Each year, physicians and nurses within the Division of Urology work together on dozens of process improvement projects both large and small. In 2015, three such projects – all driven by nurses – removed barriers to care and enhanced the patient experience.

Phone Triage System

The highest impact project involved changing how the staff uses the telephone to communicate with families, physician practices, vendors and schools. Previously, the division was receiving an average of 1,400 phone calls a month. An administrative assistant answered phone calls and forwarded messages to the nursing staff, but the high volume of messages made it challenging for nurses to respond in a timely fashion. When they did respond, they often had to leave a message, which led to more phone calls back and forth.

Now, two triage nurses answer incoming calls directly. This allows the staff to respond to parent questions and concerns more quickly, and process administrative requests (supply reorders, prescription refills, etc.) more efficiently. The initiative has decreased incoming call volume by approximately 50 percent without any decrease of care, in large part because callers’ needs are addressed in the initial phone call. Family feedback has been very positive.

Translation Services

Our patient population is culturally diverse, with a growing number of Spanish and Arabic speakers. Previously, surgical consent forms were available in English only; an interpreter translated the forms and read them to families before they signed. To change this cumbersome, time-consuming process, more than 60 consent forms were translated into Spanish and Arabic. This has improved consent accuracy and standardization across language barriers, and improved the patient and family experience. Language interpretation is still available in person, and by video and phone for families who speak these languages (and many others).

Testosterone Injection Orders

Children receiving testosterone therapy often need three injections – the first during a physician visit, and the second and third at a follow-up visit with a nurse. But until recently, our electronic medical record software only allowed physicians to order injections one at a time. This required nurses to ask the physicians to order additional injections during follow-up visits – an inefficient process. Our team collaborated with the hospital’s information services department to modify the electronic medical record system so that physicians can order a series of injections all at once. This helps ensure dose accuracy and injection documentation in the medical record.