Eliminating Waste in Emergency Departments
Wait times in emergency rooms are on the rise across the nation. People continue to seek emergency care for their Covid symptoms as the flu and RSV make a concerning comeback. As emergency rooms take on more patients, hospital administrators scramble to devise meaningful solutions for their overwhelmed staff. Lean management could be one strategy to help alleviate some of the issues facing emergency rooms and hospitals at large, and eliminating waste is the first step.
According to Kettering Global, in general, there are seven categories in which an emergency department can seek out and eliminate sources of waste.
Overproduction means creating more of something than is truly needed. In an emergency room, overproduction can arise a few ways. One way this shows up frequently is by ordering patient tests that aren’t necessary for patient diagnosis. Another way this shows up is when emergency departments overschedule their staff during less-busy hours. Emergency department administrators can evaluate patient files and scheduling to determine if overproduction is a source of waste in their department.
Waiting is often the most significant pain point in an emergency department. It’s also the most obvious point of waste and often the most discussed, as patients and nurses feel the frustration of long wait times. Identifying what contributes to the long wait times for things like triage or test results can help administrators determine where to begin making changes to eliminate this waste.
Transportation includes moving patients, equipment, and supplies from department to department or even from room to room. There are times when transportation is unavoidable, such as when moving an expensive piece of technology between patient rooms. However, basic supplies like thermometers and blood pressure cuffs should be readily available in every patient room. In addition, emergency departments should assess how things like medication are dispersed and moved between rooms and departments to see if there is a more efficient way to move these materials.
Over-processing most frequently occurs when someone in the workflow performs an unnecessary task, process, or procedure. The most commonly discussed example of this in emergency departments is unnecessary paperwork. Sometimes, patients are asked to fill out the same information across several different forms, which can also result in nurses and doctors needing to review various forms for similar information. Additionally, things like unnecessary medical procedures are also part of over-processing. Examining these processes and identifying ways to streamline paperwork and cut back on unnecessary steps will help eliminate the waste of overprocessing.
In an emergency department, inventory can refer to expired medicine taking up space on shelves or having too much equipment taking up space in an examination room. It can also become problematic when there isn’t enough medicine or equipment to help the current patients. Each of these scenarios typically arise when there is poor inventory management. Developing processes to streamline inventory flow will help eliminate inventory waste.
This type of waste occurs when a machine or a person wastes their “motion” energy. For example, when a crucial piece of equipment is stored too far away from patient rooms or when testing labs are located across the hospital. The critical question with motion waste is: “Is everything (including people) located in a convenient location?” If the answer is no, this is an opportunity to eliminate this waste.
Another major pain point for emergency departments is defects. Defects are typically defined as a product that doesn’t turn out well. In emergency departments, this can include anything from entering an incorrect code into a computer to a complete misdiagnosis. In emergency departments, these mistakes don’t just cost time and money; they can cost people their lives. Addressing defect issues should be at the top of the list for emergency department analysis.
Before any lean strategies are implemented in an emergency department, the potential waste needs to be identified. By assessing emergency departments for all seven categories of waste, administrators can accurately determine where the most waste occurs, then define strategies and procedures for eliminating this waste in the future.