5.14.2008

Where Do You Find Lean in a Hospital? Check the Closet

What is the key to improving the quality of care in a hospital?

The supply closet and the bed linens.

That seems to be the finding of one of the more interesting reports I’ve seen recently concerning a hospital improvement project.

The
case study focuses on St. Joseph’s Hospital in Parkersburg, West Virginia, owned by Signature Hospital Corporation.

Signature says the improvement effort focused on a disorganized supply closet. Nurses made numerous trips to the closet during the day. A review of the closet found:

The storage room included 2,000 individually packaged spoons and 48 boxes of cereal, along with items used once per quarter.


Patient personal care items (e.g., shampoo and combs) were stored with suture removal kits.

Five storage towers contained so much linen that it was difficult to pull it out and linens fell on the floor.

The closet was reorganized, with related items grouped together. Also, the linen distribution process was streamlined to eliminate multiple handoffs.

The results:

The average nursing unit saved approximately 9,500 feet in walking distance per 24 hour period. This equals 3,467,500 feet (or 656 miles) saved for the average nursing unit on an annual basis.


When this project is implemented in all nursing units, it will save more than 19,000 miles in the hospital on an annual basis.

The hospital saved $4,300 annually in linen cleaning costs (per nursing unit). Linen storage space was reduced by 66 percent.

In a news release, Signature said the saving of 19,000 miles of walking translates to the addition of 10,000 hours per year of bedside care with no increase in staffing. Even if the figure is overstated somewhat, that’s quite an improvement.

Signature attributes the gains to a lean strategy.

The dramatic changes are the result of Signature’s “Lean Thinking” initiative, a quality improvement discipline perfected by Toyota that the Houston-based hospital company is enacting in its community hospitals across the U.S.


Kudos to Signature for moving in the right direction.

3 comments:

  1. One study has shown that nurses spend up to 2 hours daily searching for supplies. There is tremendous opportunity in this area that many hospitals are investigating.

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  2. back in the 1980's an ED put a pedometer on a friend of mine (RN) to see how far he was walking. It's an interesting metric to apply lean. Thanks for the idea.

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