Case Management

Hospital goes lean to improve discharge process

Case Management Insider, May 5, 2015

Businesses have been going lean for years—relying on management principles that are designed to eliminate waste and streamline delivery.

Healthcare has followed suit, using these management principles in an effort to improve healthcare delivery. One recent example is that of Penn State Hershey Children’s Hospital, where researchers used Lean Six Sigma methodology to improve the pediatric discharge process.
The results of the hospital’s effort, published in the April issue of the Journal of Hospital Medicine, was faster patient discharges—and no negative effect on their readmission rate. The median discharge was 93 minutes faster among patients in the intervention, with patients leaving at 10:45 a.m. instead of 2:05 p.m. The hospital also freed up inpatient beds faster, resulting in lower wait times for patients.
The initiative, if applied in other areas of healthcare, could help open up beds, reduce emergency department overcrowding and produce other improvements, without spending a lot of money, according to Penn State officials.
To get the results, Dr. Michael Beck, a professor of pediatrics at Penn State’s College of Medicine and a physician at Penn State Hershey Children’s Hospital, applied Lean Six Sigma methodology to the pediatric discharge process to look for wasted steps and inefficiencies.
When the researchers identified problems, they made changes to the process, including adding a second group rounds team to divide up the patient caseload and developed discharge checklists to help improve and standardize the discharge process.
Another team was formed to look at the cases of patients who were scheduled to leave the following day to spot problems before they slowed down the process, according to Penn State.
The researchers also tracked the hospital’s readmission rate to look for changes to ensure faster discharges didn’t mean lower quality discharges. There were no changes to the readmission rate as a result of the intervention.
Overall, the hospital saved between $275,000 and $412,000 by increasing discharge efficiency, according to Penn State. And perhaps the best news, physicians were happy with the new model—100% voted to keep it.
Considering the success of this approach your hospital might want to consider going lean as well.

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