Lean Management Techniques Could Improve Hospital Care

Waiting times in hospital emergency departments (EDs) could be cut with the introduction of Lean Management and Six Sigma techniques, according to a new study.

Researchers at Monash University (Melbourne, Australia) investigated whether the application of Lean Management, which involves never ending efforts to eliminate or reduce waste, and Six Sigma, a disciplined, data-driven method for eliminating defects in any process, could reduce the time taken to assess and stabilize patients in the ED. The combination of the two methods, which were developed in manufacturing contexts, is referred to as Lean Six Sigma (LSS).

The researchers wished to examine if LSS assisted an increase in the flow of patients through the hospital, from admission, transit through various units, and up to discharge into the community, all without increasing the workload of staff. They found that introducing LLS in hospitals was more challenging than in manufacturing, but it could help to improve patient flow. Implementation also allowed the hospital studied to open more beds, as well as install software for monitoring bed availability.

At the ward level, the opening of more rehabilitation beds, which improved the discharge process, enhanced patient flow. The researchers found that the biggest contributors to increased work and stress in public hospitals were high bed occupancy levels and increases in inpatient numbers. Balancing the conflicting flows was important to ensure the smooth running of the ED, to limit the amount of time patients waited for a bed, and to reduce work and stress levels. The study was published in the November 2014 issue of International Journal of Human Resource Management.

“In recent years hospitals have been trying to adapt LSS processes to streamline processes and improve costs,” said management expert Prof. Greg Bamber, PhD. “There have been earlier claims about work intensification experienced by employees in lean manufacturing. Therefore, we studied the outcomes after transferring LSS concepts into a hospital context, to streamline processes and improve costs there.”

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