article = {SCR-2021-8-113}
title = {Introducing Rapid Change Escalades to Adjust Organisational Issues in Clinical Practice}
journal = {Surgical Case Reports}
year = {2021}
issn = {2613-5965}
doi = {http://dx.doi.org/10.31487/j.SCR.2021.08.13}
url = {https://www.sciencerepository.org/introducing-rapid-change_SCR-2021-8-113 
author = {Gerit  Kulik,Daniele Paccaud,Laurie Perey,Mario Hamelin,Eva Renon,Siheme Zouggagh,Anne Nowicki,Alexandre Lopes Freire,Lorry Duchoud,Eric Damian,Kaba Cissoko,Julien Chevalley,Frederic Cartiser,Christian Simon,}
keywords = {Workload, triage, absenteeism, process optimisation, waiting rooms, resource utilisation, nurse-physician collaboration}
abstract ={Background: Running clinical facilities implies facing many challenges, as neat time management and fluid care processes. A method that warrants small changes and an interconnected and collaborative proceeding is convenient for adjusting clinical processes and avoiding unwanted side effects. From an organizational perspective, a smooth clinical process translates also into a levelled occupation of team members as reflected by over-time and absenteeism. 
Methods: The policlinic nurse team introduced weekly mini-huddles of maximum 15 minutes to discuss work organizational issues, with structured access to collaborating professionals and their hierarchies. The team selected the topic of patients presenting without a planned appointment. Nurse’s over-time stock and absenteeism were assessed before and after the intervention. 
Results: The clinical process had six steps, of which the patient’s waiting room period was transformed into a nurse’s evaluation and triage period followed by a transmission note to the physician. The new process decreased the average stock of nurse’s team over-time from 65.5 to 46.8 hours (-29%), and the nurse’s absenteeism from 4.6 % to 1.97 % (-57%).
Conclusion: By cautious and collaborative proceeding, and the choice of an earnest issue by front nurses, we levelled the nurse’s workload and pleased patients and professional teams.
}