2.50
Hdl Handle:
http://hdl.handle.net/10755/198333
Title:
Lean Process Excellence Project
Abstract:
[ENA Annual Conference 2011 - Evidence-based Practice Presentation]Lean Process Excellence Project

Purpose: Prior to the Lean Project, throughput in the emergency department was delayed with both average length of stay (LOS) and left without being seen (LWBS) rates greater than the national average. The purpose of the project was to create a Lean Process Flow to improve throughput and reduce LWBS rates. Also, secondary purpose was that patient satisfaction scores and employee morale would be positively affected.

Design: This is a process improvement project designed using Lean principles. It was designed to have an impact on quality by decreasing LOS, LWBS rates, and door to doctor times.

Setting: The setting is a community-based, satellite hospital emergency department located in the southwestern United States with over 40,000 patient visits per year.

Subjects: Subjects included both staff and patients. Staff, including MD’s, mid-level providers, RN’s, emergency technicians, secretaries and admitting staff were observed for full work analysis. Movement of patients through the emergency department was observed in the form of a product process flow. The physical design of the emergency department and its’ impact on patient throughput was also analyzed.

Methods: This project was conducted using Lean methods which include the following phases:
Define: Identify the problems of delay to patient throughput to reduce LWBS and LOS.
Measure: Data collection including value stream mapping, product process flow and full work analysis of team members.
Analyze: The analysis incorporated evidence-based practices to develop standard work for nurses and other team members within their "scope of practice". Patient surveys, surveillance, and audited charts were implemented to ensure compliance.
Improve: Included triage redesign, physical construction/remodeling for a Lean Track, and using evidence-based design for standard work for all staff.
Control: Coaching the changes of the various roles in the emergency department and continued auditing and "on-the-spot" education to ensure standard works, then sustainment of improvements made through ongoing Lean Steering Committee.

Outcomes: Outcome goals for this project are to reduce the LWBS rate from 10% to 7% by 12/31/2010, and to 3 % by 12/31/13;, to reduce door-to-doctor time from 50 minutes to 40 minutes in the Lean Track by 12/31/2010; and to decrease the LOS for treat and release patients from 11 hours to 3 hours in the Lean Track by 12/31/2010. All goals have been met, with the LWBS rate currently at 3.3%. In addition, patient satisfaction numbers have improved dramatically.

Implications: The implications of this project are: improved design and a well constructed process. This resulted in major improvements in the emergency department patient throughput. Measured results show improved financial outcomes, quality and patient safety, and has significantly improved patient and staff satisfaction.
Repository Posting Date:
21-Dec-2011
Date of Publication:
21-Dec-2011

Full metadata record

DC FieldValue Language
dc.titleLean Process Excellence Projecten_GB
dc.identifier.urihttp://hdl.handle.net/10755/198333-
dc.description.abstract[ENA Annual Conference 2011 - Evidence-based Practice Presentation]Lean Process Excellence Project<br/><br/>Purpose: Prior to the Lean Project, throughput in the emergency department was delayed with both average length of stay (LOS) and left without being seen (LWBS) rates greater than the national average. The purpose of the project was to create a Lean Process Flow to improve throughput and reduce LWBS rates. Also, secondary purpose was that patient satisfaction scores and employee morale would be positively affected.<br/><br/>Design: This is a process improvement project designed using Lean principles. It was designed to have an impact on quality by decreasing LOS, LWBS rates, and door to doctor times.<br/><br/>Setting: The setting is a community-based, satellite hospital emergency department located in the southwestern United States with over 40,000 patient visits per year. <br/><br/>Subjects: Subjects included both staff and patients. Staff, including MD’s, mid-level providers, RN’s, emergency technicians, secretaries and admitting staff were observed for full work analysis. Movement of patients through the emergency department was observed in the form of a product process flow. The physical design of the emergency department and its’ impact on patient throughput was also analyzed.<br/><br/>Methods: This project was conducted using Lean methods which include the following phases:<br/>Define: Identify the problems of delay to patient throughput to reduce LWBS and LOS. <br/>Measure: Data collection including value stream mapping, product process flow and full work analysis of team members.<br/>Analyze: The analysis incorporated evidence-based practices to develop standard work for nurses and other team members within their "scope of practice". Patient surveys, surveillance, and audited charts were implemented to ensure compliance. <br/>Improve: Included triage redesign, physical construction/remodeling for a Lean Track, and using evidence-based design for standard work for all staff.<br/>Control: Coaching the changes of the various roles in the emergency department and continued auditing and "on-the-spot" education to ensure standard works, then sustainment of improvements made through ongoing Lean Steering Committee. <br/><br/>Outcomes: Outcome goals for this project are to reduce the LWBS rate from 10% to 7% by 12/31/2010, and to 3 % by 12/31/13;, to reduce door-to-doctor time from 50 minutes to 40 minutes in the Lean Track by 12/31/2010; and to decrease the LOS for treat and release patients from 11 hours to 3 hours in the Lean Track by 12/31/2010. All goals have been met, with the LWBS rate currently at 3.3%. In addition, patient satisfaction numbers have improved dramatically.<br/><br/>Implications: The implications of this project are: improved design and a well constructed process. This resulted in major improvements in the emergency department patient throughput. Measured results show improved financial outcomes, quality and patient safety, and has significantly improved patient and staff satisfaction.<br/>en_GB
dc.date.available2011-12-21T12:46:02Z-
dc.date.issued2011-12-21T12:46:02Z-
dc.date.accessioned2011-12-21T12:46:02Z-
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