Thursday, October 14, 2010

Getahn Ward: Baptist, St. Thomas improve efficiency

At Baptist Hospital, a key surgery center can handle up to three more cases a day thanks to an initiative that has cut patient waiting times before a procedure by 20 minutes.
Sister hospital Saint Thomas was able to organize its operating rooms more efficiently to reduce the number of surgical instruments that couldn't be found when turning a room over for a new patient.

The smarter approach means the hospital's staff doesn't have to open a new surgical set as often to replace missing or misplaced instruments. It also saves on sterilizations, and all that saves money.

Both hospitals got those results by putting a team of employees into action to search for specific ways to eliminate waste. It's all part of a broader concept called lean health care that reflects a push by hospitals to be more efficient as they face the pressures of health-care reform and other revenue uncertainties.

"It's a matter of investigating the issue, following through and then drilling down to see where the actual issues lie, and how can those issues get resolved," said Donna Cornette, Saint Thomas' process and systems improvement director. "The focus is not on eliminating staff. It's just to make their work flow more efficient."

Saint Thomas also has used lean health care to reduce the time that it takes for patients to be evaluated in the emergency department.

A future effort will look at ways to improve the patient identification system — from the bands put on people's hands to the labels used for medication orders.

Take lean to another level

Baptist and Saint Thomas are taking their lean health-care programs to the next level.

Gallatin-based Healthcare Performance Partners is training managers from various areas of the hospitals to become advocates for lean thinking — equipping them with techniques to solve issues in their respective units.

Proponents say that's the right approach.

"It's not enough just to do events," said Nancy McDonald, lean facilitator with the lean systems improvement department at Denver Health. That integrated health system saved about $66 million in a little more than four years. "You want to transform the culture."

Franklin-based hospital operator Capella Healthcare is expanding its lean health-care initiatives to two more hospitals this year after a pilot at a hospital in Oklahoma. That project trimmed the time patients spent in the emergency department by as much as 15 percent, said Mike Wiechart, chief operating officer at Capella.

At Baptist, the redesign of pre- and post-operation areas showed how efficiencies could be gained with the existing resources, rather than building more rooms.

"We were pushing patients into the process before; now we're pulling patients into the system as needed — and not before we need them," said Chris Sisler, process improvement director with the hospital. "By increasing capacity, we also can increase revenues."

Getahn Ward covers the business of health care for The Tennessean . He can be reached at 615-726-5968 or at

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