Using Lean/Toyota Production System (TPS) to Improve Inpatient Care

1Beth Israel Deaconess Medical Center, Boston, MA
2Beth Israel Deaconess Medical Center, Boston, MA

Meeting: Hospital Medicine 2008, April 3-5, San Diego, Calif.

Abstract number: 108

Background:

Caring for acutely ill patients in a 40‐bed ward while constantly admitting, discharging, and transferring care is a challenge. The clinical staff spends significant time completing nonclinical tasks (eg, searching for supplies). This time would be much better spent on direct patient care

Purpose:

We applied Lean/TPS methods to a medical ward to improve efficiency and process flow by identifying and eliminating waste. The goal was to increase time spent on direct patient care by optimizing the process from admission to discharge. We also hoped to improve patient and staff satisfaction

Description:

The inpatient ward is run by hospitalists in a large academic tertiary hospital. Our multidisciplinary Lean team included hospitalists, nurse, nurse‐manager, unit coordinator, and patient care tech (PCT). The Lean program office supported and facilitated. Our initial rapid improvement event (RIE) focused on workplace organization using 5S to eliminate waste, improve efficiency, and save costs. 5S (sort, set, straighten, standardize, sustain) is a Lean method that enhances productivity, quality, and safety by empowering staff members to take ownership of their workplace. During 5S RIE, by direct observation, we measured before and after times required for routine tasks (Table 1). The next RIE's focus was on inventory control in the supply room. Using smart placement principles, we organized and labeled the room layout, resulting in less time searching, and created a simple process to maintain par levels and less clutter through the removal of rarely used items. The goal was to ensure availability of supplies when needed. The cost of overstocked items in our ward alone was over $10,193. Time spent by staff searching for items decreased

Table 1.

Conclusions:

Significant clinician time was saved using Lean in this inpatient setting. This was achieved by many simple, small changes that together produced big, noticeable results. Enabling and educating staff members to identify waste in their daily work achieves continuous improvement. As a result, more time is spent on direct patient care that improves patient satisfaction. This program will provide the foundation for our future improvement efforts. In the next few months, we will focus on the admission‐discharge process to improve flow, decrease length of stay, facilitate discharges, and improve quality of patient care. In the future, we plan to standardize the processes and efficient work flow across our entire hospital

Author Disclosure:

S. Kher, none; A. Lee, none.

To cite this abstract:

Kher S, Lee A. Using Lean/Toyota Production System (TPS) to Improve Inpatient Care. Abstract published at Hospital Medicine 2008, April 3-5, San Diego, Calif. Abstract 108. https://www.shmabstracts.com/abstract/using-leantoyota-production-system-tps-to-improve-inpatient-care/. Accessed December 10, 2018.

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