CATH LAB LEAN THROUGHPUT PROJECT
· Issue: The Bethesda North Hospital Cath Lab LEAN throughput project was chartered to improve the patient experience in the Cath Lab by identifying and reducing waste. Burning Platform:
o Patient, physician, and staff satisfaction down
o New operational model implemented caused challenges with provider coverage and scheduling. Over budget, below volume projections.
o Outcome metrics showing potential for improvement (on time starts above target, average LOS averaging 4 hours against a 3 hour target, etc.)
· Project Description: The team studied the current state process by applying LEAN tools within the TriHealth methodology of Plan, Do, Check, Act. A Value Stream was created using data and direct observations.
· Opportunities Identified Include:
o Cath Lab prep time on day of cath procedure (delays in labs, orders and H&Ps)
o Time to move patients to procedure room/on time start delays
o Timely post case meetings with family (physicians batching patients)
o Scheduling patients for cath procedures (double booking, unrealistic times)
· Results:
o Cath Lab throughput time improved from a baseline of 3 hours 48 minutes to 3 hours 4 min – near the 3 hour target.
o Physicians improved the time to meet with the patient and family after the procedure and no longer ‘batch’ patients. (16 minute improvement)
o Patients do not have to arrive as early due to the improvements in pre procedure requirements Patient satisfaction increased significantly from 82.4 to 94.4.
· Lessons Learned:
o Interdisciplinary staff involvement and input critical to improvements. Involvement from physicians is key
o EMR solutions were dependent on IT and physician training/learning which increased the timeline and posed additional challenges
o Educating pts re: total procedure timelines helped to set expectations.
o Engaging staff in data collection key to identifying delays and guiding improvements.
· Submitters: Jean Ackner and Regenia Evans