Meadows Regional Medical Center has reduced the average length-of-stay per patient in its Emergency Department (ED) from 247 to roughly 125 minutes through an innovative application of Lean Manufacturing principles common to the automotive industry. At the heart of Meadows’ new process is The T SystemEV® Emergency Department Information System (EDIS), a computerized solution which coordinates registration, triage, patient tracking, documentation and other critical care factors.
Meadows, a 122-bed combination acute care and skilled nursing facility, was introduced to the Lean Manufacturing concept by a hospital trustee who attended a seminar at Georgia Tech. Impressed by what he saw, the trustee approached Alan Kent, CEO of the hospital.
“Alan felt the ED was the perfect place to try out the principles due to its strategic importance to both the hospital and the community,” said Peggy Fountain, Emergency Department Director at Meadows. “Our length-of-stay metrics were pretty typical at the time compared to similar facilities across the U.S, but we felt there was room for improvement.”
Following a three-day workshop conducted by Georgia Tech, Kent, Fountain and the Meadows task force identified 44 different action items for reducing the time required to admit, treat and discharge a non-critical ED patient. Of these, the most ambitious was the implementation of an EDIS.
“We had been talking about an EDIS for some time and had visited a hospital in South Carolina that had implemented an EDIS. We were very impressed, so intellectually and organizationally we were ready for the challenge,” Fountain said. “And from the start, one of our top choices was T SystemEV.”
T SystemEV provides emergency department physicians and nurses with the critical tools to improve quality of care and maximize workflow, from triage to discharge, with turnkey implementations and unparalleled usability. Existing interfaces to the major enterprise clinical systems make it easy for users to exchange information. EV can also be used to generate a wealth of valuable management and statistical reports.
“The other departments at Meadows are on the Meditech health care information system. By interfacing with Meditech, T SystemEV is able to retrieve a patient’s complete prior history with the hospital, including the individual’s last diagnosis and medications he or she received,” stated Fountain. “Not only are we able to track and document the current visit, but T SystemEV allows us to instantly interface with the patient’s electronic health record with a few clicks of the mouse.”
According to Fountain, the system was quickly embraced by members of the staff. “We were concerned that some of our MDs would resist the new system, but they didn’t,” she recalled. “Our nurses also like the fact that everything is right in front of you. The template prompts for things you might not have asked, and if you need more, you simply click and the interface instantly gives you more options.”
T SystemEV is accessible three ways at Meadows: at the nurses’ station; on handheld tablet PCs; and on rolling carts that allow attending clinicians to enter data at the patient’s bedside. Additionally, part of the Lean solution was to install a large plasma screen in the nurses’ station. The screen, which faces away from the waiting room, displays up-to-the-minute T SystemEV information as to which patients are in the waiting room (or bed number if transferred), their wait time, chief complaint, nurse assigned, tests ordered, and status. A color code ranks the patient’s severity of need.
The powerful combination of T SystemEV and Lean Processing Principles has made the Meadows ED team one of the most efficient in the country. Currently the department averages 120-130 minutes per patient, and on many days has achieved its 90-minute ultimate target. “T SystemEV provides us with ongoing reports on productivity, acuities and other metrics that I share with our medical director,” Fountain said. “We use these reports to track performance and identify new areas for improvement. Soon we’ll be adding T-System’s Computerized Provider Order Entry module that will let physicians order lab tests, prescriptions and other treatments without transcribing into Meditech. After that, self check-in kiosks, bar coding, online patient registration—we have a lot planned.”
About T-System:
Founded over a decade ago, T-System, Inc. and T-System Technologies, Ltd. (The T System), combine an uncommon collaboration of clinicians, technologists and service professionals dedicated to serving the current and future clinical information and technology needs of emergency medicine. Headquartered in Dallas, Texas, T-System is the leading provider of clinically accepted emergency department information system (EDIS) solutions. Today, more than 2,000 civilian and military EDs in the United States, Puerto Rico, Australia and around the world partner with T-System to make the best patient care a reality for everyone. For more information, please visit www.tsystem.com or contact Joe Lastinger at (800) 667- 2482.
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