Executive Summary

A new study highlights how schedule changes among inpatient providers on the upper floors can impact crowding and boarding in the ED. Using Lean Six Sigma (LSS) management techniques, investigators at Penn State Hershey Children’s Hospital in Hershey, PA, discovered that by adding an extra inpatient rounding team, discharge times could be accelerated, resulting in improved throughput without increasing length of stay or readmission rates.

  • Data show that the scheduling adjustments enabled the hospital to slash 90 minutes off discharge times when compared with usual care.
  • The scheduling changes enabled the hospital to discharge 45% more patients per day without increasing length-of-stay or readmission rates.
  • To make the schedule changes, a core group of seven inpatient physicians needed to agree to work an extra two or three “on service” weeks per year.
  • Investigators acknowledge that implementing this type of intervention requires culture change, which can be very difficult initially.