Page 117 - Lean six sigma demystified

96 Lean Six Sigma DemystifieD

• Waiting for the patient to regain consciousness to be transferred to recovery
(20 minutes)
• Waiting for transport to recovery (10 minutes)

Using the tools of Lean, the team analyzed the process and implemented
countermeasures to save 60 minutes.

• Surgeon draws an X on patient’s wristband when the patient has been
informed about the operation allowing anesthesia to begin. (No more
checking!)

• Prepackaged sterile disposables replace individual disposables saving two
theater nurses and 30 minutes. (This was the longest delay.)

• Standard checklists ensure that all materials are gathered before the oper-
ation starts. (Mistake proofing.)

• Anesthetic depth was adjusted so that the patient wakes up when opera-
tion is finished.

• Hospital orderlies move patients to recovery immediately.
Obviously, saving an hour per surgery will dramatically affect productivity
and profitability without affecting patient safety or outcomes.
Apply the tools of Lean to a hospital OR and watch it accelerate patient
flow.

Faster Medical Imaging in Five Days

Another roadblock to patient flow in most hospitals is medical imaging (i.e.,
X-ray). It’s not like on House, were the doctors can do their own MRIs and the
MRI is always available. Not only does it take a while to get the patient sched-
uled into the queue and imaged; it takes time to get the image read. And as
many as 15 out of 100 have to be redone!
North Shore University Hospital wanted to improve patient throughput on
its CT scanners to decrease length of stay and increase patient satisfaction.
Average turnaround time (TAT) was 20.7 hours and varied from 8 to 34 hours.
Target for improvement? 16 hours. Identified problem areas included

• Manual scheduling leading to calls from nursing units
• Time-consuming prep and delivery of contrast media