Reduce ED wait with lean management

Lean management techniques helped Lahey Clinic Medical Center, North Shore, in the city of Peabody, MA, boost patient satisfaction and reduce emergency department (ED) waiting times.

Lahey is a full-service hospital featuring a 24-hour ED, the only ED in Peabody. More than 17,000 patients visit the ED annually. In October 2007, Lahey partnered with an Ottumwa, IA-based consulting firm to coach hospital staff on the application of lean management skills by revisiting their processes in the emergency department and identifying more efficiencies to improve patient care.

The first problem identified was the increased volume of ED visits, which resulted in long wait times for patients, says Bob Schneider, senior vice president at the hospital. With the goal of preserving patient care, Lahey began a series of rapid improvement events to help physicians, nurses, and staff see work more efficiently in their daily tasks. Mr. Schneider says the goal was to improve patient flow and reduce waiting time. Facilitators led selected members of the hospital and patients in an intensive forum where new ideas for improvement were piloted.

When Lahey decided to pursue lean management practices in the ED, the organization had a particular interest in better serving patients not deemed in critical, urgent need of assistance, Mr. Schneider explains.

Lahey developed new roles and work processes that addressed those issues and significantly reduced the wait time for all patients. First, Lahey added the role of "air traffic controller" jointly managed by the unit secretary and charge nurse with help from the triage nurses. It is now their responsibility to help monitor patient flow throughout the department and to match available physicians with patients who have been waiting long periods of time and match them up accordingly, Mr. Schneider explains.