The sustainable improvement of patient flow in an emergency treatment centre using Lean
Abstract
We report the two-year experience of an academic emergency treatment centre with using Lean – a technique that focuses on adding value and eliminating waste in a service line – to continuously improve patient flow. Lean helped us make changes in the process that were designed and adopted by our frontline providers. Two years after we adopted Lean, our total length of stay has decreased 3% despite an 18% increase in the patient volume and a 22% increase in admissions per month. The implementation of Lean has also been associated with a 9% decrease in the direct expense per patient (from $112 to $102.50) and a 9% increase in patient satisfaction. We conclude that Lean, when applied as a value-driven tool and adopted by the frontline workers in accordance to the local culture of care delivery: (1) yields the enhancement of patient flow and patient satisfaction that is sustainable beyond its short-term effects and (2) adds value; patients receive higher quality care at a lower cost.
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Lean implementation in reviewed emergency departments was associated with decreased emergency department length of stay.
“Decreased ED length of stay [ 72 ] [ 73 ] [ 75 ] [ 76 ] [ 79 ] [ 80 ] [ 81 ] [ 83 ] [ 85 ]”
From Lean Thinking in Emergency Departments: A Critical Review (2011) · cites this paper as [73]
Quality improvement is intimately linked to how individual providers interact with patients on the frontlines.
““quality improvement is intimately linked to how individual providers interact with patients, on a day-to-day basis in the outpatient clinic and inpatient unit frontlines” [73].”
From Lean Thinking in Emergency Departments: A Critical Review (2011) · cites this paper as [73]
Lean implementation in reviewed emergency departments was associated with increased patient satisfaction.
“Increased patient satisfaction [ 73 ] [ 75 ] [ 81 ] [ 83 ] [ 85 ]”
From Lean Thinking in Emergency Departments: A Critical Review (2011) · cites this paper as [73]
When staff carry out improved work processes, they may exhibit increased courtesy toward patients.
“In turn, when staff carry out improved work processes, they may exhibit increased courtesy toward patients [73].”
From Lean Thinking in Emergency Departments: A Critical Review (2011) · cites this paper as [73]
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Lean Thinking in Emergency Departments: A Critical Review
Holden, R. J. (2011) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2010.08.001 · Cited by 516 · see citing works
Use of Lean in the emergency department: a case series of 4 hospitals
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Self-citation
- Authors
- Dickson, E. W., Anguelov, Z., Bott, P., Nugent, A., Walz, D., & Singh, S.
- Affiliations
- University of Iowa (US)
- University of Iowa Hospitals and Clinics (US)
- ORCID
- Nugent, Andrew
- Venue
- International Journal of Six Sigma and Competitive Advantage
- Publisher
- Inderscience Publishers
- Published
- 2008
- Volume
- 4
- Issue
- 3
- Pages
- 289
- ISSN
- 1479-2494 (ISSN-L)
- 1479-2753
- OpenAlex
- W2116444857
- Cited by
- 15
- References
- 11
- Citations by year
- 2022: 1 · 2021: 3 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 1 · 2015: 2 · 2012: 1
- FWCI
- 1.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Six Sigma and Competitive Advantage (publishedVersion)
- Topics
- Health Sciences › Health Professions › Emergency Medical Services › Healthcare Operations and Scheduling Optimization
- Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Keywords
- lean manufacturing, patient flow, length of hospital stay, waste elimination, patient satisfaction, cost per patient, continuous improvement, healthcare process redesign
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