Page 121 - Lean six sigma demystified

100 Lean Six Sigma DemystifieD

Similarly, in 2008 Seattle Children’s Hospital scaled back a planned expan-
sion from 110,000 to 75,000 feet using Lean to maintain the planned function-
ality. By building a scale model of the new facility and walking through the
mockup, teams quickly spotted and corrected design flaws; this cut design time
from months to weeks.
Efficiencies and inefficiencies are designed into most hospitals. It’s hard to
undo a building design. Individual units can be redesigned for greater efficiency
however.

A Faster Nursing Unit in Five Days

Want faster nursing units? Nurses have to walk too far to get what they need.
One redesigned nursing unit cut travel by 67% resulting in improved patient
satisfaction, nursing satisfaction, and clinical outcomes. The unit got faster in a
matter of days.
Delnor Hospital designated a nurse to handle maternity discharges; this cut
the length of stay by 10 hours, making an $80 million expansion of the mater-
nity ward unnecessary.
Additionally, nurses hesitate to take patients before shift changes, doctors
make rounds at different times, orders are issued but not executed for a period
of time, patients are discharged but no family member can collect them, and
on it goes. Delay, delay, delay.
The solution to this problem? Eliminate the delay.

Hospital Beds

Most hospitals have at least
One intensive care unit (6 to 12 beds)
One telemetry unit for monitoring heart patients (12 to 20 beds)
Two medical or surgical units (15 to 30 beds)

Length of stay (e.g., takt time) in most of these units is 2 to 3 days.
Patients also arrive from the operating room (3 to 5 per day) and direct
admissions from local physician offices (3 to 5 per day). Elective surgeries can
place a strain on the hospital bed supply which forces the ED to board patients
waiting for a bed.
On a peak day, any unit can admit 10 to 12 patients and discharge 10 to 12.
The sum of these two is called the bed turn rate (20 to 24).