Attacking waste and variation hospital-wide: A comprehensive lean-sigma deployment

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Inpatient and Ancillary Services

Charles Johnson
Vice-President for Academic Affairs
Sigma Breakthrough Technologies, Inc.

Richard Allen, Ph.D.
Sigma Breakthrough Technologies Inc.

Ian Wedgewood, Ph.D.
Executive Director
Sigma Breakthrough Technologies Inc.

An important competency for a health care organization is to drive change. We describe one hospital's success in deploying lean sigma to move it to a new level of performance. The dynamics of an effective organization-wide deployment are described as well as projects in three areas: surgery, medication delivery, and emergency department.

Lean sigma is the integration of lean and Six Sigma process improvement methodologies. Its goal is to improve patient care, safety, and satisfaction while simultaneously reducing costs.

Instead of incremental implementation of lean sigma, Columbus Regional Hospital leaders decided on organization-wide deployment. They linked strategy to the operating plan and to lean sigma projects. With the big picture, informed department heads energized their staff. During training, lean sigma projects were selected and initiated, champions assigned, projects chartered, and teams organized.

The surgery team used a kaizen event to reduce changeover time for orthopedic procedures from 43 to 14 minutes. The team then rolled out the accelerated process across all procedure types.

Working with pharmacy, the medication delivery team reduced average medication delivery time by 60 percent and improved accuracy of the first dispensed dose.

The emergency department team standardized the registration and triage processes, revised acuity assignment, and implemented triggers to accelerate patient flow. Lengths of stay were reduced, by acuity level, between 26 and 38 percent.

The financial and cultural return on investment is impressive. Staff no longer accept inefficiency and waste as inevitable and are engaged in their elimination. There is better communication across the hospital and a shared vision of its future.