Collected Quality and Patient Safety Improvement Statistics – #Lean Healthcare
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.
Organization: ThedaCare (WI)
- 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
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
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.
- 66% reduction in TPN medication error rates
- 50% reduction in ICU bloodstream infections
- 20% fewer ventilator days for patients.
- Reduced mortality for Coronary Artery Bypass Graft surgery by 48%
- Reduced unnecessary heard catheter usage by 25%, reduced risk and cost
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
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.”