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One of the key principles of Lean Thinking is to eliminate delays which consume up to 95% of the total cycle time. If you've ever been a patient in a hospital emergency room or bed, you know there are lots of delays. Over the years, health care has made tremendous strides in reducing cycle time in various aspects of care. Outpatient surgeries are one example: arrive in the morning and leave in the afternoon. No bed required. But there is still room for improvement. Goal: Accelerate the Patient's Experience of Health Care Emergency Room
Unfortunately, patients don't arrive in a rhythmic fashion, they arrive in waves. The biggest wave is between 3pm and 9pm due to rush hour traffic accidents, parents picking up sick kids from daycare and so on. The smallest wave is usually 3am to 9am. So let's say patients arrive 2-3/hour at off-peak times and 10/hour at peak times. That's one every six minutes at peak times. StaffingMost ERs of this size, at peak demand, have:
Lab work often takes 45-60 minutes start to finish. Many of these patients will also need some sort of medical imaging (X-Ray, CT scan, etc.) Which also takes 45-60 minutes. Transfer Time How long does it take to move an admitted patient to an inpatient bed? Shouldn't be any longer than 30 minutes althougth most hospitals run longer than this. Why? Trying to sync up the ER and floor nurse to give "report" on the patient's condition and diagnosis. Solution: Fax or voice mail the report and transport the patient to the floor as soon as a bed is ready. Hospital Beds
Length of stay (e.g., takt time) in most of these units is 2-3 days. Patients also arrive from the operating room (3-5 per day) and direct admissions from local physcian offices (3-5 a day). On a peak day, any unit can admit 10 or 12 patients and discharge 10-12. The sum of these two is called the "bed turn" rate (20-24). Delayed Discharge Solutions:
Dirty Beds How long does it take to clean a bed after a patient
leaves? Solution: Eliminate the delay. Are you staffed for peak bed turnover times? Probably not. Here's my point: If are a hospital and you don't know the answers to these questions, you might consider our new Patient Throughput / Length of Stay Time Tracking System only $497 plus $10 S&H. The system includes templates for:
For more information see http://www.qimacros.com/edlog.html. You can even preview a copy of the user guide at http://www.qimacros.com/pdf/EDLOSUser.pdf. © 2007 Jay Arthur, the KnowWare® Man, works with managers who want to plug the leaks in their cash flow. Hire Jay Arthur to train your staff in his one-day Lean Six Sigma Workshop! Contact Jay at (888) 468-1537, lifestar@rmi.net. Rights to reprint this article in company periodicals is freely given with the inclusion of the following tag line: "© 2007 Jay Arthur, the KnowWare® Man, (888) 468-1537, lifestar@rmi.net."
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© 2007 KnowWare International Inc. (888) 468-1537 |
It contains over 70 fill in the blank templates such as the Ishikawa diagram, QFD, DOE, FMEA, PPAP, and Gage R&R for MSA. Performs ANOVA, t-test, F-test, and regression analysis.
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