2.50
Hdl Handle:
http://hdl.handle.net/10755/162521
Type:
Presentation
Title:
Emergency Department LEAN Project
Abstract:
Emergency Department LEAN Project
Conference Sponsor:Emergency Nurses Association
Conference Year:2009
Author:Dockery, Nathan, RN, BSN
P.I. Institution Name:Saddleback Memorial Medical Center
Title:Clinical Coordinator Emergency Services
Contact Address:24451 Health Center Drive, Laguna Hills, CA, 92653, USA
Co-Authors:Caron Hill, RN, BSN; Flora Tomoyasu, RN, PHN, BSN, MSN, CNS; Kim Hogerson, RN, CEN
[Annual Conference] Clinical Topic: Waste affects all aspects of care in the Emergency Department (ED). Extra time and effort spent to obtain medications, equipment, and other supplies is considered "waste." ED nurses were walking distances of up to 3200 ft. and taking up to 12 minutes to collect needed supplies. In a survey, RNs rated the ease or difficulty of obtaining supplies and equipment for patients as a 2.95, on a scale of 1 (difficult) -5 (easy). Using this data, LEAN principles were utilized to eliminate waste and increase efficiency in the unit. Two targets for our LEAN Workshop were to reduce wasted time and distances traveled by 50%.

Implementation: The ED LEAN workshop team consisted of 20 staff members, from all areas and roles in the ED. The team met for 5 days to determine how to co-locate supplies and equipment near the patients in an effort to reduce RN travel distance and time. The team shadowed a RN, and used a stopwatch to calculate the actual time/distance walked while caring for one patient.
The team utilized the LEAN principles of 5S when deciding how to Sort, Simplify, Sweep, Standardize, and Sustain the supplies/equipment in the new locations. During the Sorting phase the team separated the needed from the un-needed items. The un-needed items were then discarded or donated. During Simplification a "home" was created for all supplies/equipment. During the Sweeping phase, visual controls were made so that staff can visually "sweep" the area to know if items are in their "homes" or if supplies are under stocked. During the Standardization phase, procedures for re-ordering and stocking were posted in the care area. Lastly a Daily Audit document was created for the Charge Nurses to monitor how the Care area is Sustained.

Outcomes: After new LEAN processes were developed, a nurse now travels only 928 feet and spends 4 minutes to obtain the same supplies/equipment. Staff reports the ease of obtaining supplies and equipment while caring for patients has increased from an average of 2.95 to 4.6 on a scale of 1 (difficult) - 5 (easy). The success of this workshop has raised staff morale and created enthusiasm to continue applying LEAN principles to other areas of the ED.

Recommendations: Our next step is to replicate the LEAN work flow in the Main Treatment Area. This would require altering MD/RN schedules and patient assignments to ensure similar acuity loads and comparable staff roles in each area. Analysis of Work Balance and data collection regarding triage processes and assignment of acuity would be required.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEmergency Department LEAN Projecten_GB
dc.identifier.urihttp://hdl.handle.net/10755/162521-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Emergency Department LEAN Project</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Dockery, Nathan, RN, BSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Saddleback Memorial Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Coordinator Emergency Services</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">24451 Health Center Drive, Laguna Hills, CA, 92653, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">NDockery@memorialcare.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Caron Hill, RN, BSN; Flora Tomoyasu, RN, PHN, BSN, MSN, CNS; Kim Hogerson, RN, CEN</td></tr><tr><td colspan="2" class="item-abstract">[Annual Conference] Clinical Topic: Waste affects all aspects of care in the Emergency Department (ED). Extra time and effort spent to obtain medications, equipment, and other supplies is considered &quot;waste.&quot; ED nurses were walking distances of up to 3200 ft. and taking up to 12 minutes to collect needed supplies. In a survey, RNs rated the ease or difficulty of obtaining supplies and equipment for patients as a 2.95, on a scale of 1 (difficult) -5 (easy). Using this data, LEAN principles were utilized to eliminate waste and increase efficiency in the unit. Two targets for our LEAN Workshop were to reduce wasted time and distances traveled by 50%.<br/> <br/>Implementation: The ED LEAN workshop team consisted of 20 staff members, from all areas and roles in the ED. The team met for 5 days to determine how to co-locate supplies and equipment near the patients in an effort to reduce RN travel distance and time. The team shadowed a RN, and used a stopwatch to calculate the actual time/distance walked while caring for one patient. <br/>The team utilized the LEAN principles of 5S when deciding how to Sort, Simplify, Sweep, Standardize, and Sustain the supplies/equipment in the new locations. During the Sorting phase the team separated the needed from the un-needed items. The un-needed items were then discarded or donated. During Simplification a &quot;home&quot; was created for all supplies/equipment. During the Sweeping phase, visual controls were made so that staff can visually &quot;sweep&quot; the area to know if items are in their &quot;homes&quot; or if supplies are under stocked. During the Standardization phase, procedures for re-ordering and stocking were posted in the care area. Lastly a Daily Audit document was created for the Charge Nurses to monitor how the Care area is Sustained. <br/><br/>Outcomes: After new LEAN processes were developed, a nurse now travels only 928 feet and spends 4 minutes to obtain the same supplies/equipment. Staff reports the ease of obtaining supplies and equipment while caring for patients has increased from an average of 2.95 to 4.6 on a scale of 1 (difficult) - 5 (easy). The success of this workshop has raised staff morale and created enthusiasm to continue applying LEAN principles to other areas of the ED.<br/><br/>Recommendations: Our next step is to replicate the LEAN work flow in the Main Treatment Area. This would require altering MD/RN schedules and patient assignments to ensure similar acuity loads and comparable staff roles in each area. Analysis of Work Balance and data collection regarding triage processes and assignment of acuity would be required. <br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:29:36Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:29:36Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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