Stop calling it "ER Congestion"


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    I've posted “lean healthcare” articles here about what's described by the media as “ER congestion.” They always describe the sad situation where patients are kept in the ER hallway for a day or two before they can get admitted into a bed.

    It's clear that the terminology is incorrect. Maybe we can nip it in the bud. It's not an ER problem, it's a systemic hospital problem. The hospital inpatient area doesn't have enough rooms for the incoming ER patients, or they don't turn the rooms fast enough, or they have, in general, poor processes for patient discharge or admission.

    The ER has treated the patient. The patient can't get into a room. Why is that the ER gets blamed for the problem?

    It really should be called “Hospital Congestion.”

    One of the solutions to this is apply lean methods to standardize, streamline, and improve processes. Oftentimes, you're putting processes in place where there were no processes before.

    The suggestion in this article seems reminiscent of a factory hiring an “expeditor” specialist to help navigate the broken system. It really should be our goal to fix the root cause of the system, not to institutionalize and improve the workarounds.

    That's true in any environment. What examples do you have from your locale, factory or hospital?

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    Mark Graban
    Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.


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