A Live Implementation of Business (Care) Process Management

Technology to Streamline Discharge Readiness Planning

E-Health 2013Cameron KeyesMay 27, 2013

Conflict of Interest and Disclosure

Cameron Keyes, MScHas no real or apparent

conflicts of interest to report

© 2013 HIMSS

Key Take Away Points

Why there is a need for business process management in healthcare

What is TOH’s strategy for implementing “care” process management (CPM)

How we are rolling it out to streamline discharge readiness planning

The Hospital’s Vision – “ To provide each patient

with the world-class care, exceptional

service and compassion that we would want for

our loved ones ”

The Ottawa Hospital

Characteristics of Patient Care Processes today

Lab

Registration/Scheduling Physician

Nursing Unit

OR

Patient

Medical Imaging

OHP

CCACLTCHome

New layer to orchestrate People, Processes, Data and TechnologyNew layer to orchestrate People, Processes, Data and Technology

The Ottawa Hospital Way

BPMCPM

CPM Journey

Launch Adopt Transform

Maturity

Conducting initial

workshops

Quick Win Pilots: Health

Records, Wellness

BPM Office Concurrent projects

Development & ExecutionDRP, VTE,

Wellness (ph 2),Health Records (ph 2)

CPM Transformation Program

Implementation

Aug 2011 Dec 2011

Adapted From: Dyer et al. 2012. Scaling BPM Adoption From Project to Program with IBM Business Process Manager. IBM.

CP

M C

ap

ab

ilit

ies

Jan 2012 - PresentKey component of

transformation strategy

Expanded platform - Rules / Event Engine

Discharge Readiness Planning Process Inpatient Care Team Pain Points

Lack of Clinician Accountability

‘Open Loop’ Communication Processes

Delegated Actions

Inability to keep track of who’s doing what

The Patient Care Team will become visible to everyone

Care providers will have clearly identified tasks that they are accountable to report on

Issues affecting discharge will be flagged at the beginning and the Medically Ready Date of the patient will be tracked and communicated throughout the patient’s stay

The Main Goals of the Pilot

Application Layer

Patient Reg Scheduling OR Mgmt EMR Communications

…

Enterprise Service Bus / Integration Engine

Care Process Management Capabilities

Web / Mobile User Interfaces

HL7 Messaging Database Management RTLS

BPMS Rules/Event Engine BI Tools Collaboration Messaging

PC iPhone iPad Portal

Enterprise Process Architecture and Key Components

RFID

Nurse Physician Health Professionals

Whiteboard

Notifications

Entitlement

Process Driven Design

DRP: Mrs. Alice Blue’s Journey

Notification to in-patient team

Mrs. Blue is admitted to Service Setting Medically

Ready Date Notification to other health professionals

Mrs. Blue is discharged

ED Consult Request

Consult alert acceptance/ delegation

Receiving acceptance

Unstable

Convalescent

48 h

24 h

Electronic Consult Requests

Physician estimates the Medically Ready for Discharge Date and requests Orders for Therapeutic

Services

A simple, easy to use visual interface that identifies the

providers involved in patient’s care

Circle of Care & Patient Roster

Patient Roster listing patient discharge status viewed by

all team members

Key Leanings

Cultural Change

Careful selection of initial projects to demonstrate value and learn

New operating model

Embedding into existing infrastructure

Iterative approach

Measuring success

Thank you!

Cameron KeyesDirector, Healthcare Process TransformationThe Ottawa Hospital(613) 737-8899 x 75910cakeyes@toh.on.ca