Spaulding, Tony

This chapter focuses on key factors that impact effective teamwork in healthcare organizations, including a case study on the applications of a teamwork model at Mayo Clinic in Rochester, MN. Studies have found positive correlations among effective teamwork, patient care, and provider satisfaction. Key factors such as teamwork training, leaderless online group discussion, servant leadership, and top management support lead to effective teamwork, which would positively impact the quadruple aim—patient experience, high-quality and safe delivery of patient care, lower costs, and provider satisfaction.

This chapter explores, analyzes, and discusses the challenges and potential recommendations for the unprecedented physician shortage affecting US healthcare systems. As a result, patients are waiting long periods to get an appointment, and in many cases, even longer to see a physician. Especially older patients who may need immediate attention and medical care end up waiting several weeks. Healthcare seems to be facing a crisis that is getting worse by the day. How did we get here, why, and what do we do about it are some of the questions addressed in this chapter.

165 Background: The Hematology Hospital Outpatient service at Rochester Methodist Hospital provides ambulatory outpatient care to patients who would normally be hospitalized on our inpatient services due to cytopenias and need for infusion/transfusion support. A quality project was conducted to streamline our process and decrease wait times. Methods: This project was a part of a Mayo Lean Collaborative initiative to increase customer satisfaction and eliminate waste. The first step was to collect baseline measurements to capture the non-value added waiting time of our entire outpatient process. These benchmark times were collected from 65 patients over 4 days. We evaluated these wait times to identify gaps in care and factors contributing to delays in our process. Data collected "before and after" each implementation phase determined if the change was beneficial. Results: Through our data collection, one major area of opportunity we identified was the wait time for CBC results. At baseline, patients were waiting in a room for 61.9 minutes for lab results. A major contributor to delay was the lack of carriers to send blood samples through the tube system being stocked in the outpatient area. We also discovered that the time from when the sample was placed in the carrier to the time it arrived in our lab was significant. Through a process analysis it was identified that the CBC tubes were being sent to a central lab prior to their final destination in the Hematology lab. We were able to re-route our CBCs directly to the hem lab. Data collected after the intervention showed we were receiving results at 51 minutes, therefore, eliminating 10.9 minutes off of an appointment. We also identified additional opportunities such as pre-assigning rooms, scheduling, exam room organization, and communication that were able to be addressed. Conclusions: As a result of this lean collaborative project we reduced patient wait time by 20.1 minutes and increased patient satisfaction. We were able to order interventions sooner thereby increasing patient safety. By process analysis, we identified multiple areas in our process that could be shortened with no additional cost.