Inside Health Care

  |  12/16/2008

Process Improvement in Georgia’s Rural Hospitals

(Georgia Tech Enterprise Innovation Institute: Atlanta) -- Georgia rural hospitals that face growing financial pressures are receiving assistance from a new Georgia Institute of Technology (Georgia Tech) pilot project that is helping them improve processes and reduce waste. Supported by the Healthcare Georgia Foundation, the initiative will help the seven rural hospitals increase capacity, improve service quality, and cut costs. The benefits will come from adopting performance improvement techniques that are already widely used in manufacturing.

The two-year demonstration project will help train rural hospital staff in lean techniques that identify waste in processes and find ways to eliminate it. Georgia Tech has successfully used the lean health care training approach with hospitals in Atlanta, Columbus, Newnan, and Vidalia.

“We want to take the techniques that have proven to be so successful in large hospitals and use them in small, rural hospitals,” says Frank Mewborn, director of the Healthcare Performance Group in Georgia Tech’s Enterprise Innovation Institute. “Rural hospitals typically don't have the resources to hire outside consultants to help with performance improvement issues, so we very much appreciate the support from Healthcare Georgia Foundation to make this initiative possible.”

Georgia Tech project leaders will work with health care professionals at the participating hospitals to conduct lean assessments, teach basic lean concepts, develop value-stream maps to analyze the flow of materials and information, and implement rapid process improvement techniques. Because the techniques rely on input from those closest to the processes being improved, each hospital will dedicate staff members to work with Georgia Tech.

“This is a substantial investment on the part of the hospitals because they must pull front-line staff from their normal responsibilities during the process improvement activities,” Mewborn noted. “Involvement of these key people is essential to the process, and it pays off long-term through better processes and buy-in from those who are on the front lines of providing patient care.”

Beyond direct process improvements, the initiative will also provide long-term benefits through senior leadership and hospital staff who have been trained in the lean techniques and who will share them with other departments and facilities. Success will be measured by improvements made during the process, and by the ability of each hospital to continue the process improvement efforts after the initiative’s conclusion.

Rural hospitals in Georgia face a financial crisis because their patients are less likely than those of metropolitan hospitals to have health insurance. At the same time, hospitals in underserved areas face other competitive disadvantages as they confront rising costs.

“A lot of rural hospitals are struggling to make payroll every month,” says Mewborn. “They don't have revenue opportunities from more profitable kinds of surgeries because they may not have a large enough market. They are meeting an essential need for health care in their areas, but their reimbursement rates tend to be low.”

One of Georgia Tech's first lean health care projects was with the emergency department at Meadows Regional Medical Center in Vidalia. As a result of the process improvement activities done there, the average time patients remained in the emergency department was reduced 44 percent and physicians were able to see more patients per hour, all while maintaining a 92-percent patient satisfaction rating.

Other hospital process improvement projects done by Georgia Tech have:

  • Shortened the lead time and reduced errors in blood testing
  • Developed a time-saving system for managing intravenous pumps
  • Reduced errors and lead time for collecting and processing tissue samples
  • Increased capacity by reducing room downtimes between patients
  • Boosted laboratory capacity and reduced errors through improved organization
  • Increased physician productivity through standardized work processes
  • Streamlined pre-registration processes

The projects are expected to be completed by June 2010.

For further information, visit www.innovate.gatech.edu/Default.aspx?tabid=32&NewsID=202.

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