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Pittsburgh Area Hospital Transforms its E.D. with Lean

Toyota model transforms St. Clair Hospital ER – Manufacturing principles meet medical care

Here’s a nice overview of a Pittsburgh area hospital’s Lean efforts in the emergency department. What were their results?

The average wait to get into the emergency department fell to just four minutes from 49 minutes; seeing a doctor after patient arrival shrunk to 28 minutes from 76 minutes, and patient satisfaction rose to the 99th percentile from the 60th percentile, according to Joan Massella, administrative vice president and chief nursing officer.

The hospital is eliminating waste, focusing on the patient, and applying technology to support their processes. It also sounds like the hospital has strong executive sponsorship and support for Lean:

Among the champions of the Toyota-inspired changes at St. Clair is Dr. G. Alan Yeasted, senior vice president and chief medical officer. Standardization of equipment, training and procedures has helped the hospital all but eliminate infections that are picked up with the insertion of central lines in intensive care unit patients — they haven’t had a central line infection in two years, he said.

“The acceptance by the emergency room staff was phenomenal,” he said. “These aren’t medical breakthroughs — it’s attention to detail.”

Steve Spear often talks about this last point — how healthcare has focused so much on technical and clinical achievement. St. Clair seems to understand that you need technical innovation AND process innovation. Discipline. Attention to detail. Basic blocking and tackling. The basics can help save lives.

It’s great to see improvements like those at St. Clair.

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Mark Graban's passion is creating a better, safer, more cost effective healthcare system for patients and better workplaces for all. Mark is a consultant, author, and speaker in the "Lean healthcare" methodology. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. His most recent project is an book titled Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also the VP of Improvement & Innovation Services for the technology company KaiNexus.

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