I recently visited Penn State University Hershey Medical Center (HMC) and the Children's Hospital of Philadelphia (CHOP).
HMC is applying Lean methods in the area of demand capacity matching in their emergency department. Thus far they've realized significant improvements. Here is a quick summary of the work they are doing and the results they are getting:
The application of demand and capacity matching and the clinical application of queueing theory, is an integrated process of healthcare engineering and lean processing to a problematic area of the hospital for throughput the emergency department (ED) has recently been studied at the Penn State University, Hershey Medical Center. A before and after study was designed to test the hypothesis by matching the demand of patients despite the lack of physical space to the capacity of care givers, without physical space. The ED was built for 32,00 visits, and currently sees nearly 50,000 with an average of 10 of the 27 beds filled with patients awaiting admission to the hospital (overcrowding). Placing ED physicians, near arrival with existing nursing and registration staff, optimal utilization of the Electronic medical record and queueing theory, physicians directed care upon arrival and determined clinical care needs, not just bed need. This resulted in a 23% reduction in a key parameter of throughput efficiency, ED length of stay, for all patients. This process has been termed Physician Directed Queueing (PDQTM).
These changes were observed without any change in resource availability and without any evidence of safety or quality issues. It has also been piloted in another south central PA emergency department with success.
At CHOP, the Pathology and Lab Services department are applying basic Lean methods like 5S and value stream mapping to uncover significant improvement opportunities to increase the turnaround time (TAT) on lab results which have a direct bearing on patient TAT. USC Consulting Group is helping CHOP on this endeavour. In the first 10 weeks, CHOP reduced Lab TAT by 50%. That's a staggering improvement. USC Consulting Group is now implementing a communication and collaboration technology infrastructure so CHOP can extract data from their Meditech lab information system to surface process data like cycle time, value added time, turnaround time, etc. It's arranged in scorecards using Microsoft Office SharePoint so it's fast and easy to access relevant data. It also gives them access to value stream maps and reports at their fingertips. This makes it easy for the teams to store, share, and collaborate on projects. It was quite impressive and it appears that CHOP is looking for ways to introduce this into other parts of the hospitals operations.
More trip reports and insights to come. By all means share your own.
Director, Operational Excellence Solutions, Microsoft Industry Solutions Organization