Better Throughput Grows Inpatient Volume 22%
A hospital in a multi-billion-dollar health system operating in the Midwest was struggling with inpatient bed availability, resulting in significant ED diversion time and admissions lost to competitor hospitals. The hospital president set a clear vision for improved bed availability with his leadership and medical staff. This change would require a shared set of strategic commitments that the entire hospital could both understand and contribute to. They asked our team to support this important work.
We worked closely with leaders and physicians to form a governance structure, articulate some of the key challenges and develop a strategy that made sense for the hospital. We engaged dozens of leaders, clinicians and physicians in a highly participatory series of rapid improvement events that focused on improved transparency of information, communication and aligned processes. The result was a well-coordinated process of planning patient discharges, beginning upon admission, and level-loading planned discharges each day.
Primary Care Physician Sees 40 More Patients per Month and Is Home for Dinner Each Night
A physician, in the top decile for performance, came to us feeling like her practice was unravelling. Her patients were regularly waiting at least 6 weeks to see her, and she was working late into the evening to stay up-to-speed on indirect work such as charting, responding to messages, and approving prescription refills.
We engaged her and her clinic team in a 12-week Lean transformation that focused on redesigning her scheduling practices and developing a standard workflow for seeing patients and completing her indirect work between patient visits. As a result of this highly engaging and rapid transformation, the physician was able to reduce the scheduling backlog, add 10 more patient visits per week, complete her indirect work, and have dinner with her family every night.
Lean Management Improves Productivity by 60%
Often times leaders focus too much of their time on reducing worked hours to achieve productivity targets, but one large health system engaged our team to teach their leaders to focus on building balanced schedules to achieve their productivity targets. We approached this project carefully, as an undertaking of this scale requires significant change management. We studies our client's business to create a focused and effective coaching solution - and then watched those leaders grow.
Our approach is different than most. With this leadership group, we focused our efforts on studying trends in volume and comparing to budgets. We then worked with the leadership to define daily measures and host a daily team huddle so that they, as a team, can monitor the achievement of the daily targeted volume. Once leadership had a firm grasp of their trends in volume, we worked to deploy a niche software product that used the department's staffing grids with algorithms to forecast volumes and publish a staffing schedule that balanced to the forecasted volume.
Through this engagement, leaders learned how to better manage productivity, be more engaged with the staff and identify challenges in daily workflow, and build a staffing schedule that fit the demands of the workload.