Allen Hospital - Waterloo Success Story

In October of 2004, Allen Hospital, a part of Iowa Health System, was awarded the exclusive contract with John Deere to provide health care to their employees, family members and their retirees. As a result of this relationship, John Deere approached Allen to participate in a process improvement team activity to improve quality for the benefit of all involved. The decision was easily made to focus on Emergency Room Throughput, since the Allen Emergency Room is currently undersized, emergency room visits are increasing at 2% per year, and waiting times were greater than the state average.

A team was convened with Deere and Company consultants which resulted in a reduction of 11 minutes per patient encounter. This also resulted in a calculated cost savings of $382,000 per year because fewer personnel are required to attend the ever-increasing patient volumes. The mid-year outcome approaches the “best practice” nationwide of patient lengths of stay. The team consisted of ER management, medical director radiology, laboratory, transporter and patient advocacy personnel.

The “bed ahead” concept is touted as a “best practice” in the literature and was implemented in March 2005 at Allen. Each nursing unit always has at the ready the next identified bed for the next appropriate patient in need of care. An audit conducted in July indicated nine out of ten requests by ER could be met for a bed due to the “bed ahead” concept.

A Discharge Process Team is also being established to begin August 14 as a spin-off of the Lean ER Throughput Team due to the results of patient satisfaction surveys as well as data collection throughout the facility which indicates the need to pre-plan discharges.

The Lean Team is moving to a Phase II operation with internal changes intended in the workflow of the emergency room in the second half of the year. Timelines are being developed to assure alterations recommended by Emergency Room staff are put in place to improve the work environment and the patient flow of the department.

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