Improving Patient Flow from the ED to a Nursing Unit

Session
Patient Throughput

Authors
Christopher Protzman
Director
Decision Support Services
Kadlec Medical Center

Michael Upchurch
Decision Support Analyst
Kadlec Medical Center

Description
This presentation demonstrates how LEAN principles can be applied to reduce the amount of time it takes a patient to be transported from the Emergency Dept to a nursing unit once the ED physician has made the decision to admit the patient.

Abstract
The challenge was to decrease the amount of time it takes to move a patient from the Emergency Dept to a nursing unit, from a baseline of 80 minutes to less than 60 minutes, once the ED physician makes the decision to admit the patient.

A "Rapid Process Improvement Cycle" methodology was applied utilizing a multi-disciplinary team. The project consumed 5 working days for LEAN education, process design, "trystorming" solutions, planning for implementation, and receiving approval from the Management Guidance Team to implement.

Results noted to date: During the "trystorming" part of the RPI team, the average was 50 minutes. When the process is executed as planned, the average time is less than 60 minutes. When the Hospitalists come to the ED to evaluate the patient after the ED physician makes the decision to admit, the average time is double.

Lessons Learned: The RPI process produces results much faster than the traditional CQI/TQM process but requires significant planning before the week of the RPI. Standardizing the process and then executing it consistently can be challenging. Maintaining momentum from the RPI can be challenging. Top leadership support is critical to success.