Rapid Improvement Events Improve ED

The Problem

Several processes used in the care of patients of Advocate Illinois Masonic Medical Center's emergency department had great opportunity to reduce waste, remove nonvalue-added steps and increase the efficiency of patient care.

Several pain points were identified:

• The movement of laboratory specimens from the emergency department to the lab could be delayed for up to an hour due to inefficient and ineffective hand-offs between the nurses and unit secretaries.
• The average length of stay for a patient whose treatment included a CT scan was near seven hours.
• Nurses and ED technologists were taken away from the bedside to transport patients to other areas, rather than utilizing transportation services due to excessive wait times.

Overall, these factors combined lead to poor associate and patient satisfaction.

The Solution

The ED leadership team supported a series of rapid improvement events and projects to tackle issues. Multi-disciplinary and cross-functional team members were selected from all areas of the hospital to participate to better understand the current pain points. Teams were provided with “just-in-time” training on lean methodology and other improvement tools. Using this knowledge, these teams were given the task of coming up with creative solutions in order to minimize handoffs and improve overall performance. Team structure used the 1/3 process owner, 1/3 customer/supplier and 1/3 outside eyes approach to ensure an effective cross sectional perspective on the issues. This methodology was utilized to ensure that best practice knowledge was incorporated into a practical, results-driven new process.