Sharp's Lean Six Sigma team was brought in to "look at the whole process from the time an emergency patient presents all the way to head in bed upstairs," says Kurt Hanft, Lean Six Sigma Master Black Belt.
But Hanft and the team recommended that rather than just do a Kaizen event—designed to address a particular issue over the course of a week—the ED team at Sharp needed to "create a department of problem solvers," Hanft says. "And that is not something that you just do overnight. You need executive involvement and a lot of training at the staff level so they can be a part of it because it's really about frontline engagement."
A value stream map—a Lean process of analyzing the flow required to bring a service to the consumer—resulted in some shocking data: 82% of the patient's time was wasted in waiting and assorted delays.
"Our goal was to eliminate all the delay and waiting from the patient experience so that we were optimizing their time for every moment they were with us," Stone says.
The waste began with an all-too-familiar triage process where the patient was often telling his or her story "up to four and five times," Stone says. The flow was typical: Talk to admitting nurse. Go back and sit down in waiting room. Talk to triage nurse. Go back and sit down in waiting room. Triage nurse again. More waiting. Then back to a bed in the ED to explain all over again to the ED nurse. Stone says the team realized it already had a model of sorts for how ED patients should be treated.