Optimizing Cargiver Workflow in a New Pediatric Intensive Care Unit

Session
Labor Management

Author
Kristin Hermann
Service Consultant
Children's Healthcare of Atlanta

Description
Hospitals are building new facilities that are safer, patient-centric, and evidence-based. Transitioning to new layouts requires workflow adjustments for staff. This session focuses on methods to analyze caregiver workflow in new spaces. It demonstrates how staffing, supplies, and resources can be optimized providing caregivers with more time at the bedside.

Abstract
Children's Healthcare of Atlanta is undergoing an expansion to provide evidence-based facilities for patient care. The Pediatric Intensive Care Unit (PICU) at Children's Healthcare of Atlanta moved to a new unit that grew from 20 to 30 beds, has three pods, and shifted from a centralized to decentralized nurse station. The new PICU layout altered caregiver's workflow, decreasing time at the bedside and delaying patients' plan of care. This project aims to evaluate workflow in PICU by identifying opportunities to give caregivers more time at the bedside, improve efficiency of patient-centered processes, and better align team cohesiveness.

Caregiver workflow was evaluated using Lean tools to enhance the structure and processes in the PICU for improved outcomes. Observational data was collected to identify how caregivers functioned in the new space and spent their time. Spaghetti diagrams, task analysis, and simulation tools were used to evaluate the data. Recommendations included removing waste in the system through 5S methods, optimizing staffing resources, creating standard work processes, and developing unit specific visual tools. Results include a 13% increase in nursing time at the bedside, and a 30% reduction in physician rounding duration. All PICU patients' plan of care is now completed 10:00 verse 13:00.