Most processes did not require extensive lean or six

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Most processes did not require extensive Lean or Six Sigma projects; rather, simple process changes required only a quick decision by management or a 1- to 2-day Workout with a small team of staff. The management engineers and Black Belts worked with the then executive vice president of health services to prioritize the identified projects. Priority was given to major projects, which required more resources from the process improvement department. As part of process transformation, major projects mentioned by interviewees were: Neonatal intensive care unit (NICU). Additional beds were being added to the hospital, and there was a shift to individual rooms from a large, centralized nursery format.
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229 Emergency room. The adult and pediatric emergency rooms were separated in the new hospital and required patients to use separate entrances. Labor and delivery triage. Women thought to be in labor would be evaluated in a new triage space adjacent to the ER, rather than being brought up to the labor and delivery floor. Short stay or “hotel space.” To save space and beds, LHC created an intermediate, distinct space for patients who were either placed under observation in the ER or were recovering from outpatient services and needed to stay in the hospital for just a few hours before being discharged. Equipment depot. Centralized equipment management space was created in the new hospital. Previously, the equipment was decentralized. As part of this study, we also looked closely at the NICU and at the changes in how nurses on the medical surgical units had to work given the structural changes in the hospital. Move-in. The Management Engineering Department was charged with planning the move-in process instead of using outside consultants. The move-in was planned using an electronic program built by the management engineers. In the weeks prior to the move, internal staff from every department ran three table-top simulations and then conducted three live dry runs with staff and volunteers acting as patients. The final two live dry runs included outside vendors, such as the ambulance services that transported patients to the new hospital. Several issues were identified and solved as part of the simulation process: improving communications among staff and emergency service technicians; identifying the best tools for communication given a lack of cell phone coverage; and making sure that emergency medical services and ambulance staff felt comfortable navigating the new hospital. In the first live dry run, radios were put on the same channel, and communications broke down, leading people to “chase” each other around to communicate. They were able to correct this in the second dry run. This final live dry run, conducted a week before the move-in, went smoothly and was described by process improvement leaders hip as “a morale booster,” giving staff the confidence that the move-in process would go smoothly.
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