How one cardiac services department used Kaizen to improve time savings

When patients think of doctor appointments and visiting specialists at hospitals, the first thing that often comes to mind is long waiting times in cramped lobbies. Although many doctors do what they can to limit this problem, the fact of the matter is that setting up for patients can be a very time-consuming and exact process.

This is particularly the case among specialists. For example, one Tennessee medical center's cardiac services unit struggled with time management. While the department was hitting all the quality of care metrics it set out to achieve, it was falling behind in other areas due to an inability to operate swiftly and inefficiently.

The biggest issues stemmed from the cardiac unit's preparation of the patient in the recovery area. Because preparation took so long, patients were encouraged to come in two and a half hours prior to the scheduled time of the procedure. Even with this much time, the cardiac unit still had trouble finding ways to avoid delays and stay on schedule.

As the Lean Healthcare Exchange notes, the structure of the cardiac unit further complicated matters. The Cath, EP and Special Procedures Lab branches maintained independent schedules but were consolidated on a single calendar that was passed from person to person as needed. This obviously hindered timely operations, a fact that was made even more obvious when the calendar was lost, resulting in weeks of people showing up for appointments for which the unit was completely unprepared.

At the same time, the cardiac unit also wanted to expand operations. With a significant portion of the American population growing older, the organization expected the number of patients coming in regularly to nearly double. This required the unit to be open 23 hours a day, which didn't bode well for an organization with time management issues.

Leveraging Lean healthcare

The solution to the logistical nightmare faced by the cardiac unit lay in Lean healthcare. A team of representatives from each of the unit's three divisions decided to hold a Kaizen event over five days to tackle the issues and identify ways of being more efficient.

“What the team found was surprising,” research from the source notes. “From actual patient observations, even though the patient was told to be there 2.5 hours ahead of time, it was taking 2.65 hours on the average from the patient's arrival into the facility until the procedure was started. It was no wonder the staff always seemed like they were behind – they were!”

The biggest cause of waste was the nursing assessment and care plan portion of the process. Because nurses didn't have access to bedside computer systems, they would have to hand-write information collected from patients. This data would then be entered into computers later on, resulting in a redundant process that created nearly 20 minutes of waste each time.

By identifying waste sources, the cardiac unit was able to effectively reduce the amount of time thrown out the window. All in all, the organization was able to reduce the time spent on each patient from 269 minutes to 180 minutes without sacrificing the quality of care.

Broadly using Lean healthcare

While patient service is one area in which Lean healthcare can be used to improve operations at practices and doctors' offices, it can be applied more broadly than that. For instance, it could even be used to bolster office operations and record management. Lean can be leveraged in a variety of ways, as long as healthcare organizations are willing to experiment.