The Science Journal of the American Association for Respiratory Care

2008 OPEN FORUM Abstracts


Mary J. Johnson1,2, Joel S. Larson1, Michelle L. Anderson1, Grace E. Belford3, Julie Clark3, Barbara B. Cleary7, Stephanie D. Littman5, Janice M. Magallenez5, Mary C. Poquette4,7, Vickie L. Timm6

Mayo Clinic Arizona (MCA) is comprised of the Mayo Clinic Building (MCB), Mayo Clinic Hospital (MCH), Mayo Clinic Specialty Building (MCSB) and several off campus sites (OCS).

The type of medical emergency response varies within MCA based on location. The project was initiated to improve response time for all medical emergencies. The MCB was identified as having the most complex system for medical emergency events and became the first target area for improvement.

MCB had 440,772 outpatient clinic visits in 2007. The vast range of disease processes and complexity of patient conditions seen at the clinic provide a higher likelihood for a medical emergency to occur than would be expected in other outpatient settings.

Site visits and interviews provided team members insight into how the medical emergency process works and where the potential for improvement would be the greatest. It was determined that the MCB medical event communication process takes 7 steps, includes at least 3 different people and takes an average of 1.5 minutes to complete. The initial 911 caller provides the information to the operator who then relays it to the MET nurse. The 911 caller and MET nurse do not communicate.

Using a variety of quality improvement tools, the team determined the best way to shorten response time would be to focus on reducing the time spent in the communication process. The project goal: Reduce the time from the initial notification received by the operator to the time the MET nurse is informed of a medical emergency event at MCB by 50%.

Potential solutions to improve the communication process were identified. Although time from the initial 911 call to arrival of responders was impacted by the type of information given and the order it was provided to the operator, more time was gained by changing the communication workflow. A process to have the operator direct connect the 911 caller to the MET nurse was trialed. Using available communications resources, the operator receives the 911 call and connects the caller to the MET nurse. By directly connecting the caller with the responder, the process steps and communication time were reduced and overall communication of the event improved.

The direct connect process trial reduced the communication time from over 1 minute to 25 seconds. The reduction in time of over 70% significantly exceeded the goal of 50% reduction. The team has recommended implementation of the workflow change.