Mark Graban's leanblog.org - Lean Healthcare, Lean Hospitals, Healthcare Kaizen, Lean Thinking, Lean Manufacturing, Toyota Production System

Collected Quality and Patient Safety Improvement Statistics – #Lean Healthcare

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I'm going to use this blog post / page to collect published statistics about the impact the Lean management philosophy has had on healthcare quality and patient safety. I will update this over time and this page can be accessed via www.leanblog.org/LeanStats. I have a similar page on employee satisfaction statistics.

If you have stats to submit, email me or comment on this post.

Source: On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry

Organization: ThedaCare (WI)

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  • Medication reconciliation errors were reduced from 1.25 per chart to ZERO errors for 2.5 years in ThedaCare's new “Collaborative Care” unit.
  • ICU length of stay was reduced from 30 days to 16
  • The percentage of patients who were “very satisfied” increased from 68% to 90% with Collaborative Care.
  • Lab specimen collection mistakes fell from 941 parts per million to just 100.
  • Warfarin patients with lab readings outside of the safe zone fell from 40% to 0.3%
  • Average “Door-to-balloon” time fell from 90 minutes to just 37 minutes
  • 89% of stroke patients received a CT scan within 25 minutes compared to just 51% before (with a 60% volume increase)

Source: Commonwealth Fund Case Study

Organization:  Allegheny General Hospital (PA)

  • CLABIs (Central Line Associated Bloodstream Infections)  were nearly eliminated, falling 76 percent from 49 infections in 37 patients (5.1 per 1,000 line days) in the year before the intervention to six infections in six patients (1.2 per 1,000 line days) during the intervention year (Figure 11). Among patients with CLABIs, the number of deaths decreased 95 percent and the death rate decreased 69 percent, from 19 of 37 patients (51%) to 1 of 6 patients (16%). Of the six CLABIs that occurred, four were attributed to failures to follow specific guidelines.

  • A case-study analysis was conducted of the revenues and expenses associated with the care of six patients with CLABIs, which found an average loss of $14,572 per case. This analysis suggests that the intervention saved over $500,000 and could save $1 million by eliminating the remaining 72 CLABs cases hospital-wide. Likewise, eliminating CLABIs, ventilator-associated pneumonia, and antibiotic-resistant infections caused by methicillin-resistant  Staphylococcus aureus could save a total of $10 million.

Organizations: 29 PRHI Organizations

  • Among the 29 PRHI member hospitals submitting data to a regional database, the rate of CLABs has decreased 55 percent, from 4.2 to 1.9 per 1,000 line days from 2001 to 2004. Hospitals have adopted approaches such as “zero tolerance” for handwashing violations and sending daily reports of infections to the hospital's CEO for review (PRHI 2004b).

Source:  Journal article

Organization: University of Pennsylvania Health System

“Redesign of these processes by the people involved in them under the guidance of a leader resulted in an 86% reduction in infections in the blood. Overall, financial performance improved by $5.1 million over a 2-year period. Mortality in intensive care units declined by 29%.

Using methods borrowed from highly reliable industries and engaging workers at the point of care can have profound and sustainable effects in nearly eliminating HAI, with significant clinical and financial benefits.”


Source:  Health Affairs Journal article

Organization: ThedaCare

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Click graphic for larger view… first three columns show progression of lean-based “Collaborative Care” unit. Fourth column shows non-lean unit for July 2008 (comparison to column three).

  • Zero medication reconciliation errors
  • Improved quality bundle compliance for pneumonia (100%)
  • Shorter length of stay

Source: HealthLeaders Media Article

Organization: Virginia Mason:

  • Nursing teams cut the incidence of pressure ulcers to 2% from 8%, preventing a projected 838 patients per year from  acquiring bedsores.

Organization:  Mercy St. Vincent Hospital, Toledo, OH

  • Reduced inpatient length of stay by 23% (or by 1.3 days)

Source: Nursing Times

Organization: Virginia Mason:

  • 75% fall in the number of litigation claims it received between 2004-05 and 2012-13.
  • Over the same period, the hospital saw the number of [safety risk] reports increase from 2,696 to 9,277 annually.
  • Conclusion: More reporting leads to more improvement, which improves safety and reduces litigation

Source:  Journal for Healthcare Quality Article

Organization: Presbyterian Healthcare Services (NM)

  • Estimated 2.5 lives saved by reducing MRSA infections by 51%.
  • Subsequently this 51% decrease in MRSA saved the hospital US$276,500.

Organization: Seattle Children's Hospital
  • 66% reduction in TPN medication error rates
  • 50% reduction in ICU bloodstream infections
  • 20% fewer ventilator days for patients.

Organization: UCSF Medical Center
  • Reduced mortality for Coronary Artery Bypass Graft surgery  by 48%
  • Reduced unnecessary heard catheter usage by 25%, reduced risk and cost

Source: Becker's
Organization:    Barnes-Jewish Hospital (St. Louis)

  • “Dramatic drop” in central line-associated blood stream infections (CLABSIs)
  • Reduced low blood sugar occurrences in inpatients by 75 percent
  • Reduced pressure ulcers 25 to 40 percent
  • Improved handoffs at shift change

Source:  JAMA
Organization:    Study of 600 organizations

  • “The use of management practices adopted from manufacturing sectors is associated with higher process-of-care measures and lower 30-day AMI mortality. Given the wide differences in management practices across hospitals, dissemination of these practices may be beneficial in achieving high-quality outcomes.”

Source: Toyota Press Release
Organization: Children's Health (Dallas)

  • “Through a collaboration with Toyota, Children's HealthSM, the leading pediatric health system in North Texas, announced today it has successfully reduced rates of central line-associated blood stream infections (CLABSIs) by 75 percent with patients in the gastroenterology unit.”

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Mark Graban is an internationally-recognized consultant, author, and speaker who has worked in healthcare, manufacturing, and startups. 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 book is an anthology 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.

12 Comments
  1. […] by Mark Graban on March 20, 2011 · 0 comments I’m going to use this blog post / page to collect published statistics about the impact the Lean management philosophy has had on healthcare quality and patient safety. I have a similar page on quality and patient safety statistics here. […]

  2. […] While the headline focused on Return On Investment, or ROI, the quotes from Mercy leaders emphasize the broad benefits of Lean. Lean is patient-focused and these methods and principles lead to quality and patient safety improvements. […]

  3. […] Some Data on Patient Safety and Quality Improvement, including PRHI and Allegheny […]

  4. […] Stories of quality and patient safety improvement usually seem to be stories of management systems, not technology or simple tools. Virginia Mason has changed their culture and management systems with their “patient safety alert” system. This system isn’t a specific technology, but rather a change in the culture that makes it OK for people to raise their hand to highlight problems or concerns. ThedaCare is an example of a system where leaders, from the CEO on down, have changed their behaviors to help improve the culture of safety and quality. […]

  5. […] such as reducing falls, reducing infections, reducing medication errors, actually SAVES money (see examples and data). Our improvement efforts must lead to better safety/quality AND cost. Whether the law of 2010 […]

  6. […] collected results of hospitals that are dramatically reducing infections and other quality and patient safety …. We have pockets of success, but the industry, as a whole, is not improving quickly […]

  7. […] of patient safety was really glossed over, if it was even mentioned) or actually talking about Lean and other systems thinking approaches (like aviation safety CRM practices) are […]

  8. […] There are many examples of health systems using Lean methods and a Lean culture to improve quality and safety in measurable ways. See some stats and examples here. […]

  9. […] my collected statistics about patient safety and harm (it’s a global problem) and some statistics about cases where safety has been improved. We need to collect more of those improvement stories and […]

  10. […] med mistakes being a problem, but there’s less of a “movement.” I mentioned how Lean is being applied to improve quality and patient safety in human […]

  11. […] is the first step in improvement. I wouldn’t waste my time pointing out problems if I believed the patient safety crisis couldn’t be made significantly better or that processes couldn’t be […]

  12. […] A representative from the nurses’ union said nurses were being told to take out trash and change linens because of Lean. That’s puzzling, since that seems to be a waste of their talent. I’ve seen Lean drive hospitals to REDUCE the amount of time nurses are doing non-nursing tasks, which allows them to focus MORE on the patients. That’s what I see as a “Lean approach” – having support staff let nurses be nurses, pharmacists be pharmacists, etc. The nursing union admits that “Lean has things to offer” but they are concerned about patient safety. Well, Lean has a lot to offer to improve quality and patient safety. […]

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