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A Lean Hospital Focuses on Patients

A Lean Emergency Department in a Lean Hospital accomplishes performance and financial goals by Implementing Lean Six Sigma. It’s time that hospitals focused on their most vocal and at risk customers – patients. Hospitals have traditionally focused on Doctor issues and ignored patient issues. Crowded waiting rooms lesson Doctors concerns that they won’t have a patient to see. Lean Six Sigma, by focusing on the patient, increases business thereby satisfying the doctor’s issues.

The following analysis was done on San Diego hospitals which don not have Lean Emergency Departments though I suspect it’s the same for many hospitals elsewhere. San Diego hospitals do not focus on the patient, and because of this, the patient’s experience more misery than they need to.

The first metric I look at has to do with Emergency Department performance. The metric is “Average Minutes Before Seeing Doctor in ED. This is how San Diego hospitals stack up against the very best:

 

Patient Pain Levels at Hospital Emergency Departments

Hospital Ave Minutes Before Seeing Dr. in ED Ave Minutes: Before Seeing Dr. in ED – Misery Index
Sharp Memorial Hospital, San Diego 74 10
Kaiser Permanente MC, San Diego 60 8
Sharp Grossmont Hospital, La Mesa 57 7
Tri-City MC, Oceanside 48 6
Scripps Memorial Hospital, Encinitas 38 4
Scripps Mercy Hospital, San Diego 36 3
UCSD Medical Center, Hillcrest 34 3
Palomar Medical Center, Escondido 33 3
Sharp Chula Vista MC 30 2
Lean Six Sigma Hospitals
Robert Wood Johnson University Hospital at Rahway, NJ using Lean Six Sigma to attain the Baldridge Award 16 0
Hill Country Memorial Hospital using Lean Six Sigma to attain Baldridge Award 22 1
Memorial Hermann Sugar Land Hospital using Lean Six Sigma to attain Baldridge Award 22 1

 

The next metric is the “Average Time Stay in ED”. Of course this is something to minimize. You first see the patient, then diagnose the issue and then take action. The faster that this is performed the less clogged your ED becomes. Lean Six Sigma hospitals are quite efficient at this:

 

 

Patient Pain Levels at Hospital Emergency Departments

 

Hospital Ave Time Stay in ED (Min)  Ave Time Stay in ED – Misery Index
Sharp Memorial Hospital, San Diego 270 10
Kaiser Permanente MC, San Diego 240 8
Sharp Grossmont Hospital, La Mesa
Tri-City MC, Oceanside 240 8
Scripps Memorial Hospital, Encinitas 223 7
Scripps Mercy Hospital, San Diego 203 6
UCSD Medical Center, Hillcrest
Palomar Medical Center, Escondido
Sharp Chula Vista MC
 Lean Six Sigma Hospitals
Robert Wood Johnson University Hospital at Rahway, NJ using Lean Six Sigma to attain the Baldridge Award 110 0
Hill Country Memorial Hospital using Lean Six Sigma to attain Baldridge Award 136 2
Memorial Hermann Sugar Land Hospital using Lean Six Sigma to attain Baldridge Award 144 2

 

“Time Waiting for a Room” is only slowed by the process unless your hospital is at or near 100% capacity in most departments. Should a patient wait in the Emergency Department if rooms are open. If they aren’t open, how come? Patients are waiting:

 

 

Patient Pain Levels at Hospital Emergency Departments

 

Hospital Transfer Time, Waiting for Room (Min) Transfer Time, Waiting for Room – Misery Index
Sharp Memorial Hospital, San Diego
Kaiser Permanente MC, San Diego 182 9
Sharp Grossmont Hospital, La Mesa
Tri-City MC, Oceanside 110 3
Scripps Memorial Hospital, Encinitas 116 4
Scripps Mercy Hospital, San Diego 190 10
UCSD Medical Center, Hillcrest
Palomar Medical Center, Escondido 168 8
Sharp Chula Vista MC
  Lean Six Sigma Hospitals
Robert Wood Johnson University Hospital at Rahway, NJ using Lean Six Sigma to attain the Baldridge Award 149 7
Hill Country Memorial Hospital using Lean Six Sigma to attain Baldridge Award 70 0
Memorial Hermann Sugar Land Hospital using Lean Six Sigma to attain Baldridge Award 89 2

 

“Average Time Before a Broken Bone Patient Receives Pain Medication” is a visceral metric. It really sums up whether the Emergency Department focuses on patient well being. Wouldn’t it be nice for your patients if they could get pain medicine right after they walk in:

 

 

Patient Pain Levels at Hospital Emergency Departments

 

Hospital Ave Time Before Broken Bone Patient Gets Pain Meds (min) Broken Bone Patient Pain Meds – Misery Index
Sharp Memorial Hospital, San Diego
Kaiser Permanente MC, San Diego
Sharp Grossmont Hospital, La Mesa
Tri-City MC, Oceanside 55 7
Scripps Memorial Hospital, Encinitas 69 10
Scripps Mercy Hospital, San Diego 67 10
UCSD Medical Center, Hillcrest
Palomar Medical Center, Escondido
Sharp Chula Vista MC
  Lean Six Sigma Hospitals
Robert Wood Johnson University Hospital at Rahway, NJ using Lean Six Sigma to attain the Baldridge Award 28 0
Hill Country Memorial Hospital using Lean Six Sigma to attain Baldridge Award 46 4
Memorial Hermann Sugar Land Hospital using Lean Six Sigma to attain Baldridge Award 34 1

 

“This metric is the Average Time Stay in ED, Inpatient”. These times are some of the longest. Take a look:

 

 

Patient Pain Levels at Hospital Emergency Departments

 

Hospital Ave Time Stay in ED, inpatient (Min)  Time Stay in ED – Misery Index
Sharp Memorial Hospital, San Diego 348 4
Kaiser Permanente MC, San Diego 596 10
Sharp Grossmont Hospital, La Mesa 454 7
Tri-City MC, Oceanside
Scripps Memorial Hospital, Encinitas 362 5
Scripps Mercy Hospital, San Diego 461 7
UCSD Medical Center, Hillcrest 413 6
Palomar Medical Center, Escondido 311 4
Sharp Chula Vista MC 450 7
   Lean Six Sigma Hospitals
Robert Wood Johnson University Hospital at Rahway, NJ using Lean Six Sigma to attain the Baldridge Award 149 0
Hill Country Memorial Hospital using Lean Six Sigma to attain Baldridge Award 230 2
Memorial Hermann Sugar Land Hospital using Lean Six Sigma to attain Baldridge Award 257 2
Information Source: ProPublica’s ER Wait Watcher. ProPublica’s ER Wait Watcher is a great resource to review American hospital Emergency Department performance.
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