Epileptologists: Workflow analysis support, First approval step

Nurse Administrator: Approval of project charter, protocol drafting/compliance support, connection to leadership approval

Neurology Department Physician Leadership: Second approval step

Site-wide Physician Leadership: Final approval step

Project costs:
Project costs will be absorbed by the outpatient neurology clinic, with the project leads being given sufficient time to dedicate to the workflow redesign project.  Supplemental staff will be brought in as needed to backfill their positions.  It is expected that over time initial costs will be recouped via the cost savings incurred by the workflow redesign

 

People: Katherine Kolson, BSN, RN & Monique Walker, BSN, RN (Project Leads), Drs. Tatum, Feyissa, Ritaccio (Epileptologists), Cammi Velichko, MSN, RN, CNRN, NE-BC (Nurse Administrator), Neurology Department Physician Leadership, Site-wide Physician Leadership

 

Departments: Neurology Nursing, Neurology Physicians, Nursing Administration, Site-wide Physician Leadership, possibly Legal

Testing of new workflows:
Once the protocol for ordering the labs is approved, a small pilot of the new workflow will be performed to test it out in practice.  One of the two epilepsy nurses will use the new workflow for a month, while the other epilepsy nurse will continue with the old workflow.  This will allow for a trial of the process before full implementation occurs.  The trial can be evaluated, and changes made before full implementation. 

Training of individuals on new workflows:
Currently there are two epilepsy nurses who will be affected by this new workflow.  One of the nurses serves as one of the project leads, and will not require training.  A training session will be used to illustrate the new workflow to the other epilepsy nurse and will include the workflow maps for visualization.  A brief team huddle will be used to convey the new workflow to the rest of the neurology department nurses.  They will not be expected to utilize the new process unless providing coverage for an absence in the epilepsy division.

Description of "Go Live" with new workflows:
"Go live" will take place once the small pilot has been completed and the workflow revised as needed.  Both epilepsy nurses will begin using the new workflow to order antiseizure drug level labs for eligible patients.  Expected volume is approximately ten patients per month.  The epileptologists will be sent a courtesy email to alert them the new workflow is now in place, and they will only need to cosign the orders after completion.  A second email communication will be sent to the neurology nursing department to alert the nurses of the change in workflow should they need to fill in for one of the epilepsy nurses.

Analysis and refinement of workflows:
Analysis will be ongoing during the pilot and after implementation.  The fact that the workflow will only mainly affect two nurses will aid in the process of discovering any workflow issues, as well as implementing refinements.  The previously stated metrics of time, cost, and number of unnecessary labs ordered will be tracked and tallied monthly for six months.  After six months a project success report will be generated to report on metric specifics pre- and post-implementation.