Barnes-Jewish Hospital (St. Louis) and its Lean Results

According to a recent article over on the STL Today website, Barnes-Jewish Hospital in St. Louis has seen dramatic improvements during the past five years with its "patient-centered care" approach. With the hospital's focus on value stream analyses and standardized work, the term "patient-centered care" is quite synonymous with Lean management.

According to Dr. John Lynch (vice president and chief medical officer), streamlining the hospitals preparations for surgery saved about $1 million in 2010. The hospital performs about 40,000 surgeries per year. In addition, standardizing the installation of patients' intravenous lines "lowered the hospital's central line bloodstream infection rate by 40 percent in the last year."

I think Dr. Lynch's reply to the criticism that these techniques might cause rote "cookie-cutter care" is important -- according to Dr. Lynch "we only use standardization when it makes sense." The hospital does not resemble an assembly line: "We're more like a body shop, where every car comes in with its own problems," Lynch says. "We always allow room for individual patient variation. We're not telling the surgeon where to cut."

Although Barnes-Jewish hospital has put such tools as kanban, poke-yoke, and root-cause analysis to great use, the major area for improvement is the reduction of wait time in the emergency department. Solutions here are difficult because of the dramatic increase of patient visits each year. Do any readers of this blog have some suggestions for increasing the efficiency for admitting patients? Should the focus be on decreasing the wait time or adding value to the wait time?