Leveraging Lean in the Emergency Department PDF

Preface: Leveraging Lean in the Emergency Department

This book is intended as guide for healthcare executives and leaders, managers, process improvement team members, and inquisitive frontline workers who want to implement and leverage Lean in the Emergency Department. Its foundation is based upon the Shingo prize winning book, Leveraging Lean in Healthcare: Transforming Your Enterprise into a High Quality Patient-Care Delivery System.¹ The core chapters provide detailed information on the concepts, principles, and implementation of Lean in the healthcare environment. We felt it was critical to provide the reader with a broad foundation on the application of Lean in healthcare so one can see the how Lean can be applied throughout the continuum of care from the emergency room to other support services. Lean concepts and tools can begin in any clinical or non-clinical support area within an integrated delivery system and universally applied.

High-Quality Patient Care is imperative in healthcare. We strive for the highest quality care systems, in the pursuit of the triple aim:

1. improving health of the population,

2. enhancing the experience of care (quality and satisfaction i.e., value), and

3. reducing the per capita cost

Organizations must ¡nds effective ways to maximize value. The Lean Business Delivery System is one way to accomplish this.

Lean is a different way to think. It begins with understanding the voice of the customer and focusing on delivering value. Lean provides the foundational concepts and tools to identify and eliminate waste. We do not encourage working faster or harder, as "haste makes wastes". We just encourage working more ef¡ciently.

Business means that Lean applies to anything that is a process, whether it is part of the physical patient care, information systems, or business systems (i.e., accounting, billing, marketing, etc.). All business processes should ´ow in order to reduce cycle times and waste throughout the entire system.

Delivery refers to what it takes to deliver your product or service to the customer. The focus is on what value is added to the customer. The emergency room is often the initial and key entry point into the healthcare delivery system. The experience the customer has in the ED can leave a lasting impression of the organization, additionally the timeliness of care in the emergency room can have signi¡cant impact on that outcome.

System means the emergency room is part of an integrated delivery network or system and relies on supporting infrastructure to evaluate, and deliver care. Understanding and looking at the overall hospital or clinical System, not just the ED, means every process we try to improve is linked or integrated with other processes. It is dif¡cult to change one process without impacting several others. For example, many patients the ED required inpatient surgery, radiology and lab resources.

System means the emergency room is part of an integrated delivery network or system and relies on supporting infrastructure to evaluate, and deliver care. Understanding and looking at the overall hospital or clinical System, not just the ED, means every process we try to improve is linked or integrated with other processes. It is dif¡cult to change one process without impacting several others. For example, many patients the ED required inpatient surgery, radiology and lab resources.

Prize, Lean positively impacts virtually all the criteria. Baldrige, Shingo, and Lean are about neverending, continuous iterations of improvement.