Interview with Steve Labbé, Nurse and Senior Clinical Innovation Advisor, and Julie Bellemare, CPC’s Senior Advisor, UMHC/CHUM
Note: CHUM stands for Centre Hospitalier de l’Université de Montréal (translated as University of Montreal Health Centre, or UMHC) and is one of the largest hospitals in Canada.
Lumevi is a privileged witness to technological advances in the healthcare sector. Our clients are important drivers of change, and we are fortunate to have a front-row seat as they leverage and adapt our clinical solutions to create customized tools that meet specific needs.
We would like to highlight a project carried out at the CHUM Endoscopy department in 2019. We spoke with Steve Labbé, a Nurse and Senior Clinical Innovation Advisor with the Pôle d’innovation et d’intelligence artificielle en santé (Innovation and Artificial Intelligence Hub in Healthcare), under the general management of the Centre hospitalier de l’Université de Montréal (CHUM), and with Julie Bellemare, Senior Advisor in the department of Cost Per Pathway of Care and Services (CPCS). During this interview, we discussed the “Patient Experience at the Heart of Innovation” project, which resulted in a solution to simplify the endoscopy care pathway.
We are here today to discuss the project you spearheaded at the CHUM Endoscopy department, “Patient Experience at the Heart of Innovation”. Could you describe this project?
Steve Labbé:
It all started with the migration of services to CHUM. We had to merge three hospitals, three distinct cultures inside a single cutting-edge framework. We asked ourselves how we would integrate these new ways of doing things, but also how we would transform this digital shift into a more human experience. How could we orchestrate the shift from paper to digital documentation? How do check-in kiosks improve the work of administrative agents? We also asked our partner patients about their expectations during an endoscopy examination. In fact, the phrase “being at the heart” of the process was often used in interviews with them. This is what inspired us to name the project “Patient Experience at the Heart of Innovation”.
The project was based on six main objectives:
- Respond to the CHUM academic mission to catalyze innovation
- Personalize care
- Create fluid processes
- Optimize the technical platform
- Ensure employee well-being and satisfaction
- Ensure patient safety
“Patient Experience at the Heart of Innovation” is a project thought up by clinical people, people in the field for whom it was essential to adapt new technologies to the workplace, to the resources, to the needs of the endoscopy department and to those of the users. The project was born out of an operational need that we understood well, and for which we mandated people in the field to be deployed quickly.
What motivated this project? What was the initial situation in the Endoscopy department?
Steve Labbé:
A typical day in Endoscopy at CHUM requires a lot of coordination. The team manages a daily volume of approximately 100 to 120 patients who, depending on the examination, must engage in different processes with providers located in every corner of a department of approximately 3,200 square feet.
The tool we developed leverages multiple types of data, from patient admission to discharge. Among other things, the tool allows staff to see patients’ physical location, where they are in their care trajectory and how much time has elapsed between each step of the process. Staff movement is efficient because information is disseminated in real time, minute by minute. The work of each team is simplified and the user experience is much more personalized.
Managers also benefit from this. Before implementing the tool, we had no way of understanding how the total duration of an endoscopy visit was broken down. How much time are patients spending in the waiting room, in preparation, in examination or in recovery? It was impossible to know, and this became a major obstacle at the time of reporting.
Julie Bellemare:
Now, depending on the objectives and measures deemed relevant, the tool is programmed to retrieve and organize data in a way that is easy to interpret. These reports and data support strategic decision-making and allow managers to intervene quickly, if necessary.
What challenges or pitfalls have you encountered along the way?
Steve Labbé:
The main challenge we faced was to fully understand our processes and how the tools already in place would help us optimize them. We collected and analyzed several types of data to understand the scope of possibilities and to define realistic goals, but also to make sure we had what we needed to calculate the value of our decisions.
Julie Bellemare:
Once this exercise was done, we had to find a way to put the data together, but more importantly, to get a real-time overview. This is when we had the idea of connecting directly to various views with Power Query and using SQL queries. This way, we could schedule an update every minute, ensuring the most up-to-date data possible. Using existing tools saved us time and money.
What methodology did you use for this project?
Steve Labbé:
Our vision is based on innovation, and the role of the Innovation and Artificial Intelligence Hub is to activate it and implement tools to accelerate it. Over six months, our needs changed and technology evolved, so we had to adopt an agile methodology. We materialize an idea, we implement it, we experiment with it. We optimize our product based on our observations in the field. How are the teams, the users or the system reacting? We work closely with clinical staff, but also with our partner patients. This is what made “Patient Experience at the Heart of Innovation” a success. Several trials have been conducted during development in close collaboration with engaged staff and partner patients.
What tangible results did you observed following implementation of the project?
Steve Labbé:
One of the main goals was to ensure that patients were satisfied with their endoscopy pathway. To measure their satisfaction, our Quality, Assessment, Performance and Ethics department created an electronic survey that is sent automatically after an examination. Survey results reached 96% satisfaction with response rates above 30%. This exceeded our expectations both in terms of satisfaction and of response rates. This was a huge success for our team.
Julie Bellemare:
I spent a lot of time in the field and with managers to fully understand the department’s operations. When I started working on the project, the total duration for an endoscopy care pathway was six hours. Now, we are between three and three and a half hours.
Steve Labbé:
There have been several positive impacts: the volume of exams performed has increased significantly, resulting in a decrease of out-of-time exams (from 60% to 17%) and a reduction in our waiting lists. Overtime caused by room overruns decreased by 87%.
Employee turnover rate has also gone down. I remember when I started in Endoscopy, I had a hard time building a team. Now, people want to work with us. They want to be part of the solution. People — from recovery nurses to administrative agents — want to contribute to the project. It’s motivating for them to know that their knowledge and skills are being used and contribute to the continuous improvement process of the tool. The beauty in all of this is that it’s all about collateral positive impacts and value created for patients, staff and managers. Our main objectives were to ensure patient and staff satisfaction.
"The volume of exams performed has increased significantly, resulting in a decrease of out-of-time exams and a reduction in our waiting lists"
The results you mention are notable (average decrease in length of stay and out-of-time exams, decreased overtime by 87% and increased employee and physician productivity and satisfaction). In your opinion, what explains this success?
Steve Labbé:
Staff mobilization has played a key role in developing the tool. Administrative agents, nurses, analysts, department managers, physicians, etc. were all rowing in the same direction.
The key is to involve partner patients and clinical teams. They are actually the main actors of our project. We consulted them at every step of the process. They were transparent and offered us valuable insights. It is thanks to them that we now have a sustainable, transferable, but above all beneficial solution.
By creating a customized solution for the Endoscopy department, CHUM has significantly accelerated and improved care episodes for patients and caregivers. Lumevi is proud to put its technological tools and experts at the service of such innovative and transformative initiatives.
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