Lessons Learned Implementing Lean Sigma in Healthcare

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Lean Six Sigma

Laurie Wolf
Management Engineer
Barnes-Jewish Hospital

Lessons learned from several projects that are part of a Lean Sigma transformation at Barnes-Jewish hospital will be shared with the audience. Projects in the presentation will include: Admitting patients from the Emergency Department as an inpatient, Discharge process of Medicine patients, Transparent Plan of Care, Decentralized equipment process, etc.

As part of a Lean Sigma transformation journey at Barnes-Jewish Hospital, a value stream analysis was conducted for the process of admitting patients onto 13 different Medicine divisions, caring for the patients, and discharging them. This presentation will review various projects that have been conducted using Lean Sigma principles and multi-disciplinary participation (physicians, nurses, case management, and leadership) for the following topics:

  1. Improved communication between the Emergency Department (ED) that saw over 86,000 patients in 2007, with a 25% admission rate and admitting physicians. (Data from initial trials showed a 34% reduction in paper and a 53% reduction in time spent completing the admission orders (1.0 physician FTE/day savings).
  2. Medication Reconciliation. Data indicate an improvement from 28% to 61% completion of the home medication list from the ED.
  3. Appropriate patient assignment upon admission
  4. Transparent Plan of Care so all caregivers, family, and patients are aware of a patient's daily needs.
  5. Discharge Process Improvement. Four components that one division used to improve discharge time by 1:00 p.m. from 0% to 90%
  6. Decentralized Equipment cleaning process

Overall Value Stream metrics such as Length of Stay, Physician Satisfaction, Number of handoffs and financial measurements will be reviewed.