How 'intense' brainstorming helped an ED cut wait times by 70%

Doctors, staff applied Japanese efficiency process to improve care

Staff members at Anderson Hospital in Cincinnati reduced the average ED wait time from 40 minutes to 12 minutes in just three years by applying a Japanese efficiency process called Kaizen, Cincinnati Business Courier reports.

  • A clockwork ED. Our three-part series on optimizing capacity and throughout in the ED can help your organization reduce wait times and improve the patient experience.

Deploying Kaizen

Stephen Feagins, vice president of medical affairs at the Mercy Health hospital, first used the Japanese efficiency approach while working as a research chemical engineer at Procter & Gamble. Kaizen involves an intense analysis of issues and then continuous follow-up meetings.

At Anderson Hospital, five doctors and 35 staff members met for a five-day brainstorming session. "It is a big investment to take 40 people, including five doctors, out of their positions for five days," Feagins notes. But, he says, "intense analysis" was necessary to "look at processes to maximize what we could do."

After the initial five-day session, the team was split into five groups. The groups met every two weeks and compared findings every other month to ensure that changes were being implemented.

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How the brainstorming improved wait times—and more

The brainstorming team identified ED wait time as an important issue. "It remains a key issue mostly because that's how people talk about emergency departments," Feagins says, adding, "You go to the emergency department, and the first thing people say is how long they waited. We saved your life three times, but it took 300 minutes to get you (admitted to) the hospital."

According to ED medical director Michael Argus, the team reduced wait times by changing how ED staff sorts patients. Instead of having patients go to doctors, a team with a doctor, nurse, and technician now goes to the patient. The patient only has to answer questions once, eliminating time wasted in repeating answers.  

In addition to reducing wait times, the process changes in the ED have been credited for various improvements across the hospital, the Courier reports. The methodology helped

  • Increase the number of patients admitted to the hospital;
  • Cut the costs of treating ED patients, which average $150 per hour;
  • Decrease the average length of stay from 394 minutes in May 2011 to 292 minutes in May 2013; and
  • Decrease the number of patients leaving the ED without being treated from 2.1% to 0.3%.

Moreover, patients appreciate the changes in their experience with the hospital. Some patients "have said they never even saw the lobby," says Brian Pope, an RN who manages the ED (Brunsman, "Cincy Biz Blog," Cincinnati Business Courier, 8/16).

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