Lean Strategies Reduce Waits in Emergency Rooms

USA Today recently published a good article highlighting a few of the ways in which emergency rooms are reducing wait times, some of which involve lean-like improvements to their processes.

• Hospitals such as Cooper Hospital-University Medical Center in Camden, N.J., are forming "fast-track" areas in their emergency departments to more quickly treat patients with minor illnesses and injuries, such as small cuts or ankle sprains. Often, these areas are staffed by physician assistants or nurse practitioners, leaving the doctors to treat more serious problems.

• Hospitals such as Dublin (Ohio) Methodist Hospital are using computerized physician ordering systems to speed patients' ability to get blood tests and other diagnostic tests. All patient records are computerized, making it easier for nurses and doctors to check on a patient's status; all tests can be ordered electronically, which can reduce delays, says Dave Boehmer, the ER medical director.

Scripps Mercy Hospital in San Diego and Chula Vista has installed a computerized tracking system to help better monitor patients and available bed space to reduce the time patients wait for an in-patient bed. The hospital has also added a second triage area and put a full-time phlebotomist in the emergency department to speed blood testing.

Hudson Valley Hospital Center in Westchester, N.Y., has implemented what it calls a "no-wait" ER by letting its triage nurse start caring for the patient by ordering tests and moving the patient registration to the bedside via portable computers.

I particularly like the first and the last of those efforts. Creating “fast-track” areas for minor problems is like the lean technique of setting up different manufacturing cells for different families of products. And letting triage nurses immediately begin patient care certainly eliminates some wasteful waiting time from the process.

The article notes that the average waiting time in an emergency room has nearly doubled over the past decade. It is good to know that at least some hospitals are trying to reverse that trend.