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Meeting
Search Results for LEAN
Abstract Number: I1
SHM Converge 2022
Background: Duplicate as-needed (referred to hereafter as “PRN”) orders for common indications such as pain, nausea, insomnia, and constipation are frequent in hospitalized patients. Without explicit instructions for circumstances or order of administration, therapeutic duplication can cause confusion for nurses and violates both Join Commission and the Centers for Medicare & Medicaid Services (CMS) guidelines. […]
Abstract Number: 140
Hospital Medicine 2018; April 8-11; Orlando, Fla.
Background: The US healthcare system is under increasing pressure to improve value and affordability. Acute care is responsible for a large proportion of overall health costs, but the complexities and pace in this environment have left an evidence gap in value-based care transformation. Novel improvement and evaluation strategies are thus needed more than ever to […]
Abstract Number: 150
SHM Converge 2021
Background: Admissions from the Emergency Department (ED) to the inpatient floor units are often inefficient; this translates to increased expense via increased length of stay (LOS), fewer available patient rooms via “patient boarding”, and an overall less positive experience for patients and their families. Reducing admission times effectively increases the capacity of the ED and […]
Abstract Number: 196
Hospital Medicine 2016, March 6-9, San Diego, Calif.
Background: Keeping admitted patients in the emergency room (ER) carries negative operational and clinical consequences. Prolonged stays reduce ER bed turnover, thereby limiting access for other patients. Furthermore prolonged ER length of stay (LOS) has shown to be an independent risk factor for 30 day mortality for admitted patients. For these reasons, Veterans Affairs (VA) […]
Abstract Number: 205
Hospital Medicine 2020, Virtual Competition
Background: Hematopoietic stem cell transplantation (HSCT) can be a life-saving and curative therapy in hematological malignancies. Pre-transplant evaluation for HSCT is a multidisciplinary process that can be complicated, time-consuming, and expensive for patients to navigate. The process requires coordination between several medical subspecialties including pulmonary, cardiology, and mental health, in addition to social workers and […]
Abstract Number: 240
Hospital Medicine 2016, March 6-9, San Diego, Calif.
Background: A LEAN principle is that front line staff provide value as defined by the customer (the patient). Within a LEAN framework, an A3 is both a way to understand your problem and a tool to organize multiple PDSA cycles into one cohesive and visible structure. While the literature cites many examples of PDSA cycles […]
Abstract Number: 247
Hospital Medicine 2018; April 8-11; Orlando, Fla.
Background: Long discharge times (DT), (the time from discharge order to patient leaving room), have detrimental impacts on any hospital. Apart from causing dissatisfaction among patients and their families who are waiting to go home, prolonged DT also increases wait times for patients being admitted from the ED. Delayed admissions pursuant to late discharges, caused […]
Abstract Number: 262
Hospital Medicine 2016, March 6-9, San Diego, Calif.
Background: The Lean-Kaizen approach of implementing patient-centered systems change by reducing waste and adding value has been widely used in health systems in the US to provide incremental process improvement. This approach to streamlining health care processes has been under-utilized in resource-poor regions of the world, even though the Lean-Kaizen approach was developed in under-resourced […]
Abstract Number: 267
Hospital Medicine 2018; April 8-11; Orlando, Fla.
Background: Unimpeded patient flow enhances quality, patient experience and access, while reducing costs. Our hospital has an in house discharge pharmacy, which allows us to send patients home with their imperative medications prior to discharge. About 53% of our discharges were delayed due to discharge medications, which equates to 27.8 hours for the ~30 daily […]
Abstract Number: 284
SHM Converge 2021
Background: There is a rising demand for hospitalist involvement in quality improvement (QI). Hospitalists now assume larger patient volumes and have become natural leaders in daily patient care, interdisciplinary rounding and patient safety. Despite a seemingly direct fit into QI, the majority of hospitalists have received minimal QI training in medical school, residency or beyond. […]