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Examples of issues addressed using Lean Healthcare problem-solving techniques

1. Issue: EKG readings were sometimes defective due to incorrect EKG lead placement on patients.
Action: A3 problem-solving identified inaccurate labeling of the EKG leads as the root cause. Processes were initiated to ensure proper maintenance of the EKG labeling, and defective readings were significantly reduced. (click image to view PDF of diagram)

2. Issue: Clinical informatics training for newly hired RNs took up to 7 weeks to schedule from the point of hire, delaying the new employee in being fully enabled to work, resulting in costly overtime to backfill the position and/or additional work during “buddy shifts”.
Action: Using Value Stream Mapping, the training schedule was redesigned to reduce the training booking time to 2 to 3 weeks. In addition, the informatics training package was reworked to make delivery of other clinical orientation courses more flexible.

3. Issue: Order from Ambulatory Care to the pharmacy stat fax sat unnoticed for an hour.
Action: A3 problem-solving identified the location of the fax machine and the internal work and communications flow as the root causes. After relocating the fax machine and re-working the flow, dropped stat orders were greatly reduced.

4. Issue: On-line service requests to Building Maintenance were not being efficiently prioritized resulting in inappropriate response times
Action: A3 problem-solving identified that the on-line service request user interface did not require the user to input the factual information necessary for the proper prioritization of and preparation for service calls. The user interface was re-designed to collect the required information, resulting in easier use of the interface, and better response time and service.