Include unit secretaries in work redesign

When a redesign team at Blessing Hospital in Quincy, IL, examined reasons behind its lengthy turnaround time for physician orders, members realized the work flow of unit secretaries was a key factor.

We measured the time from when the physician wrote the order until the time it was entered by the unit secretary, says Kevin Moffit, CHE, administrative coordinator and reengineer. We discovered unit secretaries were entering an order and then continuing with further processing of each individual chart.

As a result, it took on average one hour and 37 minutes for a routine order to be entered, 47 minutes for an ASAP order, and 24 minutes for a stat. order.

The team decided the solution was to have secretaries enter all orders immediately and then process charts. But in order to process orders and charts separately, workloads needed to be adjusted to ensure accountability.

Unit secretaries tend to be in charge of everything, yet accountable for none of it. So we assigned secretaries to a block of rooms, he says. Now not only can they process orders and charts faster, nurses and physicians know whom to ask for information.