LEAN techniques

Increasingly, hospitals are adopting LEAN techniques to improve care

Percentage of US emergency department patients seen within the recommended triage time: 1997 to 2006

The percentage of patients in the ED who are seen by a physician within the time recommended at triage has been steadily declining and is at its lowest point in at least 10 years. Of all patients in the ED, the most emergent are the least likely to be seen within the triage target time.

Horwitz, LI and Bradley, EH. Percentage of US emergency department patients seen within the recommended triage time: 1997 to 2006. Arch Intern Med 2009; 169: 1857-65 



Trends in ED wait times by triage class

Increasingly, EDs fail to provide care within the target time for their sickest patients.

J. Stephen Bohan JS. Trends in ED Wait Times by Triage Class. Journal Watch Emergency Medicine 2009 



Lean as a learning system in a hospital ward

The purpose of this article is to discuss lean as a learning system in a hospital ward.

Ballé M, Reigniér A. Lean as a Learning System in a Hospital Ward. Leadership Health Service (Bradf Engl) 2007; 20, 1: 33-41



Decreased patient charges following implementation of point-of-care cardiac troponin monitoring in acute coronary syndrome patients in a community hospital cardiology unit

Study demonstrates the cost effectiveness and clinical effectiveness of implementation of POC whole blood, cTnI testing for assisting clinicians with diagnostic and risk assessment of acute coronary syndrome (ACS) patients. Decreased hospital length of stay of 4 hours was found.

Apple FS, Chung AY, Kogut ME, Bubany S, Muramami, MM. Decreased patient charges following implementation of point-of-care cardiac troponin monitoring in acute coronary syndrome patients in a community hospital cardiology unit. Clinica Chimica Acta 2006; 370, 1-2: 191-9.



Point-of-Care Testing Reduces Length of Stay in Emergency Department Chest Pain Patients

Determines the effect of cardiac Troponin I point-of-care testing on emergency department (ED) length of stay in chest pain patients. Decreased emergency department length of stay of 1.9 hours was found.

Singer AJ, Ardise J, Gulla J, Cangro J. Point-of-Care Testing Reduces Length of Stay in Emergency Department Chest Pain Patients. Annals of Emergency Medicine 2005; 45, 6: 587-91.



Implementation of a point of care satellite laboratory in the emergency department of an academic medical center: impact on test turnaround time and patient length of stay

Emergency department (ED) overcrowding has reached crisis proportions in the United States. Many hospitals are seeking to identify process reengineering efforts to reduce crowding and ED patient length of stay (LOS). This study found a decrease in length of stay of 47 minutes by introducing POCT in the ED.

Lee-Lewandrowski E, Corboy D, Lewandrowski K, Sinclair J, McDermot S, Benzer TI. Implementation of a point of care satellite laboratory in the emergency department of an academic medical center: impact on test turnaround time and patient length of stay. Arch Pathol Lab Med 2003; 127: 456-60