Emergency Department to Inpatient Admission Process Improvement: A Kaizen Approach

摘要

Over-crowding in Emergency Department (ED) causes delays in patient care and is one of the major factors impacting patient satisfaction. Lower satisfaction scores may lead to loss of future patient volume, especially considering the strategic position of ED in bringing in new inpatient admissions. The goal of this research was to adopt Lean principles to improve the ED to inpatient admission process. A two-and-a-half day Kaizen Event was conducted with seven team members/process owners from the ED and inpatient units. The focus of this event was to reduce the time between decision to admit the ED patient to assigning that patient a bed in one of the inpatient units. Pre-Kaizen work involved process observations, data measurement and analysis, and process mapping using a flow chart. During the Kaizen, a value stream map of the process and fishbone diagram helped the team to identify the delays, non-value added (NVA) activities and process wastes from a Lean perspective. Process improvement ideas were brainstormed, piloted and measured which resulted in a 43% reduction of the NVA time. The event ended with quantitative and qualitative recommendations. Three post-Kaizen follow-up meetings confirmed that change was sustained.