stents". I am also thinking of attending some educational lectures at Arlington Hospital (now Virginia Hosp Center).
Not sure if Disney is running either INOVA Fairfax or Virginia Hospital Center. Fairfax does have valet parking at the Heart/Vascular Institute....!

martzj

Queen E,

"Jaynie - I was one of the culprits clogging up I-64 and 664 tunnel to/from OBX in June.""

You were!!! Bad QueenE!!! : ) Late May, early June is my favorite OBX time...except the sand flies bite the crap out of you seaside. At VA Beach they have so more many bods to choose from I've never been bothered. OBX is much quieter and more relaxing huh...Kitty Hawk, Manteo Marine Aquatic Center...love those beautiful places. I have a crush on one of the otters.

. I really like the accessibility of the online support experience - better chance of a group for "Under 50, full-time career woman with husband and 2 little kids - post-heart attack and stents".

Can relate 100 % to this one. Lived it for 6 years, including that twice daily commute (W'burg to NN and back). Would have killed to have had any kind of support back then. On the bright side, Riverside NN has had valet parking for years...no more struggling across that mile long parking lot in super high summer swelter.

Kennarina

First of all - congrats Too Young on your new grandbaby. I am insanely jealous.

I have been so intrigued by this topic and the book that I've told all my hospital co-workers about it and insisted that they read it. My colleagues in hospice palliative care could have written this book, actually - it's a different kind of caring at Hospice (nurses frequently say things like "This is the kind of nursing I went into nursing to do!") But the REST of the hospital - oh boy!

This morning, I also added an article about Fred Lee's Disney book to my website - "What Would Mickey and Minnie Do?":

http://myheartsisters.org/2009/07/06/disney/

XOXOXO

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