9.19.2008

Helicopters improve Patient Flow After Train Crash

There was one positive bit of news related to the terrible train crash near Los Angeles recently that caused deaths and injuries: A new emergency plan to distribute patients among area hospitals using helicopters worked well, according to an article in the Los Angeles Times.

I write about this because I suspect some lean principles may have been involved in developing the plan.

Think of it as kind of an inverted supply chain. In a typical supply chain, the provider of goods or services looks for the best way to distribute those goods or services to customers. In this case, officials were distributing customers – patients – to service providers.

Under the plan, victims were airlifted from the Chatsworth crash site to distant emergency rooms, such as at the Ronald Reagan UCLA Medical Center in Westwood, Cedars-Sinai Medical Center near West Hollywood and County-USC Medical Center in Boyle Heights.

Authorities said that at least 86 of the 135 injured passengers were hospitalized, almost half in critical condition. By comparison, 57 died and 138 were hospitalized in the 1994 Northridge earthquake. In 2005, a Metrolink crash near Glendale killed 11 and sent 140 to the hospital, but the injuries were less grave than in Friday's crash. The new plan was developed after reviews of the earlier Metrolink crash and the Santa Monica Farmers' Market crash in 2003 that left 10 dead, said Cathy Chidester, director of the county's Emergency Medical Services. The goal is to ensure that the injured get the proper level of care and to "spread patients out instead of having one hospital inundated" near a disaster scene, Chidester said…

Across the Santa Monica Mountains, the newly opened Ronald Reagan UCLA hospital treated eight crash victims, said Dr. Henry Gill Cryer, chief of trauma surgery. Five needed immediate surgery…


Cryer was pleased with how well the hospital, which opened in June, performed. But the county emergency plan, which he called "phenomenal," gets the real kudos, he said.

Dr. Daniel R. Margulies, trauma director at Cedars-Sinai, echoed the praise. His trauma center treated seven crash victims. Two needed immediate surgery.Word of the accident came as doctors and nurses were about to change shifts. An order went out immediately for them to stay put. But the distribution of patients went so smoothly that extra help wasn't needed.

The article doesn’t describe the distribution plan in detail. But I have to believe those who developed it – even if they never heard of lean – focused on eliminating waste from the process and “leveling” the flow of patients.

There also had to be a joint effort by what might be called supply chain partners – the hospitals, the agencies providing the emergency workers on the scene, the helicopter operators.

Are there lessons businesses can learn from this? What do you think?

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