Hospitals in pursuit of excellence

Lean Six Sigma Reduces Wait Time on Day of Discharge by 28 Percent in a Critical Access Hospital

Patients discharged to home waited an average of 3.5 hours to complete all of the necessary steps on the day of their discharge, from the time the physician told them they were going home to the time they left the inpatient unit. The goal was to reduce this time to less than 2 hours, based on patient feedback. Process defects included: a lack of consistency among caregivers in prioritization and order of necessary tasks and excessive non-value-added delays when caregivers were focused on other duties. Improvements included: discharge prioritization, consistent morning med pass timing among caregivers, and a clear process for all staff to follow when discharging a patient to home. Results have dramatically decreased length of time for the discharge process, from 3.5 to 2.5 hours, a 28 percent reduction. Additionally, the average time of day patients leave the unit has shifted from 13:14 to 11:19, a two hour improvement, and significant to operations due to the change from afternoon to morning hours.

This case study is part of the Illinois Hospital Association's annual quality awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals in continually improving and transforming health care in the state.  These hospitals are improving health by striving to achieve the Triple Aim--improving the patient experience of care (including quality and satisfaction); improving the health of populations; and reducing the per capita cost of health care.

Award recipients achieve measurable and meaningful progress in providing care that is:

• Safe
• Timely
• Effective
• Efficient
• Equitable
• Patient-centered

(The Institute of Medicine's six aims for improvement.)