Document Detail

Redesigning emergency department patient flows: application of Lean Thinking to health care.
MedLine Citation:
PMID:  16842310     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To describe in some detail the methods used and outcome of an application of concepts from Lean Thinking in establishing streams for patient flows in a teaching general hospital ED. METHODS: Detailed understanding was gained through process mapping with staff followed by the identification of value streams (those patients likely to be discharged from the ED, those who were likely to be admitted) and the implementation of a process of seeing those patients that minimized complex queuing in the ED. RESULTS: Streaming had a significant impact on waiting times and total durations of stay in the ED. There was a general flattening of the waiting time across all groups. A slight increase in wait for Triage categories 2 and 3 patients was offset by reductions in wait for Triage category 4 patients. All groups of patients spent significantly less overall time in the department and the average number of patients in the ED at any time decreased. There was a significant reduction in number of patients who do not wait and a slight decrease in access block. CONCLUSIONS: The streaming of patients into groups of patients cared for by a specific team of doctors and nurses, and the minimizing of complex queues in this ED by altering the practices in relation to the function of the Australasian Triage Scale improved patient flow, thereby decreasing potential for overcrowding.
Diane L King; David I Ben-Tovim; Jane Bassham
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Emergency medicine Australasia : EMA     Volume:  18     ISSN:  1742-6731     ISO Abbreviation:  Emerg Med Australas     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-07-17     Completed Date:  2006-11-20     Revised Date:  2007-04-19    
Medline Journal Info:
Nlm Unique ID:  101199824     Medline TA:  Emerg Med Australas     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  391-7     Citation Subset:  IM    
Emergency Department, Flinders Medical Centre, Bedford Park, South Australia, Australia.
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MeSH Terms
Emergency Service, Hospital / organization & administration*,  statistics & numerical data
Hospital Administration / methods
Length of Stay* / statistics & numerical data
Models, Organizational
Outcome and Process Assessment (Health Care)
Quality Assurance, Health Care / methods
South Australia
Time Factors
Triage / organization & administration
Waiting Lists*
Comment In:
Emerg Med Australas. 2007 Feb;19(1):79   [PMID:  17305671 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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