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Product Application St. Elizabeth goes Lean to provide exceptional patient care oday's patient care challenges are daunting. Treat- ment protocols are complex. Reimbursement restric- tions impact the bottom line. Patient satisfaction is declining and injuries cause nurses to transfer out of patient care or leave the profession. St. Elizabeth Hospital in Appleton, Wis. has applied Lean Six Sigma principles to develop a revolutionary approach to patient care in the emergency department and outpatient surgery. The innovative solution focuses on delivering personalized treatment that is safer, more effi cient, less stressful and more cost-effective. Until 2009, St. Elizabeth's ED and OPS consisted of a triage area, 13 bays and fi ve private rooms. Each narrow bay could accommodate either a stretcher or a recliner but not both, making patient transfers cumbersome. Although staff produc- tivity was high, managers believed virtually every aspect of the patient-care process could be improved. T The Lean team had to redesign the areas using only exist- ing resources, space and staff. The new area had to run as close to 100-percent capacity as possible each day, avoiding the pitfall of overbuilt, underutilized space. And it needed to maximize effi ciency to help minimize the impact of new reim- bursement restrictions. The team focused on three critical issues: the patient ex- perience, space optimization and patient handling. During ex- tensive interviews they listened to the "voice of the customer" — a Lean Six Sigma principle — and learned patient privacy was a key issue. Team members also studied a year's worth of ED-FT area in purple, SPA area in orange and fl ex space in red. patient admission and discharge data, discovering the ED and OPS have peak patient loads at different times of day. Simula- tion software confi rmed both areas could co-habit a single "fl ex space," renaming it the surgical procedure area, or SPA. Staff members also reviewed the typical patient transfer process to learn where to gain effi ciency. "We knew that the patient chair or bed had to be the cen- terpiece of Lean patient handling," said Michael Hofmann, RN, BSN, director of pre-operative services. St. Elizabeth's redesigned ED/SPA opened in 2011. It combines the ED/SPA functions into 48 private patient rooms. Eight of these are centrally-located "fl ex rooms" used either for emergency care or outpatient procedures, as the patient load dictates each day. "As far as we know, this hasn't been done before in the country or the world," said Hofmann. An incoming patient is now triaged in a spacious, com- fortable private room equipped with the latest in entertain- ment and information technology. All rooms are identical in layout and supplies to maximize effi ciency. Patients return to the same room after treatment. Patient handling has been streamlined with a stretcher-chair with exceptional motorized positioning, from TransMotion Medical. TMM's Universal Care Platform™ serves as wheelchair, procedure stretcher and re- cliner all in one. Patients stay on this device throughout a visit, reducing transfers by 50 percent and signifi cantly lowering the risk of patient falls and staff injuries. With Lean principles and TransMotion Medical equipment, St. Elizabeth has created a patient care environment that is simultaneously more effi cient and more personal. Its innova- tive, fl exible ED/SPA signifi cantly improves the patient experi- ence, maintains quality of care and increases staff effi ciency. The team's methodologies could serve as a roadmap for other healthcare institutions seeking to stay ahead of the curve in patient satisfaction and cost management. To learn more about TransMotion Medical, visit www.TransMotionMedical.com. 60 Medical Construction & Design | May/June 2012 www.mcdmag.com