Podcast #160 – Dr. Joe Guarisco, Emergency Department Process Improvement through Lean

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My guest for podcast #160 is Joseph S. Guarisco, M.D., FAAEM, FACEP. Dr. Guarisco is currently Chairman of the Department of Emergency Medicine and System Chief of Emergency Services for the Ochsner Health System. Dr. Guarisco is a keynote speaker at the upcoming Society for Health Systems conference (which I'll be attending) and we are both part of the American Academy of Emergency Physicians annual scientific assembly in February (where I'll be co-presenting with my Healthcare Kaizen co-author Joe Swartz on E.D. process improvement strategies). Here is a Q&A, hosted by SHS, with Dr. Guarisco.

In this episode, we talk about Dr. Guarisco's process improvement efforts at Oschner and how that was made necessary by Hurricane Katrina and the aftermath, where demand TRIPLED in their E.D. We also chat about standardized work and variation reduction fit in with the practice of medicine and improving E.D patient flow.

For a link to this episode, refer people to www.leanblog.org/160.

For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

If you have feedback on the podcast, or any questions for me or my guests, you can email me at leanpodcast@gmail.com or you can call and leave a voicemail by calling the “Lean Line” at (817) 993-0630 or contact me via Skype id “mgraban”. Please give your location and your first name. Any comments (email or voicemail) might be used in follow ups to the podcast.

Guest Bio:

Joseph S. Guarisco, M.D., FAAEM, FACEP. Dr. Guarisco is currently Chairman of the Department of Emergency Medicine and System Chief of Emergency Services for the Ochsner Health System. He joined Ochsner as a staff physician in the Department of Emergency Medicine in August, 1980. In July, 1990, he pursued a fellowship in anesthesiology at Ochsner. In July, 1992, he returned to emergency medicine as Chairman and Medical Director of the Emergency Department and is currently serving in that position becoming System Chief Emergency Services in 2007.

Dr. Guarisco has extensive experience in ED informatics automation pertinent to the design, development and implementation of ED information systems. He has published and lectured widely on the use of automation in workflow redesign and ED process improvement and is well known for his work in physician performance profiling and data driven ED management. The 2005 Ochsner Clinic Foundation award for outstanding achievements in patient satisfaction was awarded to the Department of Emergency Medicine. Additionally, Dr. Guarisco has been recently recognized by Press Ganey for innovative use of data and process design in improving patient satisfaction at Ochsner and is the winner of the Press Ganey 2005 National Success Story Award. In 2008, Press Ganey awarded the Ochsner Health System the Compass Award for the largest improvement in patient satisfaction amongst its client base. He has pioneered ED workflow redesign through innovative adaptation of Lean engineering principles to ED patient flow processes. He is also responsible for pioneering web based wait times for emergency departments nationally.

Dr. Guarisco has a bachelor's degree in engineering and is board certified in emergency medicine. He is a fellow in both the American College of Emergency Physicians and the American Academy of Emergency Medicine.

In 2012, he was named Chair of the American Academy of Emergency Physicians (AAEM) Operations Management Committee.


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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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