Lean Thinking In Emergency Departments: A Case Study
THE PRACTICE OF EMERGENCY MEDICINE/REVIEW ARTICLE
Lean Thinking in Emergency Departments: A Critical Review
Richard J. Holden, PhD
From the School of Medicine and Public Health, University of Wisconsin–Madison, Madison, WI, and the Division of Ergonomics, School of
Technology and Health, Royal Institute of Technology, Stockholm, Sweden.
Emergency departments (EDs) face problems with crowding, delays, cost containment, and patient safety. To address these and other problems, EDs increasingly implement an approach called Lean thinking. This study critically reviewed 18 articles describing the implementation of Lean in 15 EDs in the United States, Australia, and Canada. An analytic framework based on human factors engineering and occupational …show more content…
Residents encouraged to attend cardiology rounds for educational reasons5
Training of nurse to coordinate communications85
Communication tools76
Automated telephone system85
Patient chart combining documentation from nurses and physicians85
Checklists69
Standardized forms69
Exploring new medical technology (out-of-hospital 12-lead ECG)69
New equipment (eg, thyroid shields) and maintenance on existing equipment (eg, fixing computer order problem)78
Marked locations for returning equipment to right place81
New procedure for moving charts served as a workflow-facilitating technology81
Communication tools76
Use of voicemail dictation system instead of paging80
Telephone hotline to heart investigation unit69
Communication center and dedicated nurse coordinator for communication about patient arrival, care, and disposition85
Team assessment of patient history74
Improved communication with radiology department80
Rerouting of laboratory results to different printers81
Physicians and nurses reassigned to match peak patient volume76 or arrival rates, generally73
Allocation of dedicated fast track medical and nursing staff77
Division of medical and nursing staff to work on different patient
Lean Thinking in Emergency Departments: A Critical Review
Richard J. Holden, PhD
From the School of Medicine and Public Health, University of Wisconsin–Madison, Madison, WI, and the Division of Ergonomics, School of
Technology and Health, Royal Institute of Technology, Stockholm, Sweden.
Emergency departments (EDs) face problems with crowding, delays, cost containment, and patient safety. To address these and other problems, EDs increasingly implement an approach called Lean thinking. This study critically reviewed 18 articles describing the implementation of Lean in 15 EDs in the United States, Australia, and Canada. An analytic framework based on human factors engineering and occupational …show more content…
Residents encouraged to attend cardiology rounds for educational reasons5
Training of nurse to coordinate communications85
Communication tools76
Automated telephone system85
Patient chart combining documentation from nurses and physicians85
Checklists69
Standardized forms69
Exploring new medical technology (out-of-hospital 12-lead ECG)69
New equipment (eg, thyroid shields) and maintenance on existing equipment (eg, fixing computer order problem)78
Marked locations for returning equipment to right place81
New procedure for moving charts served as a workflow-facilitating technology81
Communication tools76
Use of voicemail dictation system instead of paging80
Telephone hotline to heart investigation unit69
Communication center and dedicated nurse coordinator for communication about patient arrival, care, and disposition85
Team assessment of patient history74
Improved communication with radiology department80
Rerouting of laboratory results to different printers81
Physicians and nurses reassigned to match peak patient volume76 or arrival rates, generally73
Allocation of dedicated fast track medical and nursing staff77
Division of medical and nursing staff to work on different patient