Avera McKennan Hospital and University Health Center
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Avera McKennan Hospital and University Health Center |
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Implementing lean methodology to the laboratory, emergency department, surgery department and housekeeping.
Organizational Characteristics
Number of Staffed Beds: 531
Number of Admissions: 18,773
Number of Physicians on Staff: 534
(includes medical residents)
Total Operating Expenses: $349,162
(in thousands)
Dimension of Quality—Improvement Strategies and Methodologies
About the Initiative
Objectives
Lab
There was a need for additional space and performance improvement. The lab was between permanent directors.
Initial expectations: Improved workflow; improved space design; improved productivity.
ED
The space savings in the laboratory prompted administration to ask if patient flow could be improved in the emergency department to result in additional space savings, reducing the need for new construction of 23 ED rooms.
Initial expectations: Space savings in the ED would result in saving capital dollars.
Surgery
Success in the supply replenishment process in both the laboratory and ED prompted a project in operative services which accounts for 60 percent of inventory.
Initial expectations: A robust supply replenishment system that would reduced inventory and result in savings for the organization.
Housekeeping
Patients needing to be admitted were waiting in the ED for bed placement since rooms had not been cleaned.
Initial expectations: Rooms would be cleaned in a first-in-first-out basis after patients were dismissed, increasing the availability of rooms.
Results
Lab
- Standardization of collection and transportation as well as reorganization and standardization of work in the laboratory leading to a total change in how work was collected, received and performed.
- Turnaround time dropped from an average of 68 minutes to 37 minutes from collection to verification (availability to the physician) for chemistry panels.
- Testing error rate improved from 3.9 Sigma to 5.4 Sigma level over a 2-year period and continues to improve.
ED
- Standardization of ED rooms with no specialized equipment, instead specialty carts were created with necessary supplies
- Reduction in LOS and improved availability of inpatient rooms for admissions resulted in construction of 18 rooms instead of 23.
- Most patients see a physician within 20 minutes of arrival resulting in increased patient satisfaction scored from the 60thpercentile to above the 90th percentile.
Surgery
- Patient received uninterrupted preoperative care – patients are ready for surgery in 20 minutes
- Preoperative patients were moved closer to the surgical suites eliminating the need for a preop waiting area within surgery.
- Suture inventory savings is $108,000 annually
- Bar-coded inventory replenishment system was implemented
- Bar-coded inventory capabilities enable periodic cycle counts to monitor inventory levels
Housekeeping
- Patients are dismissed in the information system within 15 minutes of departure
- The information system generates an automatic page to housekeeping notifying them of a room to clean
- Carts bring cleaning supplies directly to the point of use eliminating the need to enter and exit the room to access supplies in the hallway.
- Turnaround times for rooms is approaching 60 minutes.
Required Resources
6 to 8 FTEs for 10 to 12 week projects
Misc. supplies
Advice for Colleagues
The application of lean processes provides for improved patient outcomes, improved bottom line and can be applied to a large variety of areas within a health care system. Along with improved productivity and financial performance, it helps to achieve improved patient satisfaction.
Contact Information
Name: Leo Serrano
Title: Director of Laboratory Services and Lean Initiatives
Email:
Name: Fredrick W. Slunecka
Title: Regional President
Email:
