Results from Lean in Healthcare

Screen Shot 2016-06-04 at 5.47.47 PMFrom Chapter 1 of the revised 3rd edition, released in June 2016:

Excerpt from Lean Hospitals, 3rd Revised Edition

Download as a PDF

www.LeanHospitalsBook.com

…there are now many examples of the positive impact Lean is having in hospitals throughout the world. As a sample, Lean methods have resulted in improvements to:

Safety and Quality

Reduced central-line-associated bloodstream infections by 76%, reducing patient deaths from such infections by 95% and saving $1 million—Allegheny Hospital, Pennsylvania[i]

Reduced hospital acquired infections, saving 57 lives, reducing ICU length of stay and reducing costs by over $5 million over two years —University of Pennsylvania Medical Center[ii]

Reduced readmission rates for chronic obstructive pulmonary disease (COPD) patients by 48%—UPMC St. Margaret Hospital, Pennsylvania[iii]

Reduced falls by 22%, reducing costs by more than $500,000 – Hanover Regional Medical Center, North Carolina[iv]

Reduced pressure ulcers by 56% in three pilot areas over two years, with a 30% decrease system-wide – BJC Healthcare, Missouri[v]

Avoidance of 87 readmissions for congestive heart failure in 12 months across four hospitals, saving $830,000 – Four hospitals in California[vi]

Reduced sepsis mortality from 24% to 9%, reducing the average cost per case from $15,772 to $12,771 – Presence Health, Illinois[vii]

 

Waiting Times and Length of Stay

Reduced patient waiting time for non-emergent orthopedic surgery from 14 weeks to 31 hours (from first call to surgery); improved inpatient satisfaction scores from 68% “very satisfied” to 90%—ThedaCare, Wisconsin[viii]

Reduced emergency patient length of stay by 29% and avoided $1.25 million in new emergency department (ED) construction—Avera McKennan, South Dakota[ix]

Reduced waiting times for screening colonoscopies from 6 weeks to less than 24 hours while reducing cost per patient by 9.5% — Palo Alto Medical Foundation, California[x]

Increased the percentage of atrial fibrillation patients treated within 40 days from 11% to 94% HealthEast, Minnesota[xi]

 

Flow

Reduced turnaround time for clinical laboratory results by 60% in 2004 without adding head count or new instrumentation; further reduced times by another 33% from 2008 to 2010—Alegent Health, Nebraska[xii], [xiii]

Reduced instrument decontamination and sterilization cycle time by 54% while improving productivity by 16%—Kingston General Hospital, Ontario[xiv]

Reduced late surgery starts from 50% to 30%, reduced rescheduled procedures from 20% to 4.4%, while increasing cases per month from 329 to 351 – New York City Health and Hospitals Corporation[xv]

Reducing O.R. turnover time from 60 minutes to 30 minutes, increasing utilization rates from 25% to 65% and achieving 100% on time starts in a pilot area – Guangdong Provincial Hospital of Traditional Chinese Medicine, China[xvi]

 

Satisfaction 

Improved patient / family satisfaction rates in the NICU from 45th percentile to 99th percentile – Franciscan St. Francis, Indianapolis[xvii]

Improved physician satisfaction from 63rd percentile to 87th, being highest rated in overall care among 170 California medical groups for two consecutive years – Sutter Gould Medical Foundation, California[xviii], [xix]

Improved emergency department patient satisfaction from 5th percentile to 98th percentile in just four months (through door-to-doc times falling from 67 to 18 minutes) – Sumner Regional Medical Center, Tennessee.[xx]

 

Financial

Bottom-line benefit of almost $200 million over seven years, while achieving “the lowest observed-to-expected mortality among the academic health center members of the University Health system Consortium in 2011” and avoiding layoffs—Denver Health, Colorado[xxi]

Avoidance of $180 million in capital spending through Lean improvements—Seattle Children’s Hospital, Washington[xxii]

Improved operating margin by 44%, from 1.70% in fiscal year 2011 to 3.06% in fiscal year 2014 —HealthEast, Minnesota[xxiii]

[i]McCarthy, Douglas, and David Blumenthal, M.D., “Committed to Safety: Ten Case Studies on Reducing Harm to Patients,” The Commonwealth Fund, http://www.commonwealthfund.org/publications/fund-reports/2006/apr/committed-to-safety–ten-case-studies-on-reducing-harm-to-patients (accessed March 26 ,2015).

[ii] Martin LA, Neumann CW, Mountford J, Bisognano M, Nolan TW.Increasing Efficiency and Enhancing Value in Health Care: Ways to Achieve Savings in Operating Costs per Year. IHI Innovation Series white paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2009.

[iii] California Health Advocates, “Creative Interventions Reduce Hospital Readmissions for Medicare Beneficiaries,” October 7, 2010, http://www.cahealthadvocates.org/news/basics/2010/creative.html (accessed March 26, 2015).

[iv] Barto, Jack, “CEO Blog: Avoiding patient falls: Where patient safety meets cost reduction,”

http://www.nhrmc.org/body.cfm?id=2293&action=detail&ref=1085#sthash.JYEqkbCA.dpbs (accessed September 12, 2015).

[v]Lean Tools Used to Reduce Pressure Ulcers, http://www.hret-hen.org/index.php?option=com_phocadownload&view=category&download=1305:barnes-jewish-christian-hospital-saint-louis-mo&id=283:pressure-ulcers-case-studies

[vi] Wu, Shinyi, Pai Liu, and David Belson, “Multiple-Hospital Lean Initiative to Improve Congestive Heart Failure Care: A Mixed-Methods Evaluation,” Journal of the Society for Healthcare Improvement Professionals,

http://www.jship.org/articles/vol-3-articles-october-2013/multiple-hospital-lean-initiative-to-improve-congestive-heart-failure-care-a-mixed-methods-evaluation-2/ (accessed September 12, 2015).

[vii] Rice, Sabriya,”Learning to be Lean,” http://www.modernhealthcare.com/section/learning-to-be-lean (accessed October 22, 2015).

[viii] Toussaint, John, and Roger Gerard, On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry (Cambridge, MA: Lean Enterprise Institute, 2010), 29.

[ix] ValuMetrix Services, “Avera McKennan,” Case Study, http://www.valumetrixservices.com/sites/default/files/client_results_pdf/CS_Avera%20McKennan_ED_OC4047.pdf (accessed March 26, 2015).

[x] Maser, Ben and Osman Akhtar, “PAMF’s Ambulatory Surgery Center: A Value Stream Approach to Improvement,” Presentation at 2015 Lean Healthcare Transformation Summit, June 2015.

[xi] http://www.benzinga.com/pressreleases/15/06/p5606947/healthcare-value-network-members-share-new-quarterly-results#ixzz3dW7OMAlD

[xii] ValuMetrix Services, “Clinical Laboratory Improves Turnaround Time by 60%,” Case Study, http://www.valumetrixservices.com/sites/default/files/client_results_pdf/CS_Alegent_Lab_OC4029.pdf (accessed March 26, 2015).

[xiii] Ford, Anne, “Thanks to Weak Economy and More, Efficiency Is King,” CAP Today, April 2010, http://lnbg.us/20T (accessed March 26, 2015).

[xiv] Lefteroff, Lewis, and Mark Graban, “Lean and Process Excellence at Kingston General,” SME Lean Manufacturing2008, 53.

[xv] Rice.

[xvi] Guo, Jinshai, Shijun Ma, and Xun Zhang, “Lean management to transform a Chinese hospital,” http://www.planet-lean.com/lean-management-to-transform-a-chinese-hospital (accessed October 27, 2015).

[xvii] Graban, Mark, “Gemba in the NICU: More Notes from our “Kaizen Live” Experience at Franciscan,”

http://www.leanblog.org/2015/05/gemba-nicu-notes-kaizen-live-experience-franciscan/ (accessed September 12, 2015).

[xviii] Graban, Mark, “Podcast #230 – Paul DeChant, MD, MBA on Reducing Burnout Through Lean,” http://www.leanblog.org/230 (accessed September 20, 2015).

[xix] Consumer Reports Health, “How Good Is Your Doctor?,” Special Report for California Residents, February, 2015.

[xx] No author, “Slash door-to-doc time, boost patient satisfaction with staff-driven improvement effort,” ED Manag. 2011 Jun;23(6):70-1.

[xxi] Gabow, Patricia, The Lean Prescription: Powerful Medicine for an Ailing Health System (New York: Productivity Press, 2014), xix.

[xxii] Weed, Julie, “Factory Efficiency Comes to the Hospital,” New York Times, http://www.nytimes.com/2010/07/11/business/11seattle.html, July 10, 2010 (accessed March 26, 2015).

[xxiii] http://www.benzinga.com/pressreleases/15/06/p5606947/healthcare-value-network-members-share-new-quarterly-results#ixzz3dW7OMAlD