Virginia Mason is leading change by ensuring patient voices are heard, especially following a readmission. Like other WSHA member hospitals, Virginia Mason recognizes the importance of safe transitions to home or other medical sites in reducing unnecessary readmissions. When a transition failure occurs — signaled by an unplanned readmission — it’s important to identify the root cause. Until recently, Virginia Mason had overlooked the importance of taking time to consistently connect with patients.
Virginia Mason held a two-day Kaizen event focused on conducting patient interviews at the time of readmission to learn what the root cause of the readmission was, from the patient’s perspective. Before holding the event, interviews were done sporadically and not always in a timely manner. The lead time (time elapsed to conducting the root-cause analysis) was 5.45 days and the defect rate (percentage of readmitted patients who did not have root-cause analysis conducted) was 80 percent.
The Kaizen event helped the team identify how to embed patient interviews into staff’s normal workflows. They decided to use the Agency for Healthcare Research & Quality’s ASPIRE interview tool, as recommended by WSHA. They identified that the emergency department case manager had the capacity to conduct many of these interviews. The team also developed a template in the electronic medical record to document the patient interview, which is visible to the entire care team.
Sixty days after the Kaizen event, the Virginia Mason team achieved a 76 percent improvement in the lead time — from 5.45 days to 1.3 days — and achieved a 19 percent defect rate. They have expanded the initial pilot from three units to the entire hospital. Now they are tracking and trending the interview results to identify interventions to further reduce their readmission rate. Virginia Mason has also identified an opportunity to share their root-cause analysis results with their ambulatory care team. (Sue Bergmann)