Friday, September 9, 2011

Applying Lean Principles Reduces Wait Time

Challenge: Applying lean manufacturing techniques to an organization that cares for people might seem dubious, but it worked for the staff of Capella Healthcare in Muskogee, Okla.

Muskogee Regional Medical Center, a 275-bed facility owned by Franklin, Tenn.-based Capella Healthcare, was experiencing a serious problem: the emergency department ranked lowest among Capella's hospitals and in the bottom 1 percent of emergency departments across the country.

Background: Capella Healthcare owns and/or operates 13 general acute-care hospitals in seven states, including three in Jasper, McMinnville and Sparta, Tenn. The medical center in Muskogee, Okla., is the system's largest and offers the widest range of medical care.

"We knew we needed to improve our patient satisfaction scores," says Teresa Williams, vice president and chief quality officer of Capella Healthcare. "But we didn't want to simply meet a numeric goal. We wanted to provide better care for our patients."

Concept: Capella's senior vice president and chief operating officer, Michael Wiechart, had attended a "Lean for Healthcare" course at the University of Tennessee. Originating in the Japanese manufacturing industry, lean principles have been applied successfully by many manufacturing and service industries.

Solution: Capella executives believed applying lean principles to Muskogee's emergency department could transform it. A team comprised of Muskogee personnel and Keith Leitner, faculty member for the UT Center for Executive Education's Lean for Healthcare course, spent days and nights observing Muskogee's current processes, interactions between patients and staff, as well as documenting what was right and what needed to be improved.

One significant improvement implemented immediately was to remove a "barrier" between patients and caregivers. A wall separated the two, and although it won't be torn down until a future renovation, the caregivers were moved out from behind it. Patient rooms were also grouped into pods with nurses assigned to specific pods. The result was happier patients and more satisfied employees.

Lean emphasizes efficiency. Medical supplies that once were stored in inconvenient locations were moved bedside, and a simple system of color-coded visual cues outside each ED room conveyed patients' status to caregivers. These lean-inspired changes allowed caregivers to work more efficiently, giving them more quality time with their patients.

Results: Muskogee's emergency department began its journey in early 2010 and results were evident within months.

"Muskogee's patient satisfaction in the ED now ranks in the upper 60 percent nationally," says Beth Wright, Capella's vice president for corporate communications and strategic marketing. "We aren't going to stop now, but that's a huge difference already."

Patients' time in the ED has been reduced by almost 15 percent, with time between patient registration and discharge cut almost in half.

Doctors and nurses no longer perform tasks that don't add value to patient care. "Doctors and nurses are getting back to what they do best and what they want to do more of: care for patients," Wright says.

Capella continues to implement lean principles at its facilities.

"A key to successful lean implementation is empowering staff members," Wright says. "We've seen people realize how each department affects others and how working together can result in the elimination of waste and higher employee satisfaction."

Creating more efficient processes does not translate into eliminating positions. Growth is the desired result. With leaner processes, Capella can become the health care provider of choice in each of its 13 markets.

Case Study is provided by the University of Tennessee College of Business Administration.

Thanks to Scripps Newspaper Group / Knoxville News Sentinel Co.


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