Lean in Sioux Falls

From the Argus Leader:

Faced with a potential patient revolt over rising health care costs, hospitals nationwide are becoming more efficient.

In Sioux Falls, hospitals are taking cues from manufacturers such as Toyota to cut costs and improve patient care.

It's a major overhaul of daily tasks in both Avera McKennan Hospital and Sioux Valley Hospital - all with the goal of becoming "lean."

Lean is a corporate philosophy growing in popularity that means keeping fewer supplies to save expensive space, counting the number of steps it takes technicians to run basic tests and cutting wasted activity. It even means reworking the way housekeepers clean patients' rooms.Sioux Valley is now in the process of remodeling its main laboratory, blood bank and cardiac catheterization lab. The hospital plans to incorporate lean techniques in inventory and staffing in a surgical tower under construction, said Sioux Valley lean consultant Tony Vanderwolde.

Avera McKennan's initial work in its laboratory led to changes in its emergency, surgical and housekeeping departments.

The hospital has reduced the average patient's stay in the emergency room from two hours and 15 minutes to a current goal of an hour and a half, Slunecka said.

Those savings came in the form of setting up a triage area and finishing patient registration at the bedside after care has started. Now, staff bring carts equipped for certain situations -- such as a suture cart - to the patient instead of rushing to find equipment stored in a variety of areas.

But those gains created a bottleneck of patients who had to wait for rooms to be cleaned before they actually could leave the emergency room.

"Everybody in the emergency department ... believed it was a shortage of housekeeping staff," Slunecka said.

Instead, the lean team worked to decrease the time rooms were empty between patients, and looked for ways housekeepers could clean rooms more efficiently. The time has decreased from more than two hours to about 74 minutes, said Bret Corcoran, Avera McKennan's housekeeping manager.

The changes have come from changing how nurses tell housekeeping staff about empty rooms and also in standardizing the way employees empty trash bins and change shower curtains.

"So much of it is common sense," Corcoran said.

Housekeeper Kristina Simon said she likes the changes. Rooms are cleaner now, she said, and she feels like she's better at her job.

"I thought it was a great idea," Simon said. "I just feel like everybody should do things the same way."