Department 82 at Örebro University Hospital has treated rheumatologic diseases with intravenous Biologic Drugs for 5 years. The number patients has increased greatly in recent years. To meet this need, we started our improvement work in 2011.


Our patients needed treatment and our goal was to give all patients treatment within the prescribed time, and for them to feel secure and that they received good care. We also wanted to develop a good work environment with less stress, despite the increasing number of patients and where everyone could be engaged in the work to achieve our goals.


The work was conducted in collaboration with the Rheumatology Clinic and with the help of Kenneth Malm from ProMES international Sweden. We have applied the evidence-based method ProMES (Productivity Measurement and Enhancement System). The method has enabled us to systematically see that undertaken changes produced the desired improvements.


We have succeeded in streamlining the chain of care by minimizing many types of wasted time. In 2010 we treated 58 patients and performed a total of 217 treatments.

Three years later, in 2013, we treated 128 patients and performed a total of 821 treatments. The graphs shows the results by year. This is an improvement of 378% in number of treatments from 2010 to 2013 using the same number of staff and other resources. The results for 2014 should lead to a total of 890 treatments and 140 treated patients.


By using high-quality, agreed upon measures in a good feedback system, we have been able to regularly see our results and plan improvements. We have received substantial positive feedback on what we have done, not just from our patients but also from the hospital management. That gave us the motivation we needed to continue. We are also proud of the work we have done. The project was awarded with the Diamond Award, a quality award within Örebro County Council.