Seed Grant Profile
Physician workflow and scheduling improvements can lead to increased efficiency and improved quality of care for hospitalized children
Coordinating the care of critically ill children has become increasingly complex within the academic hospital setting. In our preliminary work, an analysis of the rounding process in a Pediatric Intensive Care Unit (using lean methods and scenario analysis) identified opportunities for improvement. Implementation of a lean rounding process then led to more efficient rounds, improved physician visibility, decreased physician manpower requirements, enhanced throughput, and improved stakeholder satisfaction. Improved efficiency in the PICU is affected by "downstream" effects in the general care areas which delay the availability of beds for the transfer of patients out of the PICU. The next steps for our research are to: 1) perform a similar analysis in the General Care areas. After development and implementation of a more efficient process, we will measure the impact on efficiency of rounds and timeliness of patient discharge. Subsequently, delays in availability of beds for transfer of patients out of the PICU can be measured, 2) develop an optimization model or heuristics for solving a complex physician scheduling and staffing model that improves the handoff complexities, 3) develop a simulation model to identify additional inefficiencies and validate this model using available data, and 4) develop an extended version of the simulation model to identify system-wide inefficiencies within the hospital system. The contribution of the proposed work to the literature and practice will be significant, as these challenges and complexities are not unique to the intensive care unit of pediatrics. Rather, these are universal challenges to all academic healthcare institutions. Further, in this era of healthcare reform, studies showing optimization of resources or manpower that enhance value are increasingly important.
Investigators: Atul Vats (Children's Healthcare of Atlanta and Emory University), Pinar Keskinocak (Georgia Institute of Technology), Kristin Goin (Children's Healthcare of Atlanta) and Corinne Taylor (Children's Healthcare of Atlanta and Emory University)