Bridging Care Support and Care Delivery with Engineering Logistics and Technology

Overview: This research entails studying lean redesign of supply delivery, support service operations, and the clinical workflow on inpatient units and represents a way to improve the value of health care – i.e., reduce waste or unnecessary costs while improving quality. Geisinger Clinic’s Supply Chain Services has developed ‘Project HELP’ (Healthcare Enabled Logistics Program) that is based on successful manufacturing and engineering workflow processes. Project HELP’s goal is to remove clinicians from logistics (support services) activities, and reinvest this time in patient care activities.

Methods: Project HELP will engineer a proactive support service system to replace the current, healthcare industry-standard reactive system, thereby eliminating wasted logistics trips and non-value added support service activities. The new system will increase support service efficiencies and consolidate the numerous independent and silo-operated departments. In addition, Project HELP intends to improve the clinical workflow in inpatient units by eliminating nursing involvement with logistics activities to the greatest extent possible. By removing nurses from these processes they will be enabled to redirect their focus to patient care activities. The team hypothesizes that by reducing care interruptions this project can demonstrate improvements in the quality of care by allowing time for increased nursing focus at the bedside, continuing education participation, mentoring opportunities, etc. This will be accomplished by designing a system that provides frontline logistics support to the clinical staff. The frontline support will be coordinated by a new team member who will be the bridge between the clinical staff and all support services. This person will be tasked with coordinating most, if not all, of the support service activities for a given work area (e.g. 1 or 2 nursing units).

To support these efforts, the team will also develop a care support information system that captures the nurses’ knowledge of support activities required to prepare for and perform care. The information system developed will guide the workflow for the logistics staff by providing the required information to proactively prepare all resources (i.e., equipment and supplies) for defined clinical procedures. This system will include information such as number of consumable supplies needed for common procedures (e.g., dressing change) performed on a nursing unit.

Funding: Agency for Healthcare Research and Quality (AHRQ)