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Lean intervention improves patient discharge times, improves emergency department throughput and reduces congestion

Michael J Beck1, Davin Okerblom1, Anika Kumar1

  • 1a Department of Pediatrics, College of Medicine , The Pennsylvania State Hershey Children's Hospital , Hershey , PA , USA.

Hospital Practice (1995)
|October 30, 2016
PubMed

Insights

Implementing lean principles in a pediatric service line significantly improved patient discharge efficiency, leading to better emergency department (ED) throughput and reduced ED boarding times.

Area of Science:

  • Healthcare Management
  • Process Improvement
  • Pediatric Hospital Operations

Background:

  • Emergency department (ED) efficiency is crucial for patient flow.
  • Improving patient discharge processes can alleviate ED congestion.
  • Lean methodologies offer a framework for operational enhancements in hospitals.

Purpose of the Study:

  • To evaluate the impact of a lean intervention on ED throughput and boarding.
  • To assess improvements in patient discharge efficiency within a tertiary care children's hospital.
  • To determine if lean principles can reduce ED boarding times by optimizing discharge processes.

Main Methods:

  • A lean intervention was implemented in a pediatric service line at a children's hospital.
  • Intervention included staffing reconfiguration, bedside discharge, and interdisciplinary huddles.
  • Discharge metrics and ED throughput markers (boarding time, discharge time) were analyzed retrospectively.

Main Results:

  • Median discharge order entry time decreased significantly (1:43 PM to 11:28 AM).
  • Median patient discharge time improved (3:25 PM to 2:25 PM), with more patients discharged before noon.
  • Median ED boarding time decreased by 49 minutes, advancing admitted patient discharge from ED by one hour.

Conclusions:

  • Lean principles successfully improved patient discharge efficiency in a pediatric service line.
  • The intervention enhanced overall ED throughput and significantly reduced ED boarding times.
  • Lean implementation demonstrates a viable strategy for optimizing hospital operations and patient flow.
Abstract

Keywords:
ED boardingLeancapacity managementdischarge timeprocess improvementsix sigma

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