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Rural hospitals apply lean patient care

Staff Report
Published Feb. 6, 2013

NEWBERRY, S.C. — If lean manufacturing helped Toyota Motor Corp. grow from a small Japanese automaker to a world conglomerate, then it might work for Newberry County Memorial Hospital and three of its sister hospitals across South Carolina.

Recently, Newberry County Memorial Hospital was selected to participate in the Carolinas Rural Hospital Lean Culture Transformation Collaborative. Other hospitals that have made a three-year commitment to the collaborative are Abbeville Area Medical Center, Clarendon Memorial Hospital and Regional Medical Center in Orangeburg.

Newberry Hospital CEO Ron Vigus
Newberry Hospital CEO Ron Vigus

The hospitals were chosen to participate in a two-state collaborative created to help small and rural hospitals in the Carolinas improve quality while gaining new efficiencies.

The collaborative is a four-year initiative funded in part by a $5 million grant from The Duke Endowment, a Charlotte, N.C.-based charitable trust that focuses on health care, child care, higher education and rural churches in the Carolinas.

Over the next three years, Newberry and the other three S.C. hospitals will concentrate on implementing “lean,” a business improvement philosophy with practices first applied in manufacturing and now used in all segments of industry, including health care.

Lean is a management philosophy largely associated with the Toyota production system that seeks to maximize customer value using fewer resources and involving everyone in an organization to carry out a set of common goals. The effort to transform how hospitals do things is well-timed, said Newberry Hospital CEO Ron Vigus.

“Hospitals large and small face a tsunami of issues,” Vigus said. “Starting in 2013, hospital reimbursements from Medicare and Medicaid will be tied to quality of care. Health care reform will mean higher patient volumes. Government and private payers are reducing what they pay for health care services. So hospitals must find better, more efficient ways to deliver the safe, high quality care patients expect.”

The S.C. Hospital Association and the N.C. Hospital Association, in partnership with The Duke Endowment, are leading the collaborative. The South Carolina Office of Rural Health and the North Carolina Office of Rural Health and Community Care also are involved.

In North Carolina, the lean management program began in 2008. Hospitals focused on value streams within their organization and examined entire workflows, identified potential areas of waste, looked for places to trim or apply new processes.

The hospitals also focused on different areas of operations such as the emergency room, physician network or pharmacy.

Some of the improvements included:

· Cutting the transportation of in-patients to and from imaging services by 60% percent.

· Improving the turnaround time for the top five laboratory tests ordered by 35%.

· Cutting the time patients waited in the emergency room to begin treatment to 28 minutes from 60 minutes.

· Cutting the amount of time for discharging a patient to 45 minutes from an average of 90 minutes. The improvement allowed the hospital to admit patients sooner, boosting patient days and increasing net revenue.

“Rural hospitals provide key medical services to residents, and effective implementation of lean management will lead to improved patient satisfaction and outcomes,” said Mary Piepenbring, vice president of The Duke Endowment.