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Promising Practices on Employee Retention

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Redesigning Equipment to Reduce Time Wasted and Increase Time Spent at Bedside

    • June 4, 2008

Intervention Title:
Redesigning Equipment to Reduce Time Wasted and Increase Time Spent at Bedside – Seton Family of Hospitals, Austin, Texas

Reduce the amount of staff time spent hunting for and gathering supplies and equipment and increase the amount of time spent at the bedside with patients.

Staff developed a model room that makes all equipment and supplies that nurses and front-line staff need easily accessible.

The time that nurses and front-line staff spent at the bedside increased from 32 percent to 55 percent.

Seton Family of Hospitals
1601 Rio Grande #300
Austin, TX 78701
P: (512) 324-8925

From the experts:
“Redesigning how we organize and store equipment has made a significant difference to the nurses and front-line staff providing care for our patients. It used to be that nurses spent a significant amount of time hunting and gathering the equipment they needed. By centralizing our equipment, nurses now have what they need, when they need it. Patients are happier and our nurses have more time to spend at the bedside.”

Mary A. Viney, R.N., M.S.N., C.N.A.A.-B.C.
VP Nursing Systems
Seton Family of Hospitals

The Seton Family of Hospitals, a not-for-profit organization, is the leading provider of health care services in Central Texas, serving an 11-county population of 1.7 million.

Clinical areas affected:

  • Medical surgical units

Staff involved:

  • Nurses
  • Physicians
  • Quality department

Staff spent eight to 10 months purchasing necessary equipment and changing work habits, four to six weeks implementing pre-filled saline syringes, and four weeks changing order sets for narcotic dosing.

Mary A. Viney, R.N., M.S.N., C.N.A.A.-B.C.
Vice President Nursing Systems Network Accreditation
P: (512) 324-8925

Innovation implementation:
Nurses and front-line staff found they were wasting valuable time hunting for and gathering equipment instead of being at the bedside with their patients. In order to decrease the time wasted looking for necessary equipment, Seton identified ways to redesign where equipment and supplies are stored and organized to increase efficiencies among staff. Multiple changes were required that involved working with supply and housekeeping staff.

To initiate the redesign process, staff created a model room with the necessary supplies and equipment. Originally, nurses and front-line staff went to a central supply area to get equipment. The model room included equipment such as an oxygen flow meter in oxygen tubing, suction canisters in suction heads, thermometers, blood pressure machines and intravenous poles. Since many of these supplies were initially shared and centrally located, there was a one-time investment to purchase equipment for individual rooms.

The model rooms were stocked with pre-filled syringes so nurses could flush IV lines with saline before and after blood draws and the administration of medication. By having the pre-filled syringes in patient rooms, nurses didn't have to find syringes and saline each time.

Another design element included changing the process of when narcotics were administered for pain. Originally, nurses went to a machine for the appropriate medications. If the exact dose they were giving was not available, another registered nurse had to witness the disposal of excess medications. Finding an available nurse for this process took time. Nurses worked with pharmacists to change the doses they provide to match what was typically administered. Physicians were also involved in the process change to discuss how they could standardize their order sets and match how medication doses are manufactured. By streamlining this process, nurses could provide patients with medications more quickly.

Advice and lessons learned:

  1. Be prepared for upfront costs. Identify upfront costs to purchase additional supplies but show the time saved by eliminating hunting and gathering.
  2. Ask nurses. Find out how nurses feel they are wasting time and what they wish could be different to allow them more time with patients.
  3. Start small. Try small redesign activities at the beginning to see if they make a difference.

Cost/benefit estimate:
Time saved equated to a minimum of 10 minutes per nurse per shift. For this unit, that meant an additional 250 minutes available to patients every day.