Operating in Silos
One of the major roadblocks to healthcare quality improvement is the tendency for Healthcare Organizations (HCOs) to operate in silos. For the most part, Emergency Departments are operated and managed separately from Medicine, Surgery, and other programs.
These entrenched silos within an HCO can lead to (seemingly) competing interests, distrust, and outright tension between programs and services within an HCO.
Currently in most HCOs, communications between departments or programs consist of frantic telephone calls or angry emails between stressed nurses and/or managers dealing with bed shortages, patient backlogs, long consultant delays, or any other of a number of sources of tension.
Transparency allows seeing through silos
Transparency is a major tenant of most current process improvement methodologies such as Lean. Simply, transparency involves the timely sharing of relevant information between programs to better understand the status of, and challenges facing, programs and services that must interact to ensure effective patient flow.
Transparency helps to improve trust between programs by clearly sharing accurate status information (“they know what we know”).
Examples of transparency can include:
- Hospital wards sharing in real-time the number of empty beds available for Emergency Department patient admissions
- Emergency Departments sharing the number of patients in treatment, in the waiting room, and awaiting admissions
Silos don’t only exist between departments, programs, or services. Silos can exist within a single department where teams of professionals (such as doctors, nurses, and healthcare aides for example) operate in near-autonomous isolation. Within a single department, transparency can mean simply breaking down the barriers between professional groups so that everyone can operate as an integrated team with coordinated tasks, objectives, and goals to enhance quality of care and patient flow.
Analytics can enable transparency
Analytics is one tool that HCOs are successfully using to enable transparency within and between departments, programs, and services. Analytics tools can open up transparency by making it easy and convenient to share key performance metrics or other indicators that matter for effective patient care (such as current lengths-of-stay, wait times, available beds, patients awaiting consults, etc).
Analytics tools that can facilitate transparency (and build cooperation and trust within and between programs) include:
- Regular performance reports distributed between programs
- On-demand performance reports accessible between programs
- Automatic alerts generated when current conditions are likely to cause patient flow issues
- Live dashboard displays that provide real-time status updates of relevant indicators (i.e., beds available, patients waiting, consults waiting, etc).
When transparency within an HCO is enabled through implementation of analytics, friction within and between departments and/or programs is reduced and an environment more conducive to “patient pull” is created. This enables the necessary resources to be available to provide high-quality care where and when required by patients and allows all involved in the care of patients to work as coordinated teams.