Applying Lean: Implementation of a Rapid Triage and Treatment System

摘要: Objective: Emergency department (ED) crowding creates issues with patient satisfaction, long wait times and leaving the ED without being seen by a doctor (LWBS). Our objective was to evaluate how applying Lean principles develop Rapid Triage Treatment (RTT) system affected metrics in our community hospital. Methods: Using principles, we made process improvements that led RTT system. this system, patients undergo rapid triage low-acuity treated physician area. No changes staffing, physical space or hospital resources occurred during study period. We then performed retrospective, observational comparing electronic medical record data six months before after implementation of Results: census 30,981 prior 33,926 after. Ambulance arrivals, acuity admission rates were unchanged throughout periods. Mean length stay longer period (4.2 hours, 95% confidence interval [CI] = 4.2-4.3; standard deviation [SD] 3.9) than (3.6 CI 3.6-3.7; SD 3.7). arrival start time 62.2 minutes (95% 61.5-63.0; 58.9) 41.9 41.5-42.4; 30.9) The LWBS rate for 4.5% 3.1-5.5) 1.5% 0.6-1.8) initiation. Conclusion: experience shows processes using thinking available can improve efficiency. In ED, use an decreased rates. [West J Emerg Med. 2011;12(2):184-191.]