How a Lean-based QI program increased discharges by noon

A study published in The Joint Commission Journal on Quality and Patient Safety examines the effectiveness of a Lean Six Sigma-based quality improvement program on timing of patient discharge.

For the study, researchers created a 'value team' at a 627-bed, tertiary care academic medical center. They implemented a quality improvement project using Lean Six Sigma methodology.

The project involved the team defining the problems around timeliness of discharge and then going through the steps in the Define, Measure, Analyze, Improve, Control framework. They then implemented interventions based on an in-depth analysis of barriers to the discharge process. The interventions included geographic cohorts of internal medicine physicians on specific hospital units and multidisciplinary huddles one day before anticipated discharge.

The study shows the percentage of discharge orders released by 10:00 a.m. increased by 21.3 points postintervention, and the percentage of patients discharged by noon increased by 7.5 points. There were no significant changes in the 30-day readmission rate or length of stay.

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