Monash University. Australia: Waiting times in hospital emergency departments could be cut with the
introduction of Lean Management and Six Sigma (LSS) techniques
according to new research.
Lean Management involves never ending efforts to eliminate or reduce
‘waste’ while Six Sigma is a disciplined, data-driven method for
eliminating defects in any process. These methods were developed in
manufacturing contexts. The two methods can be combined and referred to
as Lean Six Sigma (LSS).
Big contributors to increased work and stress in public hospitals are
high bed occupancy levels and increases in in-patient numbers.
A new study from an inter-university team of Melbourne researchers
investigated the application of LSS in a large hospital to see if it
could reduce the time taken to assess and stabilise patients in the
emergency department (ED). The team also looked to see if it assisted in
increasing the flow of patients through the hospital, from their
admission, transit through various units to their discharge into the
community without increasing the workload of staff.
The researchers found that balancing such conflicting flows was
important to ensure the smooth running of an ED, to limit the amount of
time patients are waiting for a bed and to reduce work and stress
levels.
Monash University’s management expert Professor Greg Bamber from the
Monash Business School said Lean Management and Six Sigma had been
developed to improve the productivity and efficiency of the automobile
and manufacturing industries.
“In recent years hospitals have been trying to adapt LSS processes to streamline processes and improve costs.
“There have been earlier claims about work intensification
experienced by employees in lean manufacturing. Therefore, we studied
the outcomes after transferring LSS concepts into a hospital context, to
streamline processes and improve costs there.”
The project found that introducing LLS in hospitals was more
challenging than in manufacturing, but it can help to improve patient
flow from the emergency department to hospital beds.
Implementation also allowed the hospital studied to open more beds as
well as install new software for monitoring bed availability. At the
ward level opening more rehabilitation beds, which improved the
discharge process, enhanced patient flow.
Professor Pauline Stanton from RMIT cautioned that to be successful
with innovations such as LSS, hospitals needed to have sufficient
resources and an excellent implementation process - a process that takes
the time to involve the key stakeholders, including the front line
staff.
The research was undertaken by Professors Greg Bamber and Amrik Sohal
from Monash University; Richard Gough and Dr Ruth Ballardie from
Victoria University; Professors Tim Bartram and Sandra Leggat from La
Trobe University; and Professor Pauline Stanton from RMIT.
The Australian Research Council supported the research. Early results are published in a special issue of International Journal of Human Resource Management.