The Use of Lean Six Sigma for Improving Availability of and Access to Emergency Department Data to Facilitate Patient Flow.

Ailish Daly,Ciara Robinson,Martin Mcnamara,Marie Ward,Seán Paul Teeling

doi:10.3390/ijerph182111030

Abstract

The aim of this study was to redesign an emergency department [ED] data management system to improve the availability of, and access to, data to facilitate patient flow. A pre-/post-intervention design was employed using Lean Six Sigma methodology with a focus on the voice of the customer, Gemba, and 5S to identify areas for improvement in ED data management processes and to inform solutions for improved ED patient flow processes. A multidisciplinary ED team includes medical consultants and registrars, nurses, patient service staff, radiology staff, as well as information technology and hospital management staff. Lean Six Sigma [LSS] diagnostic tools identified areas for improvement in the current process for data availability and access. A set of improvements were implemented to redesign the pathway for data collection in the ED to improve data availability and access. We achieved a reduction in the time taken to access ED patient flow data from a mean of 9 min per patient pre-intervention to immediate post-intervention. This enabled faster decision-making by the ED team related to patient assessment and treatment and informed improvements in patient flow. Optimizing patient flow through a hospital’s ED is a complex task involving collaboration and participation from multiple disciplines. Through the use of LSS methodology, we improved the availability of, and fast access to, accurate, current information regarding ED patient flow. This allows ED and hospital management teams to identify and rapidly respond to actions impacting patient flow.

Highlights

Key metrics including patient volumes, Manchester score, LOS exceeding 6 and 9 h, achievement of triage and assessment targets, and radiology volumes are captured in this report
This study identified significant resources dedicated to handling data; the process for translating that data to meaningful information regarding patient flow and making that information available to frontline staff is onerous and time-consuming, limiting the knowledge gained related to the process
Optimizing patient flow through EDs is a key target for any healthcare organization

Summary

Introduction

We achieved a reduction in the time taken to access ED patient flow data from a mean of 9 min per patient pre-intervention to immediate post-intervention This enabled faster decision-making by the ED team related to patient assessment and treatment and informed improvements in patient flow. The National Emergency Medicine Programme [1] advises all emergency departments [ED] to implement a six-hour standard for ED attendances so that 95% of patients are admitted or discharged within six hours of attending an ED This target is to ensure ED patients receive timely assessment and intervention as required by their clinical presentation. Clinical data supports and assists an ED team in their clinical decision making, and, importantly, in tracking the progress of their patients’ care journey and maintaining a smooth workflow It facilitates a better understanding of the flow of patients, bottlenecks, and patient–staff interactions [3].

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Discussion

Conclusion