People, process and optimisation
Health and Communities

Using Lean thinking to target and achieve short term improvements in Patient Off Stretcher Time

How did Prominence help an Emergency Department with consistently poor transition time for patients arriving by ambulance to find and implement improvements in an 8 week timeframe?
Project background
Our client had over 250 emergency department presentations per day with 25% of these arriving by ambulance. The Hospital needed to identify short term ways of alleviating the problem while waiting for an increase in bed capacity. Emergency Department Patient off Stretcher time (POST) was the measure chosen for a lean improvement project.
Our Approach
Working with senior managers and a large team of stakeholders including Ambulance Service representatives, Prominence consultants undertook:
  • Extensive stakeholder engagement with clinical and administrative leaders and ambulance personnel
  • Review of current key performance measures
  • On-site observation and value stream mapping of current processes
  • Identification of “quick win” actions for approval
  • Monitoring of immediate “quick win” implementation
  • Development and trialling of top solutions requiring more detailed planning
  • Continuous advice, coaching and support to the team during quick win implementation and solutions testing
  • Project debriefing and future action planning
The objectives were met by applying the following skills:
  • Lean and six sigma business process improvement methodologies including value stream mapping, root cause analysis and problem-solving
  • Stakeholder analysis
  • Staff surveys and analysis
  • Workshop planning and facilitation
  • Change leadership and management
At the end of an intensive 8-week collaborative team effort, Prominence consultants recorded the following improvements:
  • Workflow interruptions were reduced through improved communication between team members and better use of communication systems and procedures
  • Entry, exit and workflow was improved by the creation of an ordered triage area with better signage and location of equipment
  • Improved and standardised triage and Administrative Officer workflow
  • An overall outcome of improvement in Patient Off Stretcher Time (POST) over the course of the project, and strategies in place to continue improvements