Decrease Turn -Around Time for Room Readiness After Patient Discharge / Lean Study at KHCC

Delay of Patient transfer from Emergency Room to inpatient room after actual patient discharge from inpatient room will negatively affect patient flow in ER. There are variation in room readiness between floors so we need to standardize the process and timing in order to reflect on patient experience toward waiting time, which will enhance the bed utilization among institution, room preparation after patient discharge depend on many factors (House Keeping, Nurses floor preparation, communication With ER ,internal ER) that's effect on the workflow. Aim: Decrease turn-around time for room readiness after Patient Discharge; Improve bed utilization both in ER and in patient units; Standardized time for room readiness after patient discharge from floors. Method: Lean improvement methodology was adopted to eliminate the unnecessary waste during ER workflow. Lean improvement [1] team was trained on lean concepts and methodology by an expert staff. Value stream map [2] was drawn and an initial data was collected, then lean interactions were deployed on multidisciplinary dimensions, followed by tow set data collection to measure the success of the interventions. It was a cycle of training, collecting data, meeting nursing supervisors, Housekeeping, ER Unite, floors unite. Then implementing the proposed interventions and finally collecting data. Results: Turn-around time for room readiness after Patient Discharge gradually decreased by 39% from 149 minutes to 105 minutes. There were remarkable deductions in Housekeeper informed turn-around time by 82%, and patients transferred from ER to Floor by 44%. Improvement in patient flow, decreasing turn-around time for room readiness and ultimately improved patient and family satisfaction and improve bed utilization in both Emergency room and inpatients floor were measured outcomes to lean project. Conclusion: Lean improvement methodology is an excellent tool to reduce the nonvalue added time and ultimately improves the patient's safety.