How Lean Six can help speed ED discharge

Pennsylvania State University announced researchers from Penn State Hershey (Pa.) Children's Hospital found traditional business improvement strategies can work in the emergency department too.

Applying the Lean Six Sigma methodology to the ED, the researchers found it was possible to reduce pediatric patient discharges by a matter of hours without diminishing quality or increasing readmissions.

"We successfully eliminated an hour-and-a-half off all of our discharge times —consistently, predictably and reliably — for the busiest months of the year," said Michael Beck, MD, in statement. Dr. Beck is an associate professor of pediatrics at Penn State College of Medicine and led the study. "We were discharging 45 percent more patients per day, faster than the control groups, without increasing length of stay or increasing 7, 14, or 30-day readmission rates."

Researchers added a rounding team to the ED to the existing team and divided the caseload evenly between the teams. They used discharge checklists to help standardize processes and completed paperwork at the bedside. Each evening, the team met to go over morning discharges ahead of time.

A six-month application of these strategies produced the following results.

  • The group using Lean Six strategies reported an entire discharge time 200 minutes shorter than the control group.
  • The median time of discharge was 93 minutes earlier when using the Lean Six strategies.
  • Significantly more patients (75 percent) said they would recommend the hospital, than before the study (53 percent).
  • 100 percent of physicians voted to keep the new model, despite increased work hours from double-staffing the ED.

 

More articles on capacity management:

5 statistics about hospital capacity over time
Mission Hospital reaches capacity, president asks people to avoid ER when possible
UK HealthCare to add 120 beds

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