Lean Projects

Lean is a methodology focused on customer value. Through process analysis and the elimination of waste, value streams are created that identify unnecessary complexity and time-intensive processes. Lean thinking emerged within the Japanese automobile industry after World War II (Ohno, 1988) and it can be traced back to early days of Ford Motor Company (Ford & Crowther, 1926)

These are the five principles of Lean:

• Specify value in the eye of the customer.
• Identify value stream.
• Make the process flow.
• Let the customer pull.
• Achieve perfection thru continuous improvement.

Only recently, has the Lean methodology emerged in health care. The goals of integrating Lean into hospital practice are to:

• Improve the care experience of every patient.
• Better match demand and capacity.
• Improve quality, safety and reduce risk.
• Drive reductions in workforce issues.
• Improve customer and employee satisfaction.

At San Joaquin Community Hospital, we have intitiated 13 Lean projects to improve quality, safety and timeliness throughout different areas of our organization. As we get data on these initiatives, we will add the information to this site.

Our Lean initiatives include:

• Reduce turnaround time for IP X-Ray.
• Increase timeliness of outpatient CT scanner.
• Decrease turnaround time for venous thromboembolism (VTE) prophylaxis (received within 24 hours after surgery).
• Increase timeliness of receiving admission orders.
• Improve pain management in the Med/Surg/Peds units.
• Improve throughput from ED to ICU for septic patients.
• Reduce lab turn-around time for cardiac profile.
• Decrease radiology turnaround time for diagnostic images.
• OR/central service surgical instrument tray completeness.
• Creating a process to handle incomplete medication orders between nursing and pharmacy to ensure patient receives ordered medications in a timely manner (all units, all medications).
• Improve medication transcription on the medication administration record.
• TAR (treatment authorization request form) management for MediCal concurrent patients.
• Core Measure compliance improvement to 100 percent.