How lean manufacturing improved ER wait times, satisfaction at a California hospital

Lean manufacturing principles are responsible for a significant drop in emergency department wait times and a big boost in patient satisfaction at Stanford Hospital and Clinics in California, according to an article in Scope.

Best of all, the approach didn't expand the ED's current resources, Marlena Kane, executive director for performance excellence & medicine services at the hospital, told the publication. 

Lean management--as conceived by the Toyota company--is based on constant improvement and valuing people. Kane described the process to Scope as "looking at things from the patient's perspective and getting people to talk to each other."

The hospital formed a multidisciplinary team led by nurse leaders and physicians to meet increased demand and improve the patient experience in the ED. They applied lean principles, engaging frontline staff and empowering them to handle issues and problems as they came up. Staff then worked with other departments to isolate and resolve inefficiencies.

Within a year, she said, ED wait times dropped by 17 percent, in spite of the fact that the department treated more patients than the year before. The operating costs stayed the same.

Paul DeChant, M.D, wrote in Hospitals and Health Networks that lean management techniques can go a long way toward empowering personnel to provide higher quality, more effective care.

Imagine what would be possible, he said, if an entire healthcare institution "has the ability to effectively respond to the challenges it faces; has its entire workforce actively engaged in solving problems, removing waste and eliminating defects; and is able to focus its energy on maximizing the caring, healing interactions our patients crave."

A profound cultural change will be in order to bring that about, he said, and "change of this scope is possible only with strong, committed leadership."

Indeed, Scope noted that when the lean approach fails, it's usually because the leadership team wasn't fully invested in the process.

Some "safety-net" hospitals are already using lean manufacturing concepts to streamline their own operations and function more effectively. A North Carolina hospital system has incorporated the system to reduce patient falls by 22 percent and improve safety.

To learn more:
- read the Scope article
- here's the H&HN piece