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,
Introducing Rapid Change Escalades to Adjust Organisational Issues in Clinical Practice
Surgical Case Reports
2021
2613-5965
http://dx.doi.org/10.31487/j.SCR.2021.08.13
https://www.sciencerepository.org/introducing-rapid-change_SCR-2021-8-113 
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.
Keywords: Workload, triage, absenteeism, process optimisation, waiting rooms, resource utilisation, nurse-physician collaboration