Going online with purchase requisitions in rural facilities: How a Waste Walk improved outcomes for physiotherapy patients in Upper River Valley FromDanica Wallace, Physiotherapy Supervisor, Horizon’s Upper River Valley Hospital
What do YOU think about the Active Offer? From Lorna Mansfield, Active Offer Every Day Facilitator, Official Languages
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the email and her approval to purchasing, and then purchasing processes the order and forwards to the company. The benefits The impact of this little change has been significant, not necessarily in dollars saved but as an improvement to patient care and satisfaction. Our new process allows the majority of our orders to be received in one week or less. The shorter time has significantly improved patient satisfaction and outcomes, such as attaining a stable limb size and decreasing the likelihood of the patient’s limb swelling returning and other complications. It has also decreased the number of trips they have to make to the hospital for bandaging and allows them to get back to their normal routine much sooner. For instance, while bandaged the patient cannot shower, but once they have their garment they are able to. There is also a benefit for patients waiting to see Natalie, as she is not required to continue bandaging those waiting for garment; she now has more time to see new patients so their wait time for treatment has decreased. We have expanded this process to include staff travel and education requests and payment requisition forms. This provides a timelier and more efficient way of processing documents and efficient and effective record of requests made.
When provided the opportunity for White Belt raining, I was excited at the prospect of finally being able to tackle a few of those little things that really “bugged” me. One of my “bugs” was the length of time it took for our purchase requisitions to be processed and supplies received. The problem Supervising physiotherapy services in the Upper River Valley area does have some challenges. All purchase requisitions must be signed by the regional manager of Physiotherapy Services, who works out of the Dr. Everett Chalmers Regional Hospital (DECRH). This process, although simple, was very lengthy. On average, from when I completed a purchase requisition until it reached purchasing at the DECRH for processing, there could be a time lapse of four to seven days. facilities, the schedule of the truck transporting said interoffice mail, and the time it took to have the interoffice envelope delivered to physiotherapy, signed by the manager and sent to purchasing. For many items and supplies, ordering in this fashion and a delay of a week or two was not a significant hardship. However, at the Upper River Valley Hospital (URVH) we provide treatment for patients suffering from lymphedema. One of our This was due to the time it took for the delivery of interoffice mail within both
physiotherapists, Natalie Dykstra is specialized in the treatment of lymphedema, which involves compression bandaging of limbs and measuring and fitting for the proper compression garment to maintain the limb once it has been stabilized. When a patient’s limb has reached its optimal size, measurements for a custom garment are taken and recorded on the appropriate order forms and a purchase requisition is completed. Then, following the aforementioned chain of events, some patients wait three to four weeks for their garments to arrive. During this time they are seen three times a week to have compression bandaging applied to the limb in order to maintain its optimum size. If not their limb grows larger, the newly ordered compression garment would not fit and treatment would have to be reinstated. Traveling to URVH three times a week for three to four weeks isn’t easy for patients, and the bandages interfere with daily activities. This process also affected our physiotherapist’s time, our waitlist and increased the cost for the bandage material. The solution When little things bug you it’s time to look toward technology! I contacted purchasing and spoke with my manager and it was determined that both would accept scanned emails of the purchase requisitions forms. Our new process involves scanning the purchase requisition and garment order forms, emailing it to my manager, who then forwards
What do YOU think about the Active Offer?
Horizon’s Active Offer Every Day initiative has allowed more than 2,800 employees to express their thoughts and ideas. Like all aspects of health care, effective communication and clear understanding are very important in maintaining our commitment to exceptional care. By sharing experiences and engaging in open dialogue, Horizon is gathering feedback from all employees and managers regarding how the organization provides the Active Offer. We would like to thank each and every participant for their helpful and meaningful contributions. Every participant is encouraged to open up and discuss their challenges in providing the Active Offer and services in patients’ language of choice, as well as to express their level of satisfaction on how the organization has achieved this in the past. As an employee, you have an important role in providing care that is truly patient-centred. That’s why your opinions and ideas are important for us to understand what works and what could be done better when providing services in both official languages. Your suggestions help to improve unit-specific issues, such as contingency plans, which can lead to better service and higher patient satisfaction. We often hear, “I speak French, why should I attend?” or “I don’t speak French, these sessions are not for me.” These dialogue sessions have nothing to do with learning a language. They are about engaging you, our employees, in a conversation on how we can succeed by working together and helping each other. An Active Offer dialogue session is an excellent opportunity to be heard and to ask the questions you may have related to languages. ”
This little waste walk was not so little after all.
An example of how the new purchase requisition process for a custom fit garment has improved patient care (Remember: the ordering process formerly took four to seven days, and patients waited two to four weeks for their garment.)
Tuesday, July 3, 2018 12:03 p.m.: Patient order emailed to Regional Manager.
Many excellent ideas and constructive feedback have already been received, but we want the BIG picture from as many employees as possible. Please join us at a session and help us understand your concerns. All data is being collected and analyzed. Your contribution will provide insight to areas requiring improvement and/or change.
Please contact your local Official Language Advisor or Lorna Mansfield, Facilitator of Active Offer Dialogue Sessions, to register for a session.
A female patient before (left) and after treatment of lymphedema with custom fit compression garments.
12:15 p.m.: Email forwarded to Procurement. 1:36 p.m.: Order completed by purchasing to vendor. Wednesday, July 11, 2018 Patient receives their compression garment.
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Amale patient before (left) and after treatment of lymphedema with custom fit compression garments.
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