Standardized Treatment of Patients with Alcohol Withdrawal - Oct. 2011
Overview
The Chief of the Medicine Service (Rick Albert, MD) requested that a multidisciplinary team of physicians, nurses, and pharmacists conduct a Rapid Improvement Event (RIE) to address the high rate of ICU utilization for treating patients with alcohol withdrawal.
Using LEAN
Using the systematic approach of LEAN process improvement adopted at Denver Health, the RIE team identified waste and opportunities for improvement. Standard LEAN tools such as process mapping, waste walks, communication/hand-off circle, and standardized work were utilized to develop a new future state with an improved algorithm for caring for this challenging patient population.
Tactics
- Developed new standard work in the form of a new medication and treatment protocol, obtained consensus for the new protocol by physician, nursing, and pharmacy leaders in the organization.
- Developed an education and communication plan to implement the new protocol.
Results
Based on a review of the data, the team projects that the new protocol could maintain and improve the safety and quality of care for these patients and reduce ICU utilization by an average of one day (from 3.6 down to 2.6 days) in the ICU. The savings to the institution was calculated to be $2,000,000/year.
Testimonial
One of the RIE participants, Dr. Tim Olsen, a medical resident, noted on his participant survey that his participation as a team member on this RIE was "The most educational and empowering non-clinical activity of residency thus far!"