TY - JOUR
AR - SCR-2021-8-113
TI - Introducing Rapid Change Escalades to Adjust Organisational Issues in Clinical Practice
AU - Gerit , Kulik
AU - Daniele, Paccaud
AU - Laurie, Perey
AU - Mario, Hamelin
AU - Eva, Renon
AU - Siheme, Zouggagh
AU - Anne, Nowicki
AU - Alexandre, Lopes Freire
AU - Lorry, Duchoud
AU - Eric, Damian
AU - Kaba, Cissoko
AU - Julien, Chevalley
AU - Frederic, Cartiser
AU - Christian, Simon
JO - Surgical Case Reports
PY - 2021
DA - Mon 30, Aug 2021
SN - 2613-5965
DO - http://dx.doi.org/10.31487/j.SCR.2021.08.13
UR - https://www.sciencerepository.org/introducing-rapid-change_SCR-2021-8-113 
KW - Workload, triage, absenteeism, process optimisation, waiting rooms, resource utilisation, nurse-physician collaboration
AB - 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.